Precision and Sensitivity of Magnetic Resonance Imaging in Detecting Meniscal Tears in a Local Tertiary Hospital
Background: Meniscal tear is a common orthopedic condition seen in the clinic. The sensitivity of physical examination tests (joint line tenderness, McMurray test, and Apley grind test) for clinical diagnosis has been established at 60 to 70% and specificity has been noted to range from 70 to 77%. Diagnostic accuracy is significantly improved with plain magnetic resonance imaging (MRI) where sensitivity ranges from 64 to 83% and specificity at 84 to 93%. On the other hand, arthroscopy remains to be the best procedure since it has the advantage of visualizing pathologies of the knee. However, the invasive nature of the procedure is making physicians consider other diagnostic modalities. This study aims to evaluate the diagnostic accuracy of MRI compared to arthroscopy in the diagnosis of meniscal tear.
Methods: Review of medical records was done among patients who underwent arthroscopy for meniscal tears from January 2014 to December 2014 in a local tertiary hospital. Intraoperative findings were compared with preoperative MRI readings. Sensitivity and positive predictive value were then calculated.
Results: A total of 110 cases of meniscal tears were reviewed. MRI was able to detect 92 out of the 110 arthroscopically-diagnosed meniscal tears with a sensitivity of 83.6% and a positive predictive value of 93.9%.
Conclusion: Despite the adequacy of MRI in diagnosing meniscal tears in a local tertiary hospital, the practicality of proceeding with arthroscopy instead of confirming diagnosis with MRI remains to be a considerable option, given that the risks of the procedure are all explained well to patients.