De Smet Arthur A, Mukherjee Rajat
Department of Radiology, University of Wisconsin School of Medicine and Public Health, 600 Highland Ave., E3/311, Madison, WI 53792, USA.
AJR Am J Roentgenol. 2008 Jan;190(1):22-6. doi: 10.2214/AJR.07.2611.
We performed this study to determine whether clinical, MRI, or arthroscopic findings are associated with missed lateral meniscal tears to help understand why these tears are missed on MRI.
We reviewed the medical records of 483 patients who had undergone knee MRI and arthroscopy. We assessed patient age; spontaneous or traumatic onset of knee pain; interval between pain onset and MRI; interval between MRI and arthroscopy; and arthroscopic type, size, and location of lateral meniscal tear for their association with a missed lateral meniscal tear. Each MR examination with a missed lateral meniscal tear was reviewed to determine whether the tear could be seen in retrospect.
Thirty-six of the 189 lateral meniscal tears found at arthroscopy were not diagnosed on the original MR interpretations. There was a significant association between a missed lateral tear and a posterior horn tear or a tear involving only one third of the meniscus. There was no association between a missed lateral meniscal tear and the other variables. Review of the 36 missed tears revealed that 10 tears were visible retrospectively, six of which were longitudinal peripheral tears in the posterior horn.
Lateral meniscal tears are more likely to be missed if the tear involves only one third of the meniscus or is in the posterior horn. Longitudinal peripheral tears of the posterior horn were the most commonly missed tears that could be seen in retrospect.
我们开展这项研究以确定临床、磁共振成像（MRI）或关节镜检查结果是否与漏诊的外侧半月板撕裂相关，从而有助于理解为何这些撕裂在MRI上被漏诊。
我们回顾了483例接受膝关节MRI和关节镜检查患者的病历。我们评估了患者年龄；膝关节疼痛的自发或创伤性发作；疼痛发作与MRI之间的间隔时间；MRI与关节镜检查之间的间隔时间；以及外侧半月板撕裂的关节镜类型、大小和位置，以确定它们与漏诊的外侧半月板撕裂之间的关联。对每例漏诊外侧半月板撕裂的MR检查进行回顾，以确定撕裂是否可回顾性观察到。
在关节镜检查发现的189例外侧半月板撕裂中，有36例在最初的MR解读中未被诊断出来。漏诊的外侧撕裂与后角撕裂或仅累及半月板三分之一的撕裂之间存在显著关联。漏诊的外侧半月板撕裂与其他变量之间无关联。对36例漏诊撕裂的回顾显示，10例撕裂可回顾性观察到，其中6例为后角的纵向周边撕裂。
如果撕裂仅累及半月板的三分之一或位于后角，则外侧半月板撕裂更有可能被漏诊。后角的纵向周边撕裂是最常见的可回顾性观察到的漏诊撕裂。
