The Value of Ultrasound Diagnostic Imaging of Meniscal Knee Injuries Verified by Experimental and Arthroscopic Investigations.

Abstract

(1) Introduction: Meniscal knee injuries may develop as the result of trauma or overloading. Ultrasound imaging is an observer-dependent modality, meaning that the assessment of structural damage depends on the investigator's experience.. None of the published papers provides a standardized method for ultrasound examination of knee menisci. The main goal of this study is to realize and standardize ultrasound imaging diagnostics of meniscal knee injuries based on individual features of ultrasound presentation and to evaluate the applicability of this modality in clinical practice. (2) Material and methods: This study consisted of two anatomical parts, including a clinical part that started with clinical examination of 50 patients with suspected meniscal knee injuries. After this we performed ultrasound examinations in patients with positive clinical test results, using sonographic confirmation for inclusion in the next stage. Finally, knee arthroscopy by two physicians in an operating room was performed, with procedures documented through photographs and video recordings, and analytic material obtained from patients in the control group documented similarly. (3) Results: In the clinical part of the study, arthroscopic examination revealed 13 longitudinal injuries (corresponding to 36% of all injuries in the group), 14 multidirectional injuries (corresponding to 28% of all injuries), 3 radial injuries (corresponding to 6% of all injuries), and 20 oblique injuries (corresponding to 40% of all injuries). The analysis of the sensitivity and specificity of the diagnostic test in terms of recognizing actual meniscal injuries on the basis of full-thickness or partial-thickness delamination, meniscal cyst oedema, and articular space stenosis revealed that the presence of at least two of these three characteristics was associated with the sensitivity of 88% and the specificity of 86% relative to the number of actual meniscal injuries as seen in arthroscopic examination. (4) Conclusions: Research results confirm that clinical examination combined with ultrasound imaging is a very efficient tool for evaluation of meniscal injuries.