Efficacy of Magnetic Resonance Imaging Evaluation for Meniscal Tear in Acute Anterior Cruciate Ligament Injuries

Nam, Tae-Seok; Kim, Min Kyu; Ahn, Ji Hyun

doi:10.1016/j.arthro.2013.12.016

Cited by 30 publications

(23 citation statements)

References 33 publications

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“…Meniscal injuries showed low accuracy (66 % MM, 66 % LM). Previous research has found that the presence of ACL injury is associated with a reduction in the sensitivity and negative predictive value for MRI [4,19]. In our study, ACL injuries were found in 37 out of 38 patients, and therefore, this could explain the low diagnostic accuracy of the MRI.…”

Section: Discussioncontrasting

confidence: 50%

How sensitive and specific is 1.5 Tesla MRI for diagnosing injuries in patients with knee dislocation?

Derby

Imrecke

Henckel

et al. 2015

Knee Surg Sports Traumatol Arthrosc

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Section: Discussioncontrasting

confidence: 50%

How sensitive and specific is 1.5 Tesla MRI for diagnosing injuries in patients with knee dislocation?

Derby

Imrecke

Henckel

et al. 2015

Knee Surg Sports Traumatol Arthrosc

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“…Several other authors have reported reduced accuracy in the presence of acute ACL rupture. 24,34 Although MRI accuracy is clearly influenced by multiple knee pathologies, it is also influenced by patient age. England et al 13 have reported high rates of incidental meniscal findings on MRI of the knee in the general population and that these findings tend to increase with age.…”

Section: Diagnostic Accuracy Of the Thessaly Test And Other Tests Formentioning

confidence: 99%

Diagnostic accuracy of the Thessaly test, standardised clinical history and other clinical examination tests (Apley’s, McMurray’s and joint line tenderness) for meniscal tears in comparison with magnetic resonance imaging diagnosis

Blyth

Anthony

Francq³

et al. 2015

Health Technol Assess

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BackgroundReliable non-invasive diagnosis of meniscal tears is difficult. Magnetic resonance imaging (MRI) is often used but is expensive and incidental findings are problematic. There are a number of physical examination tests for the diagnosis of meniscal tears that are simple, cheap and non-invasive.ObjectivesTo determine the diagnostic accuracy of the Thessaly test and to determine if the Thessaly test (alone or in combination with other physical tests) can obviate the need for further investigation by MRI or arthroscopy for patients with a suspected meniscal tear.DesignSingle-centre prospective diagnostic accuracy study.SettingAlthough the study was performed in a secondary care setting, it was designed to replicate the results that would have been achieved in a primary care setting.ParticipantsTwo cohorts of patients were recruited: patients with knee pathology (n = 292) and a control cohort with no knee pathology (n = 75).Main outcome measuresSensitivity, specificity and diagnostic accuracy of the Thessaly test in determining the presence of meniscal tears.MethodsParticipants were assessed by both a primary care clinician and a musculoskeletal clinician. Both clinicians performed the Thessaly test, McMurray’s test, Apley’s test, joint line tenderness test and took a standardised clinical history from the patient.ResultsThe Thessaly test had a sensitivity of 0.66, a specificity of 0.39 and a diagnostic accuracy of 54% when utilised by primary care clinicians. This compared with a sensitivity of 0.62, a specificity of 0.55 and diagnostic accuracy of 59% when used by musculoskeletal clinicians. The diagnostics accuracy of the other tests when used by primary care clinicians was 54% for McMurray’s test, 53% for Apley’s test, 54% for the joint line tenderness test and 55% for clinical history. For primary care clinicians, age and past history of osteoarthritis were both significant predictors of MRI diagnosis of meniscal tears. For musculoskeletal clinicians age and a positive diagnosis of meniscal tears on clinical history taking were significant predictors of MRI diagnosis. No physical tests were significant predictors of MRI diagnosis in our multivariate models. The specificity of MRI diagnosis was tested in subgroup of patients who went on to have a knee arthroscopy and was found to be low [0.53 (95% confidence interval 0.28 to 0.77)], although the sensitivity was 1.0.ConclusionsThe Thessaly test was no better at diagnosing meniscal tears than other established physical tests. The sensitivity, specificity and diagnostic accuracy of all physical tests was too low to be of routine clinical value as an alternative to MRI. Caution needs to be exercised in the indiscriminate use of MRI scanning in the identification of meniscal tears in the diagnosis of the painful knee, due to the low specificity seen in the presence of concomitant knee pathology. Further research is required to determine the true diagnostic accuracy and cost-effectiveness of MRI for the detection of meniscal tears.Trial registrationCurrent Controlled Trial ISRCTN43527822.FundingThe National Institute for Health Research Health Technology Assessment programme.

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“…There are several studies in literature related to meniscus tears accompanying ACL damage. (22) Nam et al (9) reported that ACL tears were accompanied by MM tears at the rate of 59% and by LM tears at 44%. In our study, 80.5% of ACL tears were accompanied by MM tears and 33.3% by LM tears, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies in the literature have reported that the determination of meniscus tears concomitant to ACL injuries is even more difficult (8). In a study by Nam et al (9) the sensitivity and negative predictive value (NPV) of MRI were determined to be lower in patients with ACL tear compared to those without. The aim of this study was to determine the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy rates of MRI in the meniscus and cruciate ligament pathologies by comparing these values with arthroscopic findings.…”

Section: Introductionmentioning

confidence: 98%

The Efficacy of Magnetic Resonance Imaging in The Determination Of Meniscus Tears in Patients With Anterior Cruciate Ligament Tears

Gürsoy¹,

Bulut²,

Mete³

et al. 2019

Eastern J Med

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The aim of this study was to determine the accuracy of MRI in meniscus and cruciate ligament (CL) pathologies. Another aim of the study was to determine the accuracy of MRI in the determination of meniscus tears in cases with and without ACL tear. The study included 96 patients who were applied for meniscus and/or CL injury and examined by MRI between 2015-2018.The meniscus and CL were examined by MRI for findings of tears. The arthroscopy results were accepted as the gold standard and compared with the MRI results. The sensitivity, specificity, PPV, NPV, accuracy of MRI were calculated in the determination of meniscus and CL tears. The patients were also separated into 2 groups as those with ACL tear and without ACL tear. MRI accuracy in meniscus tear was compared between the 2 groups. The sensitivity, specificity, PPV, NPV and accuracy rates of MRI in the evaluation of the medial meniscus tears were 93.5%, 88.8%, 97.3%, 76.1% and 92.7% respectively. These values were 64.8%, 94.9%, 88.8%, 81.1% and 83.3% for the lateral meniscus (LM), 55.5%, 81.6%, 64.5%, 75.3% and 71.8% for ACL and 100%, 98.9%, 66.6%, 100% and 98.9% for posterior cruciate ligament. In the determination of LM tears, the specificity of MRI was significantly lower in the group with ACL tear (p=0.021).No statistically significant difference was found in respect of the other values. MRI has lower accuracy rates for ACL tear than for the meniscus. There was no significant difference in the accuracy of the MRI of meniscus tears between the groups with and without ACL tear.

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Efficacy of Magnetic Resonance Imaging Evaluation for Meniscal Tear in Acute Anterior Cruciate Ligament Injuries

Cited by 30 publications

References 33 publications

How sensitive and specific is 1.5 Tesla MRI for diagnosing injuries in patients with knee dislocation?

How sensitive and specific is 1.5 Tesla MRI for diagnosing injuries in patients with knee dislocation?

Diagnostic accuracy of the Thessaly test, standardised clinical history and other clinical examination tests (Apley’s, McMurray’s and joint line tenderness) for meniscal tears in comparison with magnetic resonance imaging diagnosis

The Efficacy of Magnetic Resonance Imaging in The Determination Of Meniscus Tears in Patients With Anterior Cruciate Ligament Tears

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