Wasilczyk Cezary
Medical Department, Wasilczyk Medical Clinic, ul. Kosiarzy 37/80, 02-953 Warszawa, Poland.
Diagnostics (Basel). 2023 Oct 20;13(20):3264. doi: 10.3390/diagnostics13203264.
(1) Introduction: Meniscal knee injuries may develop as the result of trauma or overloading. Ultrasound imaging is an observer-dependent modality, meaning that the assessment of structural damage depends on the investigator's experience.. None of the published papers provides a standardized method for ultrasound examination of knee menisci. The main goal of this study is to realize and standardize ultrasound imaging diagnostics of meniscal knee injuries based on individual features of ultrasound presentation and to evaluate the applicability of this modality in clinical practice. (2) Material and methods: This study consisted of two anatomical parts, including a clinical part that started with clinical examination of 50 patients with suspected meniscal knee injuries. After this we performed ultrasound examinations in patients with positive clinical test results, using sonographic confirmation for inclusion in the next stage. Finally, knee arthroscopy by two physicians in an operating room was performed, with procedures documented through photographs and video recordings, and analytic material obtained from patients in the control group documented similarly. (3) Results: In the clinical part of the study, arthroscopic examination revealed 13 longitudinal injuries (corresponding to 36% of all injuries in the group), 14 multidirectional injuries (corresponding to 28% of all injuries), 3 radial injuries (corresponding to 6% of all injuries), and 20 oblique injuries (corresponding to 40% of all injuries). The analysis of the sensitivity and specificity of the diagnostic test in terms of recognizing actual meniscal injuries on the basis of full-thickness or partial-thickness delamination, meniscal cyst oedema, and articular space stenosis revealed that the presence of at least two of these three characteristics was associated with the sensitivity of 88% and the specificity of 86% relative to the number of actual meniscal injuries as seen in arthroscopic examination. (4) Conclusions: Research results confirm that clinical examination combined with ultrasound imaging is a very efficient tool for evaluation of meniscal injuries.
(1) 引言：膝关节半月板损伤可能由创伤或过度负荷引起。超声成像依赖于观察者，这意味着对结构损伤的评估取决于研究者的经验。目前已发表的论文均未提供膝关节半月板超声检查的标准化方法。本研究的主要目的是基于超声表现的个体特征实现并标准化膝关节半月板损伤的超声成像诊断，并评估该方法在临床实践中的适用性。(2) 材料与方法：本研究包括两个解剖部分，其中临床部分始于对50例疑似膝关节半月板损伤患者的临床检查。之后，对临床检查结果呈阳性的患者进行超声检查，并通过超声确认纳入下一阶段。最后，由两名医生在手术室进行膝关节镜检查，手术过程通过照片和视频记录，对照组患者获取的分析材料也进行类似记录。(3) 结果：在研究的临床部分，关节镜检查发现13例纵向损伤（占该组所有损伤的36%）、14例多向损伤（占所有损伤的28%）、3例放射状损伤（占所有损伤的6%）和20例斜向损伤（占所有损伤的40%）。根据全层或部分层裂、半月板囊肿水肿和关节间隙狭窄来识别实际半月板损伤的诊断试验的敏感性和特异性分析表明，这三个特征中至少出现两个与关节镜检查中所见实际半月板损伤数量相比，敏感性为88%，特异性为86%。(4) 结论：研究结果证实，临床检查结合超声成像对于评估半月板损伤是一种非常有效的工具。
