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doi: https://doi.org/10.15441/ceem.23.111    [Accepted]
The predictive value of point-of-care ultrasonography versus magnetic resonance imaging in assessing medial meniscal tears in patients with acute knee injury
Omid Ahmadi1 , Mehdi Motififard2 , Farhad Heydari1 , Saeed Hatami2 , Azita Azimi Meibody1,3
1Department of Emergency Medicine, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
2Department of Orthopedic Surgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
3Department of Health in Disaster and Emergencies, Faculty of Management and Medical Information, Isfahan University of Medical Sciences, Isfahan, Iran
Correspondence  Farhad Heydari Tel: +989131367643, Email: farhad_heidari@med.mui.ac.ir
Received: August 18, 2023. Revised: September 23, 2023.  Accepted: October 15, 2023. Published online: January 29, 2024.
ABSTRACT
Objective
Musculoskeletal ultrasound is increasingly used as the modality of choice in diagnosing many medical situations. The present study aimed to compare the efficacy of point-of-care ultrasonography (POCUS) and magnetic resonance imaging (MRI) to detect acute medial meniscus knee tears.
Methods
The prospective study was conducted on patients with suspected medial meniscus knee tear in the emergency department. In the absence of a knee fracture on x-ray, POCUS on the knee was performed. All patients underwent POCUS and MRI of the knee followed by arthroscopy. POCUS findings were then compared to MRI findings to diagnose medial meniscus tear.
Results
A final total of 157 patients with a mean age of 25.04±7.41 years was included. Out of 157 patients, 94 (59.9%) were male. Medial meniscus tears were detected in 89 patients (56.7%) using arthroscopy as the gold standard. The sensitivity, specificity, positive and negative predictive values, and accuracy of POCUS to detect medial meniscus tears were 88.8% (95% confidence interval [CI], 80.3%–94.5%), 89.7% (95% CI, 79.9%–95.8%), 91.9% (95% CI, 84.8%–95.8%), 85.9% (95% CI, 77.2%–91.7%), and 89.2% (95% CI, 83.3%–93.6%), respectively. The diagnostic accuracy of MRI to detect medial meniscus injury was 93.0% (95% CI, 87.8%–96.4%).
Conclusion
The present study demonstrated that POCUS is an accurate and reliable diagnostic tool alternative to MRI in detecting medial meniscal tears. POCUS had acceptable sensitivity, specificity, and accuracy in detecting meniscal injuries and could be performed as an effective immediate investigation to guide further modalities in patients with acute knee trauma.
Keywords: Knee; Tibial menisci; Ultrasound; Magnetic resonance imaging; Wounds and injuries
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