Skip to main content
SpringerLink
Log in

A predictive model with radiographic signs can be a useful supplementary diagnostic tool for complete discoid lateral meniscus in adults

  • KNEE
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

To investigate the diagnostic accuracy of radiographic signs for complete discoid lateral meniscus and whether a predictive model combining the radiographic signs can improve its diagnostic accuracy in adults.

Methods

A total of adult 119 knees with complete discoid lateral meniscus confirmed by arthroscopy and 119 age- and sex-matched knees with normal meniscus were included. The radiographic signs of lateral joint space, fibular head height, lateral tibial spine height, lateral tibial plateau obliquity, lateral femoral condyle squaring, lateral tibial plateau cupping, lateral femoral condyle notching, and the condylar cut-off sign were evaluated. The receiver-operating characteristic (ROC) curves and area under the curve (AUC) were evaluated for best accuracy. A prediction model was developed by multivariable regression with generalized estimating models, and was validated using data from 111 knees of children with complete discoid lateral meniscus and 111 normal controls.

Results

The fibular head height, lateral joint space, lateral tibial plateau obliquity, and the condylar cut-off sign were significantly different between the complete discoid lateral meniscus and the normal groups (p < 0.05). Among the four radiographic signs, the fibular head height showed the highest accuracy with 78.9% sensitivity and 57.3% specificity. The prediction models developed by logistic regression showed significantly improved accuracy for complete discoid lateral meniscus compared to the fibular head height (sensitivity: 69.8%, specificity: 82.9%, p = 0.001). For validation, the AUC of children seemed to be larger than that of adults, which indicated that the prediction models could be applied for children to detect complete discoid lateral meniscus.

Conclusion

Among several radiographic signs, the fibular head height can be used as a screening tool for complete discoid lateral meniscus. The prediction models combined with lateral joint space, fibular head height, lateral tibial plateau obliquity, and/or the condylar cut-off sign yielded a much higher diagnostic value than each radiographic sign. Therefore, fibular head height and prediction models combined with radiographic signs can provide improved diagnostic value for complete discoid lateral meniscus.

Level of evidence

III.

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

Access this article

Log in via an institution

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
Fig. 5

Similar content being viewed by others

References

  1. Ahn JH, Choi SH, Lee YS, Yoo JC, Chang MJ, Bae S, Bae YR (2011) Symptomatic torn discoid lateral meniscus in adults. Knee Surg Sports Traumatol Arthrosc 19(2):158–164

    Article  Google Scholar 

  2. Bin SI, Kim JC, Kim JM, Park SS, Han YK (2002) Correlation between type of discoid lateral menisci and tear pattern. Knee Surg Sports Traumatol Arthrosc 10(4):218–222

    Article  Google Scholar 

  3. Cho WJ, Kim JM, Lee BS, Kim HJ, Bin SI (2019) Discoid lateral meniscus: a simple horizontal tear was associated with less articular cartilage degeneration compared to other types of tear. Knee Surg Sports Traumatol Arthrosc 27(10):3390–3395

    Article  Google Scholar 

  4. Good CR, Green DW, Griffith MH, Valen AW, Widmann RF, Rodeo SA (2007) Arthroscopic treatment of symptomatic discoid meniscus in children: classification, technique, and results. Arthroscopy 23(2):157–163

    Article  Google Scholar 

  5. Ha CW, Lee YS, Park JC (2009) The condylar cutoff sign: quantifying lateral femoral condylar hypoplasia in a complete discoid meniscus. Clin Orthop Relat Res 467(5):1365–1369

    Article  Google Scholar 

  6. Ha CW, Jang JW, Kim M, Na SE, Lee HJ, Park YB (2017) The utility of the radiographic condylar cut-off sign in children and adolescents with complete discoid lateral meniscus. Knee Surg Sports Traumatol Arthrosc 25(12):3862–3868

    Article  Google Scholar 

  7. Jeon SW, Choi CH, Jung M, Chun YM, Kim SJ, Jin S, Kim SH (2019) The fate of the contralateral knee in patients with a lateral discoid meniscus. Arthroscopy 35(2):500–506

    Article  Google Scholar 

  8. Jiang W, Li X, Su H, Yang C (2016) A new method to diagnose discoid lateral menisci on radiographs. Knee Surg Sports Traumatol Arthrosc 24(5):1519–1524

    Article  Google Scholar 

  9. Kim SJ, Moon SH, Shin SJ (2000) Radiographic knee dimensions in discoid lateral meniscus: comparison with normal control. Arthroscopy 16(5):511–516

    Article  CAS  Google Scholar 

  10. Kim JG, Han SW, Lee DH (2016) Diagnosis and treatment of discoid meniscus. Knee Surg Relat Res 28(4):255–262

    Article  Google Scholar 

  11. Kim JH, Bin SI, Lee BS, Kim JM, Kim NK, Lee CR (2018) Does discoid lateral meniscus have inborn peripheral rim instability? Comparison between intact discoid lateral meniscus and normal lateral meniscus. Arch Orthop Trauma Surg 138(12):1725–1730

    Article  Google Scholar 

  12. Klingele KE, Kocher MS, Hresko MT, Gerbino P, Micheli LJ (2004) Discoid lateral meniscus: prevalence of peripheral rim instability. J Pediatr Orthop 24(1):79–82

    Article  Google Scholar 

  13. Kramer DE, Micheli LJ (2009) Meniscal tears and discoid meniscus in children: diagnosis and treatment. J Am Acad Orthop Surg 17(11):698–707

    Article  Google Scholar 

  14. Kushare I, Klingele K, Samora W (2015) Discoid meniscus: diagnosis and management. Orthop Clin North Am 46(4):533–540

    Article  Google Scholar 

  15. Lee YS, Teo SH, Ahn JH, Lee OS, Lee SH, Lee JH (2017) Systematic review of the long-term surgical outcomes of discoid lateral meniscus. Arthroscopy 33(10):1884–1895

    Article  Google Scholar 

  16. Malviya S, Voepel-Lewis T, Eldevik OP, Rockwell DT, Wong JH, Tait AR (2000) Sedation and general anaesthesia in children undergoing MRI and CT: adverse events and outcomes. Br J Anaesth 84(6):743–748

    Article  CAS  Google Scholar 

  17. Okazaki K, Miura H, Matsuda S, Hashizume M, Iwamoto Y (2006) Arthroscopic resection of the discoid lateral meniscus: long-term follow-up for 16 years. Arthroscopy 22(9):967–971

    Article  Google Scholar 

  18. Park YB, Ha CW, Jang JW, Kim M, Lee HJ, Park YG (2018) Prediction models to improve the diagnostic value of plain radiographs in children with complete discoid lateral meniscus. Arthroscopy 34(2):479–489.e473

    Article  Google Scholar 

  19. Restrepo R, Weisberg MD, Pevsner R, Swirsky S, Lee EY (2019) Discoid meniscus in the pediatric population: emphasis on MR imaging signs of instability. Magn Reson Imaging Clin N Am 27(2):323–339

    Article  Google Scholar 

  20. Rohren EM, Kosarek FJ, Helms CA (2001) Discoid lateral meniscus and the frequency of meniscal tears. Skeletal Radiol 30(6):316–320

    Article  CAS  Google Scholar 

  21. Sabbag OD, Hevesi M, Sanders TL, Camp CL, Dahm DL, Levy BA, Stuart MJ, Krych AJ (2019) High rate of recurrent meniscal tear and lateral compartment osteoarthritis in patients treated for symptomatic lateral discoid meniscus: a population-based study. Orthop J Sports Med 7(7):2325967119856284

    Article  Google Scholar 

  22. Sohn DW, Bin SI, Kim JM, Lee BS, Kim SJ (2018) Discoid lateral meniscus can be overlooked by magnetic resonance imaging in patients with meniscal tears. Knee Surg Sports Traumatol Arthrosc 26(8):2317–2323

    Article  Google Scholar 

  23. Song JG, Han JH, Kwon JH, Shetty GM, Franco LA, Kwon DY, Nha KW (2015) Radiographic evaluation of complete and incomplete discoid lateral meniscus. Knee 22(3):163–168

    Article  Google Scholar 

  24. Yaniv M, Blumberg N (2007) The discoid meniscus. J Child Orthop 1(2):89–96

    Article  Google Scholar 

Download references

Funding

This research was supported by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (grant number: HI14C3484). The funding sources had no involvement in the study design, collection, analysis or interpretation of the data, writing of the manuscript, or in the decision to submit the manuscript for publication.

Author information

Author notes

  1. Yong-Beom Park and Seong Hwan Kim have contributed equally to this work.

Authors and Affiliations

  1. Department of Orthopedic Surgery, Chung-Ang University College of Medicine, Chung-Ang University Hospital, 102 Heukseok-ro, Dongjak-gu, Seoul, 06973, South Korea

    Yong-Beom Park

  2. Department of Orthopedic Surgery, Chung-Ang University College of Medicine, Hyundae General Hospital, 21, Bonghyeon-ro, Jinjeop-eup, Namyangju-si, Gyeonggi-do, 12013, South Korea

    Seong Hwan Kim

  3. Department of Orthopedic Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea

    Chul-Won Ha, Jung-Won Han & Jin-Wook Noh

  4. Stem Cell and Regenerative Medicine Institute, Samsung Medical Center, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea

    Chul-Won Ha

  5. Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea

    Chul-Won Ha

Authors
  1. Yong-Beom Park
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Seong Hwan Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Chul-Won Ha
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jung-Won Han
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jin-Wook Noh
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Chul-Won Ha.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This study was approved by the Institutional Review Board of investigational institution (SMC, No. 2018-06-134).

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 39 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Park, YB., Kim, S.H., Ha, CW. et al. A predictive model with radiographic signs can be a useful supplementary diagnostic tool for complete discoid lateral meniscus in adults. Knee Surg Sports Traumatol Arthrosc 29, 474–482 (2021). https://doi.org/10.1007/s00167-020-05972-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00167-020-05972-z

Keywords

Search

Navigation