Skip to main content
SpringerLink
Log in

Diagnostics of degenerative meniscal tears at 3-Tesla MRI compared to arthroscopy as reference standard

  • Arthroscopy and Sports Medicine
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

The goal of this study was to evaluate the diagnostic performance of 3-Tesla MRI for the assessment of degenerative meniscal tears in clinical practice.

Materials and methods

In patients with chronic knee pain, a negative history of acute trauma and a mean age of 52 years, 3-Tesla MRI were performed a few days prior to arthroscopy. In 86 menisci, diagnostic values of 3-Tesla MRI for the detection of degenerative tears were evaluated using arthroscopy as reference standard. The MRI classification, for meniscus diagnostics, described by Crues was used.

Results

At arthroscopy, all tears identified (19 horizontal, 7 complex, 3 radial) were degenerative as confirmed by histological examination. MRI grade II lesions had a prevalence of 24% and a rate of 24% of missed tears, whereas grade I lesions were not associated with a torn meniscus at arthroscopy. For meniscal tears, (grade III) sensitivity and specificity of 3-Telsa MRI was 79 and 95% for both menisci, 86 and 100% for the medial meniscus, and 57 and 92% for the lateral meniscus. The best diagnostic performance was found for complex tears, horizontal tears showed relatively good results, poor results were documented for radial tears.

Conclusion

For the medial meniscus, where horizontal and complex tears were more prevalent, 3-Tesla MRI shows a higher accuracy than for the lateral meniscus. Particularly with regard to the medial meniscus, 3-Tesla MRI could be effectively used when a degenerative tear is suspected. Nevertheless, in regard to a remarkable number of false positive and false negative findings the diagnostic value of a 3-Tesla MRI investigation should not be overestimated.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Ben-Galim P, Steinberg EL, Amir H, Ash N, Dekel S, Arbel R (2000) Accuracy of magnetic resonance imaging of the knee and unjustified surgery. Clin Orthop Relat Res 447:100–104

    Article  Google Scholar 

  2. Bohnsack M, Ruhmann O, Sander-Beuermann A, Wirth CJ (1999) Comparison of clinical examination with NMR spectroscopy in the diagnosis of meniscal lesions in daily practice. Z Orthop Ihre Grenzgeb 137(1):38–42

    Article  PubMed  CAS  Google Scholar 

  3. Cheung LP, Li KC, Hollett MD, Bergman AG, Herfkens RJ (1997) Meniscal tears of the knee: accuracy of detection with fast spin-echo MR imaging and arthroscopic correlation in 293 patients. Radiology 203(2):508–512

    PubMed  CAS  Google Scholar 

  4. Craig JG, Go L, Blechinger J, Hearshen D, Bouffard JA, Diamond M, van Holsbeeck MT (2005) Three-tesla imaging of the knee: initial experience. Skeletal Radiol 34(8):453–461

    Article  PubMed  Google Scholar 

  5. Crues JV III, Mink J, Levy TL, Lotysch M, Stoller DW (1987) Meniscal tears of the knee: accuracy of MR imaging. Radiology 164:445–448

    PubMed  Google Scholar 

  6. De Smet AA, Graf BK (1994) Meniscal tears missed on MR imaging: relationship to meniscal tear patterns and anterior cruciate ligament tears. Am J Roentgenol 162(4):905–911

    Google Scholar 

  7. Elvenes J, Jerome CP, Reikeras O, Johansen O (2000) Magnetic resonance imaging as a screening procedure to avoid arthroscopy for meniscal tears. Arch Orthop Trauma Surg 120(1–2):14–16

    PubMed  CAS  Google Scholar 

  8. Fischer SP, Fox JM, Del Pizzo W, Friedman MJ, Snyder SJ, Ferkel RD (1991) Accuracy of diagnoses from magnetic resonance imaging of the knee. A multi-center analysis of one thousand and fourteen patients. J Bone Joint Surg Am 73(1):2–10

    PubMed  CAS  Google Scholar 

  9. Glashow JL, Katz R, Schneider M, Scott WN (1989) Double-blind assessment of the value of magnetic resonance imaging in the diagnosis of anterior cruciate and meniscal lesions. J Bone Joint Surg Am 71(1):113–119

    PubMed  CAS  Google Scholar 

  10. Gold GE, Han E, Stainsby J, Wrigth G, Brittain J, Beaulieu C (2004) Musculoskeletal MRI at 3.0 T: relaxation times and times and image contrast. Am J Roentgenol 183:343–351

    Google Scholar 

  11. Hajek PC, Gylys-Morin VM, Baker LL, Sartoris DJ, Haghighi P, Resnick D (1987) The high signal intensity meniscus of the knee. Magnetic resonance evaluation and in vivo correlation. Invest Radiol 22(11):883–890

    Article  PubMed  CAS  Google Scholar 

  12. Hodler J, Haghighi P, Pathria MN, Trudell D, Resnick D (1992) Meniscal changes in the elderly: correlation of MR imaging and histologic findings. Radiology 184(1):221–225

    PubMed  CAS  Google Scholar 

  13. Imhoff A, Buess E, Hodler J, Schreiber A (1994) Relevance of proton spin tomographic meniscus diagnosis in correlation with arthroscopy. Orthopäde 23(2):117–124

    PubMed  CAS  Google Scholar 

  14. Jee WH, McCauley TR, Kim JM (2004) Magnetic resonance diagnosis of meniscal tears in patients with acute anterior cruciate ligament tears. J Comput Assist Tomogr 28(3):402–406

    Article  PubMed  Google Scholar 

  15. Jerosch J, Castro WH, Assheuer J (1996) Age-related magnetic resonance imaging morphology of the menisci in asymptomatic individuals. Arch Orthop Trauma Surg 115(3–4):199–202

    Article  PubMed  CAS  Google Scholar 

  16. Kocabey Y, Tetik O, Isbell WM, Atay OA, Johnson DL (2004) The value of clinical examination versus magnetic resonance imaging in the diagnosis of meniscal tears and anterior cruciate ligament rupture. Arthroscopy 20(7):696–700

    PubMed  Google Scholar 

  17. Kornick J, Trefelner E, McCarthy S, Lange R, Lynch K, Jokl P (1990) Meniscal abnormalities in the asymptomatic population at MR imaging. Radiology 177(2):463–465

    PubMed  CAS  Google Scholar 

  18. LaPrade RF, Burnett QM 2nd, Veenstra MA, Hodgman CG (1994) The prevalence of abnormal magnetic resonance imaging findings in asymptomatic knees. With correlation of magnetic resonance imaging to arthroscopic findings in symptomatic knees. Am J Sports Med 22(6):739–745

    Article  PubMed  CAS  Google Scholar 

  19. Magee T, Williams D (2006) 3.0-T MRI of meniscal tears. Am J Roentgenol 187(2):371–375

    Article  Google Scholar 

  20. Matava MJ, Eck K, Totty W, Wright RW, Shively RA (1999) Magnetic resonance imaging as a tool to predict meniscal reparability. Am J Sports Med 27(4):436–443

    PubMed  CAS  Google Scholar 

  21. Muellner T, Weinstabl R, Schabus R, Vecsei V, Kainberger F (1997) The diagnosis of meniscal tears in athletes. A comparison of clinical and magnetic resonance imaging investigations. Am J Sports Med 25(1):7–12

    Article  PubMed  CAS  Google Scholar 

  22. Negendank WG, Fernandez-Madrid FR, Heilbrun LK, Teitge RA (1990) Magnetic resonance imaging of meniscal degeneration in asymptomatic knees. J Orthop Res 8(3):311–320

    Article  PubMed  CAS  Google Scholar 

  23. Outerbridge RE (1961) The etiology of chondromalacia patellae. J Bone Joint Surg Br 43: 752–767

    PubMed  Google Scholar 

  24. Polly DW Jr, Callaghan JJ, Sikes RA, McCabe JM, McMahon K, Savory CG (1988) The accuracy of selective magnetic resonance imaging compared with the findings of arthroscopy of the knee. J Bone Joint Surg Am 70(2):192–198

    PubMed  Google Scholar 

  25. Quinn SF, Brown TF (1991) Meniscal tears diagnosed with MR imaging versus arthroscopy: how reliable a standard is arthroscopy? Radiology 181(3):843–847

    PubMed  CAS  Google Scholar 

  26. Ramnath RR, Magee T, Wasudev N, Murrah R (2006) Accuracy of 3-T MRI using fast spin-echo technique to detect meniscal tears of the knee. Am J Roentgenol 187(1):221–225

    Article  Google Scholar 

  27. Raunest J, Hotzinger H, Burrig KF (1994) Magnetic resonance imaging (MRI) and arthroscopy in the detection of meniscal degenerations: correlation of arthroscopy and MRI with histology findings. Arthroscopy 10(6):634–640

    Article  PubMed  CAS  Google Scholar 

  28. Rose NE, Gold SM (1996) A comparison of accuracy between clinical examination and magnetic resonance imaging in the diagnosis of meniscal and anterior cruciate ligament tears. Arthroscopy 12(4):398–405

    Article  PubMed  CAS  Google Scholar 

  29. Rubin DA (1997). MR imaging of the knee menisci. Radiol Clin North Am 35(1):21–44

    PubMed  CAS  Google Scholar 

  30. Runkel M, Kreitner KF, Regentrop HJ, Kersjes W (2000) Sensitivity of magnetic resonance tomography in detecting meniscus tears. Unfallchirurg 103(12):1079–1085

    Article  PubMed  CAS  Google Scholar 

  31. Saragaglia D, Rose-Pittet L, Lebas JF, Coulomb M, Butel J (1989) Magnetic resonance imaging in studying injuries of the ligaments and menisci of the knee. 85 cases controlled by arthroscopy. Rev Chir Orthop Reparatrice Appar Mot 75(7):452–458

    PubMed  CAS  Google Scholar 

  32. Schmitt F, Grosu D, Mohr C, Purdy D, Salem K, Scott KT, Stoeckel B (2004) 3 Tesla MRI: successful results with higher field strengths. Radiologe 44:31–48

    Article  PubMed  CAS  Google Scholar 

  33. Sproule JA, Khan F, Rice JJ, Nicholson P, McElwain JP (2005) Altered signal intensity in the posterior horn of the medial meniscus: an MR finding of questionable significance. Arch Orthop Trauma Surg 125(4):267–271

    Article  PubMed  CAS  Google Scholar 

  34. Stoller DW, Martin C, Crues JV 3rd, Kaplan L, Mink JH (1987) Meniscal tears: pathologic correlation with MR imaging. Radiology 163(3):731–735

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Klinik für Orthopädie und Unfallchirurgie, Rheinische Friedrich-Wilhelms-Universität Bonn, Sigmund-Freud-Str. 25, 53105, Bonn, Germany

    L. V. von Engelhardt, A. Schmitz, P. H. Pennekamp & D. C. Wirtz

  2. Radiologische Klinik, Rheinische Friedrich-Wilhelms-Universität Bonn, Sigmund-Freud-Str. 25, 53105, Bonn, Germany

    H. H. Schild & F. von Falkenhausen

Authors
  1. L. V. von Engelhardt
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. Schmitz
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. P. H. Pennekamp
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. H. H. Schild
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. D. C. Wirtz
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. F. von Falkenhausen
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to L. V. von Engelhardt.

Rights and permissions

Reprints and permissions

About this article

Cite this article

von Engelhardt, L.V., Schmitz, A., Pennekamp, P.H. et al. Diagnostics of degenerative meniscal tears at 3-Tesla MRI compared to arthroscopy as reference standard. Arch Orthop Trauma Surg 128, 451–456 (2008). https://doi.org/10.1007/s00402-007-0485-6

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00402-007-0485-6

Keywords

Search

Navigation