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J Knee Surg 2020; 33(12): 1251-1255
DOI: 10.1055/s-0039-1693449
Original Article

Should We Prefer Magnetic Resonance Imaging to Physical Examination in Meniscal Tears

Gökhun Arıcan 
1   Department of Orthopaedics, Ankara Training and Research Hospital, Ankara, Turkey
,
Ahmet Özmeriç
1   Department of Orthopaedics, Ankara Training and Research Hospital, Ankara, Turkey
,
Özgür Şahin
1   Department of Orthopaedics, Ankara Training and Research Hospital, Ankara, Turkey
,
Serkan İltar
2   Department of Orthopaedics, University of Health Sciences (UHS), Ankara Training and Research Hospital, Ankara, Turkey
,
Kadir Bahadır Alemdaroğlu
2   Department of Orthopaedics, University of Health Sciences (UHS), Ankara Training and Research Hospital, Ankara, Turkey
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Abstract

The aim of this study was to compare the sensitivity, specificity, accuracy, positive and negative predictive values of magnetic resonance imaging (MRI), and clinical examination in the diagnosis of meniscus tears with the findings obtained from the knee joint arthroscopy. A retrospective study was made of 452 patients who underwent knee arthroscopy due to meniscus tears between 2012 and 2017. Physical examination was performed using the Thessaly's, McMurray's, and Joint line tenderness tests (JLTT). On preoperative MRI, medial meniscal tears were observed in 292 patients, lateral meniscal tears in 96 patients, and medial and lateral meniscal tears in 64 patients. According to the arthroscopy results, 284 patients had medial meniscal tears, 108 patients had lateral meniscal tears, and 60 patients had medial and lateral meniscal tears. Sensitivity and specificity of the JLTT was determined as 93 and 86% respectively for medial meniscal tears and 94 and 89% for lateral meniscal tears. The McMurray's test was 60% sensitive, 68% specific for medial meniscal tears (MMT), and 73% sensitive and 68% specific for lateral meniscus tears (LMT). The Thessaly's test was 93% sensitive and 87% specific for medial meniscal tears; and 94% sensitive and 88% specific for LMT. Compared with the arthroscopic findings, MRI was observed to have sensitivity of 94% for MMT and 84% for LMT. For specificity, the values were 89% for MMT and 91% for LMT. Accuracy was 89% for MMT and 86% for LMT. In comparison with the arthroscopic findings, the triple test was determined to have sensitivity of 92% for MMT and 89% for LMT. The specificity was 88% for MMT and 91% for LMT. The results of this study showed that a combination of selected physical examination methods is as sensitive as MRI in the diagnosis of meniscus tears.

Keywords

meniscal tears - McMurray's test - JLTT - Thessaly's test


Publication History

Received: 28 October 2018

Accepted: 19 May 2019

Article published online:
09 July 2019

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