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半月板前角损伤诊断

Meniscal Ramp Injury Diagnosis.

作者信息

Jorge Pedro Baches, Oliveira Diego Escudeiro de, Mussatto Guilherme do Amaral, Horita Melanie Mayumi, Salas Victor Eduardo Roman, Jorge Rafael Baches

机构信息

Irmandade da Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brasil.

出版信息

Rev Bras Ortop (Sao Paulo). 2024 Dec 7;59(5):e702-e706. doi: 10.1055/s-0044-1791791. eCollection 2024 Oct.

Abstract

: This study compared diagnostic methods for meniscal ramp injury (magnetic resonance imaging [MRI], arthrotomography, and arthroscopy) to determine the most sensitive and the agreement level between them.  We studied 21 patients, all young athletes with suspected anterior cruciate ligament (ACL) injury after trauma for at least 3 months and no evidence or history of other osteoarticular injuries in the knee. The patients underwent MRI and arthrotomography. Following ACL injury confirmation, they underwent arthroscopy for ligament reconstruction and evaluation of the medial meniscus to confirm or exclude a ramp injury. McNemar's agreement test compared the diagnostic methods. We also assessed specificity and sensitivity using arthroscopy as the gold standard with a 95% confidence interval and p < 0.005. : The results were consistent with the literature. MRI had 73.3% sensitivity and 83.3% specificity, with 76.2% agreement with the gold standard. Arthrotomography sensitivity and specificity were 100% and 66.7%, respectively, with 90.5% agreement with arthroscopy. : In our study, arthrotomography was the most sensitive diagnostic method and had the highest agreement with the gold standard. We recommend its consideration for diagnosing ACL injuries.

摘要

本研究比较了半月板斜行损伤的诊断方法(磁共振成像[MRI]、关节断层摄影术和关节镜检查),以确定最敏感的方法以及它们之间的一致性水平。

我们研究了21例患者,均为年轻运动员,外伤后疑似前交叉韧带(ACL)损伤至少3个月,且无膝关节其他骨关节损伤的证据或病史。患者接受了MRI和关节断层摄影术检查。在确认ACL损伤后,他们接受了关节镜检查以进行韧带重建和评估内侧半月板,以确认或排除斜行损伤。采用McNemar一致性检验比较诊断方法。我们还以关节镜检查为金标准,评估了特异性和敏感性,置信区间为95%,p<0.005。

结果与文献一致。MRI的敏感性为73.3%,特异性为83.3%,与金标准的一致性为76.2%。关节断层摄影术的敏感性和特异性分别为100%和66.7%,与关节镜检查的一致性为90.5%。

在我们的研究中,关节断层摄影术是最敏感的诊断方法,与金标准的一致性最高。我们建议在诊断ACL损伤时考虑使用该方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4e69/11624941/dab2ae7609da/10-1055-s-0044-1791791-i2200148en-1.jpg

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