MRI vs. Clinical Examination for Diagnosing Meniscus Tears: A Review
Ryzewicz M, Peterson B, Siparsky PN, Bartz RL. The diagnosis of meniscus tears: the role of MRI and clinical examination. Clin Orthop. 2007;123–133.
Editorial Reviewer: Rick Corbett DC, FCCR(C), FCCO(C)
Published: June, 2009
Journal of the Academy of Chiropractic Orthopedists
June 2009, Volume 6, Issue 2
Received: 14 May 2009
Accepted: 3 March 2009
The original article copyright belongs to the original publisher. This review is available from: http://www.dcorthoacademy.com © 2009 Corbett and the Academy of Chiropractic Orthopedists. This is an Open Access article which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Objective: To determine whether a MRI should be routinely ordered before arthroscopy for clinically diagnosed meniscus tears, by means of a systematic review of the literature.
Data sources: PubMed and the Cochrane database were searched for studies in English that evaluated physical examination maneuvers and/or imaging studies for the diagnosis of meniscus tears in humans (1264 references).
Editorial Summary: For clinically diagnosed meniscal lesions.
- McMurray, Apley, Thessaly at 5° knee flexion, Ege test were of high specificity but low sensitivity;
- Joint line tenderness had lower specificity but higher sensitivity;
- Thessaly test at 20° flexion had both high specificity and sensitivity;
- Accuracy of clinical examination was reduced in presence of ligament injury or degenerative lesions;
- Experienced clinicians identified meniscus lesions requiring arthroscopic repair at least as well as MRI;
- An MRI should be considered prior to arthroscopic intervention for clinically diagnosed meniscal lesions only in the event that the clinical exam is equivocal.