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History, clinical findings, magnetic resonance imaging, and arthroscopic correlation in meniscal lesions

  • Ersin ErcinEmail author
  • Ibrahim Kaya
  • Ibrahim Sungur
  • Emrah Demirbas
  • Ali Akin Ugras
  • Ercan Mahmut Cetinus
Knee

Abstract

Purpose

The aim of this prospective study was to compare the accuracy of clinical examination and magnetic resonance imaging (MRI) versus arthroscopic findings and to determine the value of an experienced examiner in clinical decision making.

Methods

A total of 30 patients with a preoperative MRI underwent arthroscopy over a 5-month period. All patients had a clinical examination performed by an experienced knee surgeon, a specialist in general orthopedics, a senior resident, and a fourth-year resident. These examiners recorded and evaluated the results of seven tests: the medial and lateral joint line tenderness test, the McMurray test, the Apley test, the Stienmann I test, the Payr’s test, Childress’ sign, and the Ege’s test. The injury was classified as a meniscal tear if there were two positive tests.

Clinical history, physical examination, and MRI findings were compared with the arthroscopic findings. The accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of these methods of evaluation were then calculated.

Results

Clinical examination performed by an experienced knee surgeon had better specificity (90% vs. 60%), positive predictive value (95% vs. 83%), negative predictive value (90% vs. 86%), and diagnostic accuracy (93% vs. 83%) than MRI for medial meniscal tears. These parameters showed only a marginal difference in lateral meniscal tears. The experienced knee surgeon had better sensitivity, specificity, predictive values, and diagnostic accuracy parameters for medial meniscus tears in comparison with the other three examiners.

Conclusion

These results indicate that clinical examination by an experienced examiner using multiple meniscus tests is sufficient for a diagnosis of a meniscal tear.

Level of evidence

II.

Keywords

Knee Meniscus tears MR imaging Arthroscopy Clinical examination 

Notes

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Ersin Ercin
    • 1
    Email author
  • Ibrahim Kaya
    • 2
  • Ibrahim Sungur
    • 2
  • Emrah Demirbas
    • 3
  • Ali Akin Ugras
    • 2
  • Ercan Mahmut Cetinus
    • 2
  1. 1.Ankara Mevki Military HospitalOrthopedics and Traumatology ClinicUnalan, IstanbulTurkey
  2. 2.Haseki Training and Research HospitalOrthopedics and Traumatology ClinicIstanbulTurkey
  3. 3.Kartal Yavuz Selim HospitalOrthopedics and Traumatology ClinicIstanbulTurkey

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