Ahmadi Omid, Heydari Farhad, Golshani Keihan, Derakhshan Sirous
Department of Emergency Medicine, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Arch Acad Emerg Med. 2022 Jun 9;10(1):e47. doi: 10.22037/aaem.v10i1.1480. eCollection 2022.
The use of point-of-care ultrasonography (POCUS) for identifying medial collateral ligament (MCL) tears has increased in recent years. This study aimed to evaluate the diagnostic accuracy of POCUS in the diagnosis of acute MCL tears of the knee.
This prospective cross-sectional study was performed on patients with suspected MCL tear of the knee in the emergency department (ED). After history taking and primary physical examination, radiographic imaging of the knee was done. If there was no fracture in the knee X-ray, the POCUS examination was done. All of the patients were asked to refer to an orthopedic clinic, 7-10 days after discharge from ED, for Magnetic Resonance Imaging (MRI) evaluation. The second POCUS was done in the orthopedic clinic. Finally, the findings of POCUS and MRI were compared in diagnosing MCL injury.
Two hundred and fifty patients with a mean age of 25.05 ± 9.12 years were analyzed (86.8% male). According to the MRI findings, as the gold standard, 55(22.0%) patients had MCL injury. The sensitivity, specificity, positive and negative predictive values (PPV and NPV), and accuracy of ultrasound in detection of MCL injury, in comparison with MRI were 83.64 (95% CI, 71.20 to 92.23), 94.36% (95% CI, 90.13 to 97.15), 80.70% (95% CI, 69.95 to 88.25), 95.34% (95% CI, 91.83 to 97.38), and 92.00% (95% CI, 87.92 to 95.05), respectively. The area under the receiver operating characteristic (ROC) curve of POCUS was 0.890 (95% CI, 0.844 to 0.926).
It seems that POCUS can be applied in screening patients with MCL tears following blunt knee trauma.
近年来，床旁超声检查（POCUS）在识别内侧副韧带（MCL）撕裂方面的应用有所增加。本研究旨在评估POCUS对诊断膝关节急性MCL撕裂的诊断准确性。
对急诊科疑似膝关节MCL撕裂的患者进行了这项前瞻性横断面研究。在进行病史采集和初步体格检查后，对膝关节进行了影像学检查。如果膝关节X线片未发现骨折，则进行POCUS检查。所有患者在从急诊科出院7 - 10天后被要求前往骨科门诊进行磁共振成像（MRI）评估。在骨科门诊进行了第二次POCUS检查。最后，比较了POCUS和MRI在诊断MCL损伤方面的结果。
分析了250例平均年龄为25.05±9.12岁的患者（86.8%为男性）。以MRI结果作为金标准，55例（22.0%）患者存在MCL损伤。与MRI相比，超声检测MCL损伤的敏感性、特异性、阳性和阴性预测值（PPV和NPV）以及准确性分别为83.64（95%CI，71.20至92.23）、94.36%（95%CI，90.13至97.15）、80.70%（95%CI，69.95至88.25）、95.34%（95%CI，91.83至97.38）和92.00%（95%CI，87.92至95.05）。POCUS的受试者操作特征（ROC）曲线下面积为0.890（95%CI，0.844至0.926）。
似乎POCUS可用于筛查膝关节钝性创伤后MCL撕裂的患者。
