Ahmadi Omid, Motififard Mehdi, Heydari Farhad, Hatami Saeed, Meibody Azita Azimi
Department of Emergency Medicine, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Department of Orthopedic Surgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Clin Exp Emerg Med. 2024 Jun;11(2):188-194. doi: 10.15441/ceem.23.111. Epub 2024 Jan 29.
Musculoskeletal ultrasound is increasingly used as the modality of choice in diagnosing many medical situations. The present study aimed to compare the accuracy of point-of-care ultrasonography (POCUS) and magnetic resonance imaging (MRI) to detect acute medial meniscus tears in knee.
The prospective study was conducted on patients with suspected medial meniscus tears in knee. in the emergency department. In the absence of a knee fracture on x-ray, POCUS on the knee was performed. All patients underwent POCUS and MRI of the knee followed by arthroscopy. POCUS findings were then compared to MRI findings to diagnose medial meniscus tears.
A final total of 157 patients with a mean age of 25.04±7.41 years was included. Out of 157 patients, 94 (59.9%) were male. Medial meniscus tears were detected in 89 patients (56.7%) using arthroscopy as the gold standard. The sensitivity, specificity, positive and negative predictive values, and accuracy of POCUS to detect medial meniscus tears were 88.8% (95% confidence interval [CI], 80.3%-94.5%), 89.7% (95% CI, 79.9%-95.8%), 91.9% (95% CI, 84.8%-95.8%), 85.9% (95% CI, 77.2%-91.7%), and 89.2% (95% CI, 83.3%-93.6%), respectively. The diagnostic accuracy of MRI to detect medial meniscus injury was 93.0% (95% CI, 87.8%- 96.4%).
The present study demonstrated that POCUS is an accurate and reliable diagnostic tool alternative to MRI in detecting medial meniscal tears. POCUS had acceptable sensitivity, specificity, and accuracy in detecting meniscal injuries and could be performed as an effective immediate investigation to guide further modalities in patients with acute knee trauma.
肌肉骨骼超声在许多医疗情况的诊断中越来越多地被用作首选方式。本研究旨在比较床旁超声检查（POCUS）和磁共振成像（MRI）检测膝关节急性内侧半月板撕裂的准确性。
对急诊科疑似膝关节内侧半月板撕裂的患者进行前瞻性研究。在X线检查未发现膝关节骨折的情况下，对膝关节进行POCUS检查。所有患者均接受膝关节的POCUS和MRI检查，随后进行关节镜检查。然后将POCUS检查结果与MRI检查结果进行比较，以诊断内侧半月板撕裂。
最终共纳入157例患者，平均年龄为25.04±7.41岁。在157例患者中，94例（59.9%）为男性。以关节镜检查为金标准，89例患者（56.7%）检测到内侧半月板撕裂。POCUS检测内侧半月板撕裂的敏感性、特异性、阳性和阴性预测值以及准确性分别为88.8%（95%置信区间[CI]，80.3%-94.5%）、89.7%（95%CI，79.9%-95.8%）、91.9%（95%CI，84.8%-95.8%）、85.9%（95%CI，77.2%-91.7%）和89.2%（95%CI，83.3%-93.6%）。MRI检测内侧半月板损伤的诊断准确性为93.0%（95%CI，87.8%-96.4%）。
本研究表明，POCUS是一种在检测内侧半月板撕裂方面准确且可靠的诊断工具，可替代MRI。POCUS在检测半月板损伤方面具有可接受的敏感性、特异性和准确性，可作为一种有效的即时检查，用于指导急性膝关节创伤患者的进一步检查方式。
