title: Magnetic resonance imaging in acute traumatic and chronic meniscal tears of the knee: a diagnostic accuracy study in young adults.
abstract: BACKGROUND
  No previous research has investigated the diagnostic validity of magnetic resonance imaging for acute versus chronic meniscal tears using comparable materials and methods.
  
  
  OBJECTIVE
  There is no difference in the diagnostic validity of magnetic resonance imaging for acute versus chronic meniscal tears in young adults.
  
  
  METHODS
  Cohort study (diagnosis); Level of evidence, 2.
  
  
  METHODS
  A total of 628 young adult military personnel underwent magnetic resonance imaging and arthroscopy of the knee over a 6-year period. Inclusion criteria were met by 82 patients with acute knee trauma (magnetic resonance imaging within 30 days from trauma) and 40 patients with chronic knee symptoms (symptoms lasting over 6 months before magnetic resonance imaging). The original magnetic resonance imaging and arthroscopy records were reviewed twice by a musculoskeletally trained radiologist, blinded to previous magnetic resonance imaging and arthroscopy findings. Interobserver correlations and intraobserver reliability were calculated and reported. Arthroscopy served as the gold standard when calculating the diagnostic values of magnetic resonance imaging for acute and chronic meniscal tears.
  
  
  RESULTS
  The median age of the patients was 20 years (range, 18-25). Magnetic resonance imaging detected acute meniscal tears with sensitivity of 67%, specificity of 93%, and diagnostic accuracy of 88% and chronic meniscal tears with 64%, 91%, and 86%, respectively. There was no statistically significant difference in magnetic resonance imaging results between the 2 groups.
  
  
  CONCLUSIONS
  The diagnostic validity of magnetic resonance imaging is similar for meniscal tears in acute knee trauma and in knee symptoms lasting over 6 months in young adults. The results also suggest that effusion or hemarthrosis do not weaken the diagnostic validity of magnetic resonance imaging. The magnetic resonance imaging sensitivity achieved in the present study was relatively poor, but the specificity was good for both acute and chronic meniscal tears. Despite negative magnetic resonance imaging findings at the acute stage of knee trauma, patient monitoring and readiness for arthroscopy should be considered if justified by the patient's symptoms.
authors.affiliation: Centre for Military Medicine, Research Unit, Helsinki, Finland. pikuikka@hytti.uku.fi
authors.forename: Paavo-Ilari
authors.initials: PI
authors.lastname: Kuikka
authors.forename: Petri
authors.initials: P
authors.lastname: Sillanpää
authors.forename: Ville M
authors.initials: VM
authors.lastname: Mattila
authors.forename: Maria H
authors.initials: MH
authors.lastname: Niva
authors.forename: Harri K
authors.initials: HK
authors.lastname: Pihlajamäki
mesh_terms: D000293:Adolescent; D000328:Adult; D001182:Arthroscopy; D005260:Female; D005387:Finland; D006801:Humans; D007718:Knee Injuries / Q000175:diagnosis; D008279:Magnetic Resonance Imaging; D008297:Male; D008592:Menisci, Tibial / Q000473:pathology*; D008889:Military Personnel; D012421:Rupture; D012680:Sensitivity and Specificity; D000070600:Tibial Meniscus Injuries; D055815:Young Adult