Sensitivity of magnetic resonance tomography in detecting meniscus tears

Abstract

In order to assure diagnostic accuracy, 172 knee joints were examined prospectively by MRI. After MRI, all knee joints were examined by arthroscopy. Tears of the medial meniscus were found in 102 patients, the lateral meniscus showed a tear in 29 cases. Assuming that arthroscopy represents the golden standard of diagnostic measure concerning the knee joint, it can be stated that false-positive MRI findings on the medial and lateral meniscus were diagnosed in three cases and false-negative MRI findings were diagnosed for two knee joints regarding the medial meniscus and four times regarding the lateral meniscus. For the medial meniscus a sensitivity of 98%, a specificity of 96%, an accuracy of 94%, and the positive and negative value of prediction were calculated at 97% each. Regarding the lateral meniscus, a sensitivity of 85%, a specificity of 98%, an accuracy of 92%, a positive predictive value of 88%, and a negative predictive value of 85% were found. Under the prerequisite that the MRI is carried out correctly and assessed by an experienced radiologist, the accuracy of the MRI for meniscus diagnosis is almost equivalent to the one by arthroscopy. Under these conditions, MRI can be recommended when no safe and sufficient clinical diagnosis can be made. The rate of unnecessary arthroscopies with a pure diagnostic purpose can be lowered significantly by means of MRI.