The Value of Clinical Examination and Mri versus Intraoperative Findings in the Diagnosis of Meniscal Tears

The aim of this study was to compare the accuracy of the clinical examination and magnetic resonance imaging versus intraoperative findings in meniscal tears. We evaluated 400 patients retrospectively in a 5-year period from 2001–2006 with knee pain and diagnosed with a meniscal tear. Accuracy, sensitivity, specificity, and positive/negative predictive values were established, comparing the clinical results and the results of MRI with the intraoperative findings as the “gold standard”. The clinical examination produced less true-positive results compared to the MRI, false-positive results were less in MRI compared to the clinical examination. The rate of true-negative results was higher in MRI compared to the clinical diagnosis, false-negative results could be found frequently in clinical diagnosis compared to the MRI. Comparing the results of the MRI with arthroscopic findings it is obvious that the accuracy, specificity, sensitivity, and the positive and negative predictive values are higher than in the group of the clinical examination versus arthroscopic results. These results indicate that an MRI is necessary to complete an exact clinical diagnosis in meniscus tears, but surgery should only follow an MRI, when positive clinical symptoms have been exactly identified. K e y w o r d s Meniscus tear, Clinical diagnosis, MRI, Intraoperative findings, Arthroscopic knee joint surgery