Abstract
Background: Hypermobile lateral meniscus is difficult to diagnose with imaging due to its absence of tears or anomalies. We aimed to clarify the accuracy of the preoperative diagnosis using magnetic resonance imaging (MRI). Methods: The preoperative MRI status of the posterosuperior popliteomeniscal fascicle (sPMF), anteroinferior popliteomeniscal fascicle (iPMF), and popliteal hiatus were examined retrospectively on sagittal images in the hypermobile lateral meniscus group (n = 22) and an age- and gender-matched control group (n = 44). These statuses were evaluated by a logistic regression analysis to assess their degree of diagnostic accuracy. Results: The area under the curve (AUC) of the sPMF, iPMF, popliteal hiatus, and all three criteria combined was 0.66, 0.74, 0.64, and 0.77, respectively (low, moderate, low, and moderate accuracy, respectively). The odds ratios of the most severe type 3 forms of the sPMF, iPMF, and popliteal hiatus for hypermobile lateral meniscus were significantly high (5.50, 12.20, and 5.00, respectively). Although the diagnostic accuracy was not high enough, the significantly higher odds ratio for type 3 may indicate a hypermobile lateral meniscus. Conclusion: a definitive diagnosis of hypermobile lateral meniscus is difficult with MRI findings alone; however, MRI evaluations of the iPMF, sPMF, and the widening of popliteal hiatus can be used as an adjunct to diagnosis.
Highlights
Hypermobile lateral meniscus is characterized by a history of painful catching or locking symptoms and is diagnosed arthroscopically by reproducing the subluxation of the lateral meniscus without tears or anomalies [1]
There is a study which stated that there is a high incidence of a widening popliteal hiatus as a result of injury to the sPMF and iPMF in patients with hypermobile lateral meniscus [11], there are no reports so far on the diagnostic accuracy of evaluating PMFs by magnetic resonance imaging (MRI)
This study quantitively examined the diagnostic accuracy of MRI findings for hypermobile lateral meniscus
Summary
Hypermobile lateral meniscus is characterized by a history of painful catching or locking symptoms and is diagnosed arthroscopically by reproducing the subluxation of the lateral meniscus without tears or anomalies [1]. The anteroinferior popliteomeniscal fascicle (iPMF) contribute significantly to the stability of the posterior lateral meniscus [12,13] These are the fibers that connect the posterior part of the lateral meniscus to the joint capsule, and are located on the medial and lateral sides of the popliteal tendon. These structures can be visualized with an arthroscope [10,14]. There is a study which stated that there is a high incidence of a widening popliteal hiatus as a result of injury to the sPMF and iPMF in patients with hypermobile lateral meniscus [11], there are no reports so far on the diagnostic accuracy of evaluating PMFs by MRI. If the diagnostic accuracy of MRI can be confirmed to be high, it could potentially serve as a diagnostic aid for many orthopedic surgeons
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