title: Usefulness of knee arthroscopy for diagnosis of knee pain in pediatric patients: comparison with preoperative clinical diagnosis.
abstract: OBJECTIVE
  To investigate the knee arthroscopic findings of pediatric patients with knee pain.
  
  
  METHODS
  Ninety-five knees of 94 patients (46 males and 48 females) aged 15 years or younger who underwent knee arthroscopy during a 4-year period from January 2007 were studied. The mean age at surgery was 13.5 (7-15) years. The mean interval from symptom onset to arthroscopic examination was 6.8 months (5 days to 2 years 10 months).
  
  
  RESULTS
  The most common cause of knee pain was sports-related activities (64 knees). Other causes included falling from a moving bicycle (5 knees), while knee pain appeared with no defined reason in 14 knees. The most frequent final diagnosis based on knee arthroscopic findings was anterior cruciate ligament (ACL) injury (35 knees), followed by discoid lateral meniscus (16 knees), lateral meniscal tear (11 knees), and medial plica syndrome (9 knees), while no arthroscopic abnormality was observed in 8 of 95 knees. Among the 95 knees, the diagnosis based on preoperative physical tests and imaging findings was different from the arthroscopic diagnosis in 16 knees, 8 of which were diagnosed preoperatively as medial meniscal tear.
  
  
  CONCLUSIONS
  ACL injury and discoid lateral meniscus were the predominant conditions in pediatric patients who underwent knee arthroscopic surgery for knee pain. Knee arthroscopy is useful to provide a definitive diagnosis for knee pain in pediatric patients. Preoperative evaluations had a diagnostic accuracy of only 83.2 % and failed to diagnose conditions such as medial plica syndrome and chondral injury. Therefore, diagnosis before knee arthroscopy has to be interpreted with caution.
authors.affiliation: Sports Medicine and Knee Center, National Hospital Organization, Kofu National Hospital, 11-35 Tenjin-cho, Kofu, Yamanashi, Japan. tmhagino@amber.plala.or.jp.
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Hagino
authors.forename: Satoshi
authors.initials: S
authors.lastname: Ochiai
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Watanabe
authors.forename: Shinya
authors.initials: S
authors.lastname: Senga
authors.forename: Masanori
authors.initials: M
authors.lastname: Saito
authors.forename: Masanori
authors.initials: M
authors.lastname: Wako
authors.forename: Takashi
authors.initials: T
authors.lastname: Ando
authors.forename: Eiichi
authors.initials: E
authors.lastname: Sato
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Haro
mesh_terms: D000293:Adolescent; D018771:Arthralgia / Q000209:etiology* / Q000601:surgery; D001182:Arthroscopy; D002648:Child; D005260:Female; D006801:Humans; D007592:Joint Diseases / Q000175:diagnosis*; D007718:Knee Injuries / Q000175:diagnosis* / Q000601:surgery; D007719:Knee Joint / Q000601:surgery*; D008297:Male; D057234:Preoperative Period