The concordance of MRI and arthroscopy in traumatic meniscal lesions in children

Bouju, Yves; Carpentier, E; Bergerault, F.; Courtivron, B. de; Bonnard, C.; Garaud, P.

doi:10.1016/j.otsr.2011.07.010

Cited by 17 publications

(7 citation statements)

References 21 publications

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“… 27 , 33 , 42 Similar encouraging literature has been published documenting the ability of MRI to detect MM and LM injuries. 2 , 16 , 27 , 32 – 34 , 42 However, MRI is seemingly more reliable in detecting meniscal tears when these are in isolation than when associated with an ACL injury. 8 , 9 , 35 , 40 A 2014 study by Nam et al 36 examined traumatic meniscal lesions in adults and adolescents who had either an acute ACL tear or an intact ACL.…”

Section: Discussionmentioning

confidence: 99%

“…In the pediatric and adolescent population, the ability to detect meniscal tears using MRI varies from poor to excellent. 2 , 16 , 27 , 33 , 35 , 40 , 42 The highest measurements of sensitivity and specificity (ranging from 87.0% to 95.0%) have been reported in studies with small samples of anterior cruciate ligament (ACL)-deficient knees, making them difficult to generalize for the growing number of young patients with ACL injuries. 2 , 16 , 27 , 32 , 33 , 42 Further, significant differences in diagnostic accuracy have been observed among younger, immature populations.…”

mentioning

confidence: 99%

“… 2 , 16 , 27 , 33 , 35 , 40 , 42 The highest measurements of sensitivity and specificity (ranging from 87.0% to 95.0%) have been reported in studies with small samples of anterior cruciate ligament (ACL)-deficient knees, making them difficult to generalize for the growing number of young patients with ACL injuries. 2 , 16 , 27 , 32 , 33 , 42 Further, significant differences in diagnostic accuracy have been observed among younger, immature populations. 27 , 34 , 35 , 40 Limitations that we perceived from published literature were the inclusion of patients with substantial delays between MRI and surgery (in 2 studies, this approached 1 year), as well as no differentiation between acute and chronic ACL-deficient knees.…”

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confidence: 99%

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Sensitivity and Specificity of MRI in Diagnosing Concomitant Meniscal Injuries With Pediatric and Adolescent Acute ACL Tears

Dawkins

Kolin

Park

et al. 2022

Orthopaedic Journal of Sports Medicine

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Background: Preoperative diagnosis of concomitant meniscal tears in pediatric and adolescent patients with acute anterior cruciate ligament (ACL) deficiency is challenging. Purpose: To investigate the diagnostic performance of magnetic resonance imaging (MRI) in detecting meniscal injuries for pediatric and adolescent patients with acute ACL tears. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: The authors retrospectively identified patients aged ≤18 years who underwent acute ACL reconstruction between 2006 and 2018 at 2 tertiary academic hospitals. The primary outcomes were arthroscopically confirmed medial, lateral, or any (defined as medial and/or lateral) meniscal tears. To control for chronically deficient knees, patients must have received their MRI study within 4 weeks of injury and must have undergone surgery no more than 8 weeks after their MRI study. Preoperative MRI reports were compared with the gold standard of arthroscopically confirmed tears to calculate sensitivity, specificity, positive predictive value, and negative predictive value. In a secondary analysis, patients were stratified by age into 2 groups (≤13 or ≥14 years), body mass index-for-age data from the Centers for Disease Control were used to classify patients as obese or nonobese, and differences between sensitivity and specificity proportions were analyzed using chi-square test for homogeneity. Results: Overall, 406 patients with a mean age of 15.4 years (range, 10-18 years) were identified. The sensitivity, specificity, positive predictive value, and negative predictive value were as follows: for lateral meniscal (LM) tears, 51.0%, 86.5%, 78.3%, and 65.0%; for medial meniscal tears, 83.2%, 80.6%, 62.3%, and 92.5%; and for any meniscal tear, 75.0%, 72.1%, 81.5%, and 63.8%, respectively. In the stratified analysis, MRI was less specific for the following diagnoses: any meniscal tear in patients aged ≤13 years ( P = .048) and LM tears in obese patients ( P = .020). Conclusion: The diagnostic ability of MRI to predict meniscal injuries present at acute ACL reconstruction was moderate. Performance was poorest at the lateral meniscus, where MRI failed to detect 97 tears that were found arthroscopically. Specificity was significantly lower in younger patients for any meniscal tear and in obese patients for LM tears.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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Sensitivity and Specificity of MRI in Diagnosing Concomitant Meniscal Injuries With Pediatric and Adolescent Acute ACL Tears

Dawkins

Kolin

Park

et al. 2022

Orthopaedic Journal of Sports Medicine

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“…43 Furthermore, according to Bouju et al, MRI overestimates medial and underestimates lateral meniscal lesions when compared with diagnostic arthroscopy (figure 6). 44 Discoid meniscus can be diagnosed by MRI when three or more consecutive sagittal sections (5 mm-thick slices) demonstrate a continuity of the meniscus between the anterior and posterior horns (bow-tie sign) (figure 4B). 18 MRI can also be used to evaluate meniscal integrity, stability, residual healing and anatomy after discoid meniscal surgery.…”

Section: Imaging Studiesmentioning

confidence: 99%

Isolated meniscus injuries in skeletally immature children and adolescents: state of the art

et al. 2022

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The prevalence of isolated meniscal injuries in children and adolescents is low; however, we see an increase mainly due to intensified sports-related activities at an early age. A meniscal repair should be attempted whenever possible as children present with increased meniscal healing potential. The diagnosis and management of meniscal tears involve both patient factors and tear characteristics: size, anatomical location and associated injuries. Special attention should be given to the feature of discoid menisci and related tears as they require a specific management plan. This state-of-the-art review highlights the most recent studies on clinical evaluation, surgical techniques, tips and tricks, pitfalls, outcomes, return-to-sports, geographical differences and future perspectives related to meniscal injuries in children and adolescents.

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“…Diagnosing acute menisci tear is based on suggestive clinical findings and magnetic resonance imaging (MRI) findings. 5 There are several pitfalls in diagnosing tear of immature menisci. Due to relatively good vascular supply to the immature menisci in younger children, treatment philosophy is different in children.…”

Section: Introductionmentioning

confidence: 99%

Clinical considerations of anatomy and magnetic resonance imaging in pediatric meniscus tear, with imaging-based treatment options

Cabral

Sinikumpu

2023

Journal of Children's Orthopaedics

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Background: The incidence of meniscal tears in children has been increasing. Early sport specialization, more intense training activity, and increasing participation in competitive sports may have affected to that increasing trend. Diagnosing acute menisci tear in children is based on suggestive clinical and magnetic resonance imaging findings. There are special particulars in immature menisci, due to relatively good vascular supply. Furthermore, growing skeleton makes differences in injury pattern, and a clinician needs to recognize not only meniscus but also potential injuries in growth plates and ligaments, which are usual in connection with pediatric meniscus leasion. Clinical and imaging investigation prior to treatment is crucial, because non-operative care is considerable, to achieve spontaneous healing, especially in peripherial tears of younger children. Second, repair is preferred always as possible, in spite of resection due to high rate of long-term sequelae after partial meniscectomy. High standard preoperative imaging aid in preparing to the meniscus sparing arthroscopic intervention. Methods: In this current concept article, the clinical considerations of imaging the injured pediatric knee with a suspected meniscus tear and the treatment options by the imaging findings are reviewed. Level of evidence: level III.

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The concordance of MRI and arthroscopy in traumatic meniscal lesions in children

Abstract: MRI serves only as a support and does not provide sure diagnosis of meniscus lesion. Interpretation should take account of the clinical examination and the pediatric orthopedic specialist's experience.

Cited by 17 publications

References 21 publications

Sensitivity and Specificity of MRI in Diagnosing Concomitant Meniscal Injuries With Pediatric and Adolescent Acute ACL Tears

Sensitivity and Specificity of MRI in Diagnosing Concomitant Meniscal Injuries With Pediatric and Adolescent Acute ACL Tears

Isolated meniscus injuries in skeletally immature children and adolescents: state of the art

Clinical considerations of anatomy and magnetic resonance imaging in pediatric meniscus tear, with imaging-based treatment options

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