The arthrogram in diagnosis of meniscal lesions in the fourth decade of life.

Forty-nine patients older than 35 years of age (mean, 45 years) undergoing arthrotomy for clinically diagnosed meniscal tears had preoperative double-contrast arthrograms. Fifty of 53 meniscii were visualized as torn and treated by surgical excision. At the time of operation the incidence of transverse tears was high (34%). In only 72% of cases was there complete correlation between the preoperative arthrographic diagnosis and the definitive surgical diagnosis. This diagnostic disparity was most marked on the lateral side (53% correlation) and unrelated to the high incidence of transverse tears (66% correlation). In this age group, arthrography is not a reliable indicator to the diagnosis of torn meniscii.