Lu Xin, Qian Jun, Yang Bo, Li Zheng, Fan Yu, Jiang Bo
Department of Orthopaedic Surgery.
Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Medicine (Baltimore). 2020 Apr;99(14):e19646. doi: 10.1097/MD.0000000000019646.
Discoid lateral meniscus is one of the most common knee problems in clinical practice. Several radiographic findings have been reported to screen discoid lateral meniscus, but the diagnostic value of those signs varies.We introduce a new method of measurement on plain radiograph for initial screening discoid lateral meniscus and describe its efficacy and correlation to symptomatic discoid lateral meniscus.This is a retrospective case-control study.Seventy-eight arthroscopic proven symptomatic discoid lateral meniscus adult patients plus 73 patients of matched control group were retrospectively reviewed at our institution between 2012 and 2017. We studied their standardized non-weight-bearing knee radiograph anterior-posterior view and measured the following parameters: lateral joint space height, lateral tibia spine height, fibular head height, lateral tibia plateau obliquity (LTPO), and lateral condyle convex angle (LCCA).Significant statistical differences were found in the lateral joint space height, lateral tibia spine height, fibular head height, LTPO and LCCA measurements between the 2 groups (P < .05). Also, we found the phenomenon that angle parameters such as LTPO and LCCA had high sensitivities with relatively low specificities compared with height parameters.We propose that LCCA is a new measurement which is statistically larger in discoid meniscus patients. Furthermore, it can be useful for screening discoid lateral meniscus on plain radiograph with its relative high sensitivity.Level of Evidence: Level III, Case-control study.
盘状外侧半月板是临床实践中最常见的膝关节问题之一。已有多项影像学表现被报道用于筛查盘状外侧半月板，但这些征象的诊断价值各不相同。我们介绍一种在普通X线片上进行测量的新方法，用于初步筛查盘状外侧半月板，并描述其有效性以及与有症状的盘状外侧半月板的相关性。这是一项回顾性病例对照研究。2012年至2017年期间，我们在本机构对78例经关节镜证实有症状的盘状外侧半月板成年患者以及73例匹配的对照组患者进行了回顾性研究。我们研究了他们标准化的非负重膝关节前后位X线片，并测量了以下参数：外侧关节间隙高度、外侧胫骨棘高度、腓骨头高度、外侧胫骨平台倾斜度（LTPO）和外侧髁凸角（LCCA）。两组在外侧关节间隙高度、外侧胫骨棘高度、腓骨头高度、LTPO和LCCA测量值上存在显著统计学差异（P<0.05）。此外，我们发现与高度参数相比，LTPO和LCCA等角度参数具有较高的敏感性但特异性相对较低的现象。我们提出LCCA是一种新的测量方法，在盘状半月板患者中其统计学值更大。此外，它在普通X线片上筛查盘状外侧半月板时具有较高的敏感性，可能会很有用。证据级别：III级，病例对照研究。
