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The Predictive Value of Point-Of-Care Ultrasonography Versus Magnetic Resonance Imaging in Assessing Medial Meniscal Tears in Patients With Acute Knee Injury Publisher



Ahmadi O1 ; Motififard M2 ; Heydari F1 ; Hatami S2 ; Meibody AA1, 3
Authors
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Authors Affiliations
  1. 1. Department of Emergency Medicine, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
  2. 2. Department of Orthopedic Surgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
  3. 3. Department of Health in Disaster and Emergencies, Faculty of Management and Medical Information, Isfahan University of Medical Sciences, Isfahan, Iran

Source: Clinical and Experimental Emergency Medicine Published:2024


Abstract

Objective Musculoskeletal ultrasound is increasingly used as the modality of choice in diagnosing many medical situations. The present study aimed to compare the accuracy of point-of-care ultrasonography (POCUS) and magnetic resonance imaging (MRI) to detect acute medial meniscus tears in knee. Methods The prospective study was conducted on patients with suspected medial meniscus tears in knee. in the emergency department. In the absence of a knee fracture on x-ray, POCUS on the knee was performed. All patients underwent POCUS and MRI of the knee followed by arthroscopy. POCUS findings were then compared to MRI findings to diagnose medial meniscus tears. Results A final total of 157 patients with a mean age of 25.04±7.41 years was included. Out of 157 patients, 94 (59.9%) were male. Medial meniscus tears were detected in 89 patients (56.7%) using arthroscopy as the gold standard. The sensitivity, specificity, positive and negative predictive values, and accuracy of POCUS to detect medial meniscus tears were 88.8% (95% confidence interval [CI], 80.3%–94.5%), 89.7% (95% CI, 79.9%–95.8%), 91.9% (95% CI, 84.8%–95.8%), 85.9% (95% CI, 77.2%–91.7%), and 89.2% (95% CI, 83.3%–93.6%), respectively. The diagnostic accuracy of MRI to detect medial meniscus injury was 93.0% (95% CI, 87.8%– 96.4%). Conclusion The present study demonstrated that POCUS is an accurate and reliable diagnostic tool alternative to MRI in detecting medial meniscal tears. POCUS had acceptable sensitivity, specificity, and accuracy in detecting meniscal injuries and could be performed as an effective immediate investigation to guide further modalities in patients with acute knee trauma. © 2024 The Korean Society of Emergency Medicine
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