[Comparison of clinical examination with NMR spectroscopy in the diagnosis of meniscal lesions in daily practice].
BACKGROUND
We investigated the value of Magnetic Resonance Imaging compared to the clinical examination for meniscal lesions.


METHODS
From 1991 to 1995 we did arthroscopic evaluation at 824 patients with the diagnose "meniscal lesion". 73 of them had an MRI-examination elsewhere before surgery.


RESULTS
During arthroscopy we found 473 lesions of the medial meniscus and 160 of the lateral meniscus. The MRI-examination had an accuracy of 70% for the medial meniscus (sensitivity 79%, specificity 63%, positive predictive value 64%, negative predictive value 78%) and 78% for the lateral meniscus (sensitivity 50%, specificity 86%, positive predictive value 50%, negative predictive value 86%). The clinical examination had an accuracy of 73% for the medial meniscus (sensitivity 98%, specificity 39%, positive predictive value 69%, negative predictive value 88%) and 87% for the lateral meniscus (sensitivity 67%, specificity 92%, positive predictive value 65%, negative predictive value 93%).


CONCLUSIONS
We conclude, that by an experienced examiner a meniscal lesion can be diagnosed adequately by clinical examination alone. The different radiologists who did the MRI examination in our study belong to different outward departments and used different apparatus with sometimes insufficient quality of the pictures. Therefore the sensitivity and specificity of the MRI for meniscal lesions is markedly lower than in other studies of departments where a close cooperation between the radiologist and the orthopedic surgeon is performed.
D001182:Arthroscopy; D006801:Humans; D007718:Knee Injuries / Q000175:diagnosis* / Q000601:surgery; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008592:Menisci, Tibial / Q000473:pathology* / Q000601:surgery; D011300:Preoperative Care; D015203:Reproducibility of Results