Diagnostic Accuracy of Magnetic Resonance Imaging in the Detection of Meniscal Injury in Patients With Knee Trauma: Keeping Arthroscopy As a Gold Standard

Introduction: Damage to the knee's meniscal tissue is medically important because the meniscus plays a vital role in distributing weight, absorbing impact, and stabilizing the joint. Although arthroscopy continues to be the benchmark for the conclusive identification of knee-related injuries, magnetic resonance imaging (MRI) has gained traction as a widely used non-invasive technique for evaluating possible meniscal damage. The objective of this research is to assess the reliability of MRI as a diagnostic tool for identifying meniscal tears, with arthroscopic results serving as the definitive reference.

Methods: This observational study took place in the Radiology Department of Ziauddin University Hospital, located in Karachi, Pakistan, from June to November of 2019, subsequent to receiving ethical clearance from the hospital's review board. MRI assessments were conducted by seasoned senior radiologists who had a minimum of five years of domain-specific experience. Arthroscopic evaluations were executed by a skilled orthopedic surgeon. Information regarding patient demographics and clinical history was gathered through a pre-established protocol. Statistical analysis of the collected data was performed using SPSS Statistics version 21 (IBM Corp. Released 2012. IBM SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp.).

Results: This research included a total of 141 participants, with 95 (67.4%) being male. The average age of the subjects was 38.89 years, with a standard deviation of 6.87 years. The mean body mass index (BMI) stood at 22.81 kg/m^2 with a standard deviation of 1.81. The typical duration since the injury occurred was 3.23 months, with a standard deviation of 1.6 months. According to the MRI evaluations, 83 participants (58.9%) exhibited a tear in the medial meniscus, while 58 (41.1%) showed a tear in the lateral meniscus. The MRI tests revealed a sensitivity of 94% and a specificity of 87.8% in identifying meniscal tears, boasting an overall diagnostic precision of 92.2%.

Conclusion: This study substantiates that MRI possesses a high degree of sensitivity in the identification of meniscal injuries. It serves as an effective preliminary assessment tool for pinpointing patients who could potentially benefit from therapeutic arthroscopy, thereby often negating the necessity for diagnostic arthroscopy.