Skip to main content
SpringerLink
Log in

Diagnostic accuracy of ultrasonography in assessing meniscal injury: meta-analysis of prospective studies

  • Original Article
  • Published:
Journal of Orthopaedic Science

Abstract

Background

The accuracy of ultrasonography for diagnosing meniscal injury remains controversial. The aim of the present meta-analysis was to establish the role of ultrasonography in the diagnosis of meniscal injury by analyzing the data from prospectively designed studies.

Methods

A systematic review was performed by searching electronic bibliographic databases prior to November 2014. Studies with diagnostic results that fulfilled the inclusion criteria were included. The methodological quality of the studies was assessed. Sensitivity, specificity and other measures of the accuracy of ultrasonography in the diagnosis of meniscal injury were summarized. Summary receiver-operating characteristic (SROC) curves were used to summarize overall test performance. Publication bias was assessed used Deek’s funnel plot asymmetry test.

Results

Seven prospective studies with 551 patients were eligible for the meta-analysis. The Quality Assessment of Diagnostic Accuracy Studies scores for the included studies ranged from 10–13. The summary estimates of the sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio of ultrasonography in the diagnosis of meniscal injury were 0.88 (95 % CI 0.84–0.91), 0.90 (95 % CI 0.86–0.93), 7.07 (95 % CI 4.34–11.52), 0.17 (95 % CI 0.10–0.26) and 58.13 (95 % CI 24.38–138.62), respectively. There was moderate to significant heterogeneity across the above measures (P < 0.05). The area under the curve of the SROC was 0.948, indicating a high overall diagnostic accuracy. No publication bias was noted across the studies (P = 0.393), which suggested little influence of publication bias on the overall results.

Conclusion

Our results suggest that the diagnostic accuracy of ultrasonography for diagnosing meniscal injury is acceptable, with a high specificity but moderate sensitivity.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

Explore related subjects

Discover the latest articles, news and stories from top researchers in related subjects.

References

  1. Sharma UK, Shrestha BK, Rijal S, Bijukachhe B, Barakoti R, Banskota B, Pradhan I, Banskota AK. Clinical, MRI and arthroscopic correlation in internal derangement of knee. Kathmandu Univ Med J (KUMJ). 2011;9(35):174–8.

    CAS  PubMed  Google Scholar 

  2. Chambers S, Cooney A, Caplan N, Dowen D, Kader D. The accuracy of magnetic resonance imaging (MRI) in detecting meniscal pathology. J R Nav Med Serv. 2014;100(2):157–60.

    CAS  PubMed  Google Scholar 

  3. Van Dyck P, Vanhoenacker FM, Lambrecht V, Wouters K, Gielen JL, Dossche L, Parizel PM. Prospective comparison of 1.5 and 3.0-T MRI for evaluating the knee menisci and ACL. J Bone Joint Surg Am. 2013;95(10):916–24.

    Article  PubMed  Google Scholar 

  4. Azzoni R, Cabitza P. Is there a role for sonography in the diagnosis of tears of the knee menisci? J Clin Ultrasound. 2002;30(8):472–6.

    Article  PubMed  Google Scholar 

  5. De Maeseneer M, Lenchik L, Starok M, Pedowitz R, Trudell D, Resnick D. Normal and abnormal medial meniscocapsular structures: MR imaging and sonography in cadavers. AJR Am J Roentgenol. 1998;171(4):969–76.

    Article  PubMed  Google Scholar 

  6. Wareluk P, Szopinski KT. Value of modern sonography in the assessment of meniscal lesions. Eur J Radiol. 2012;81(9):2366–9.

    Article  PubMed  Google Scholar 

  7. Alizadeh A, BabaeiJandaghi A, KeshavarzZirak A, Karimi A, Mardani-Kivi M, Rajabzadeh A. Knee sonography as a diagnostic test for medial meniscal tears in young patients. Eur J OrthopSurgTraumatol. 2013;23(8):927–31.

    Google Scholar 

  8. Timotijevic S, Vukasinovic Z, Bascarevic Z. Correlation of clinical examination, ultrasound sonography, and magnetic resonance imaging findings with arthroscopic findings in relation to acute and chronic lateral meniscus injuries. J Orthop Sci. 2014;19(1):71–6.

    Article  PubMed  Google Scholar 

  9. Whiting P, Rutjes AW, Reitsma JB, Bossuyt PM, Kleijnen J. The development of QUADAS: a tool for the quality assessment of studies of diagnostic accuracy included in systematic reviews. BMC Med Res Methodol. 2003;10(3):25.

    Article  Google Scholar 

  10. Deville WL, Buntinx F, Bouter LM, Montori VM, de Vet HC, van der Windt DA, Bezemer PD. Conducting systematic reviews of diagnostic studies: didactic guidelines. BMC Med Res Methodol. 2002;3(2):9.

    Article  Google Scholar 

  11. Irwig L, Macaskill P, Glasziou P, Fahey M. Meta-analytic methods for diagnostic test accuracy. J ClinEpidemiol. 1995;48(1):119–30 (discussion 31–32).

    CAS  Google Scholar 

  12. Moses LE, Shapiro D, Littenberg B. Combining independent studies of a diagnostic test into a summary ROC curve: data-analytic approaches and some additional considerations. Stat Med. 1993;12(14):1293–316.

    Article  CAS  PubMed  Google Scholar 

  13. Deeks JJ, Macaskill P, Irwig L. The performance of tests of publication bias and other sample size effects in systematic reviews of diagnostic test accuracy was assessed. J ClinEpidemiol. 2005;58(9):882–93.

    Google Scholar 

  14. Khan Z, Faruqui Z, Ogyunbiyi O, Rosset G, Iqbal J. Ultrasound assessment of internal derangement of the knee. Acta Orthop Belg. 2006;72(1):72–6.

    PubMed  Google Scholar 

  15. Lan YP, Wu XL. Value of ultrasonography in diagnosis of meniscus lesions. J Trauma Surg. 2006;8(6):499–501.

    Google Scholar 

  16. Najafi J, Bagheri S, Lahiji FA. The value of sonography with micro convex probes in diagnosing meniscal tears compared with arthroscopy. J Ultrasound Med. 2006;25(5):593–7.

    PubMed  Google Scholar 

  17. Shetty AA, Tindall AJ, James KD, Relwani J, Fernando KW. Accuracy of hand-held ultrasound scanning in detecting meniscal tears. J Bone Joint Surg Br. 2008;90(8):1045–8.

    Article  CAS  PubMed  Google Scholar 

  18. Shanbhogue AK, Sandhu MS, Singh P, Ojili V, Khandelwal N, Sen R. Real time spatial compound ultrasound in the evaluation of meniscal injuries: a comparison study with conventional ultrasound and MRI. Knee. 2009;16(3):191–5.

    Article  PubMed  Google Scholar 

  19. Bruce W, Lee TS, Sundarajan V, Walker P, Magnussen J, Van der Wall H. Performance characteristics of ultrasound of the knee in a general radiological setting. Knee. 2004;11(4):303–6.

    Article  PubMed  Google Scholar 

  20. Glas AS, Lijmer JG, Prins MH, Bonsel GJ, Bossuyt PM. The diagnostic odds ratio: a single indicator of test performance. J Clin Epidemiol. 2003;56(11):1129–35.

    Article  PubMed  Google Scholar 

  21. Gatsonis C, Paliwal P. Meta-analysis of diagnostic and screening test accuracy evaluations: methodologic primer. AJR Am J Roentgenol. 2006;187(2):271–81.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

We thank Zi Feng Ling Sheng from Dingxiangyuan for her significant help of supplying Figures to this article.

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Department of Osteology, No. 1 People’s Hospital of Nanning, 89 Qixing Rd, Nanning, 530022, Guangxi, China

    Hai Dai, Zong-gui Huang & Jin-xin Liu

  2. Department of Clinical Laboratory, First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, China

    Zhi-jian Chen

Authors
  1. Hai Dai
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Zong-gui Huang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Zhi-jian Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jin-xin Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jin-xin Liu.

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Dai, H., Huang, Zg., Chen, Zj. et al. Diagnostic accuracy of ultrasonography in assessing meniscal injury: meta-analysis of prospective studies. J Orthop Sci 20, 675–681 (2015). https://doi.org/10.1007/s00776-015-0728-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00776-015-0728-2

Keywords

Search

Navigation