Daniel D, Daniels E, Aronson D
Clin Orthop Relat Res. 1982 Mar(163):218-24.
A study of 281 patients evaluated for a meniscus pathologic condition was performed to assess the accuracy of the clinical diagnosis and arthrogram and delineate the role of arthroscopy. Following the clinical examination, the surgeon stated his level of confidence in his diagnosis, as did the radiologist in his interpretation of the arthrogram. In 134 cases inspected by arthroscopy or arthrotomy, the clinician proved to be correct 74% of the time, and the arthrogram accuracy in evaluating the medial meniscus was 89%; the majority of the errors were false positive diagnoses. In the 82 meniscus tears in which an arthrogram was performed the diagnosis was made in 80 cases, or 98%. The arthrogram accuracy in the lateral compartment was 81%; however, of the 31 lateral meniscus tears in which an arthrogram was performed, a positive diagnosis was yielded by arthrogram in only ten cases. In 34 lateral meniscus tears, a positive clinical diagnosis was made in only 12 cases. Arthroscopy was performed in 117 cases and proved helpful in patient management in 65 cases (55%). Arthroscopy was performed in 25 patients with lateral meniscus tears and a diagnosis of a lateral meniscus tear was made in all cases. The observations suggest that prior to performing an arthrotomy, arthroscopic examination of the knee should be performed routinely in patients suspected of having meniscus tears.
对281例因半月板病理状况接受评估的患者进行了一项研究，以评估临床诊断和关节造影的准确性，并明确关节镜检查的作用。临床检查后，外科医生表明了他对诊断的信心程度，放射科医生也表明了他对关节造影解读的信心程度。在134例通过关节镜检查或切开手术检查的病例中，临床医生的诊断在74%的情况下被证明是正确的，关节造影评估内侧半月板的准确性为89%；大多数错误是假阳性诊断。在82例进行了关节造影的半月板撕裂病例中，有80例（98%）做出了诊断。关节造影评估外侧半月板的准确性为81%；然而，在31例进行了关节造影的外侧半月板撕裂病例中，关节造影仅在10例中得出阳性诊断。在34例外侧半月板撕裂病例中，只有12例做出了阳性临床诊断。对117例患者进行了关节镜检查，其中65例（55%）证明对患者管理有帮助。对25例外侧半月板撕裂患者进行了关节镜检查，所有病例均诊断为外侧半月板撕裂。这些观察结果表明，在进行切开手术之前，对于疑似半月板撕裂的患者，应常规进行膝关节镜检查。
