Clinical, MRI, and arthroscopic findings associated with failure to diagnose a lateral meniscal tear on knee MRI
Clinical, MRI, and arthroscopic findings associated with failure to diagnose a lateral meniscal tear on knee MRI
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DOI：
10.2214/ajr.07.2611
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发表时间：
2008-01-01
影响因子：
5
通讯作者：
Mukherjee, Rajat
中科院分区：
文献类型：
--
作者：
De Smet, Arthur A.;Mukherjee, Rajat
客观的。我们进行这项研究是为了确定临床、MRI 或关节镜检查结果是否与遗漏的外侧半月板撕裂有关，以帮助了解为什么 MRI 会遗漏这些撕裂。 材料和方法。我们回顾了 483 名接受过膝关节 MRI 和关节镜检查的患者的医疗记录。我们评估了患者的年龄；自发性或外伤性膝关节疼痛；疼痛发作和 MRI 之间的间隔； MRI 和关节镜检查之间的间隔；以及关节镜下外侧半月板撕裂的类型、大小和位置，以了解其与漏诊的外侧半月板撕裂的关系。每次 MR 检查时都会对漏检的外侧半月板撕裂进行回顾，以确定是否可以在回顾时看到撕裂。 结果。在关节镜检查中发现的 189 例外侧半月板撕裂中，有 36 例未根据最初的 MR 解释进行诊断。错过的外侧撕裂与后角撕裂或仅涉及三分之一半月板的撕裂之间存在显着关联。错过的外侧半月板撕裂与其他变量之间没有关联。对 36 例漏检的泪液进行检查后发现，有 10 例泪液是可见的，其中 6 例是后角的纵向周边撕裂。结论。如果撕裂仅涉及半月板的三分之一或位于后角，则更可能错过外侧半月板撕裂。回想起来，后角的纵向周边撕裂是最常被遗漏的撕裂。
OBJECTIVE. We performed this study to determine whether clinical, MRI, or arthroscopic findings are associated with missed lateral meniscal tears to help understand why these tears are missed on MRI.MATERIALS AND METHODS. We reviewed the medical records of 483 patients who had undergone knee MRI and arthroscopy. We assessed patient age; spontaneous or traumatic onset of knee pain; interval between pain onset and MRI; interval between MRI and arthroscopy; and arthroscopic type, size, and location of lateral meniscal tear for their association with a missed lateral meniscal tear. Each MR examination with a missed lateral meniscal tear was reviewed to determine whether the tear could be seen in retrospect.RESULTS. Thirty-six of the 189 lateral meniscal tears found at arthroscopy were not diagnosed on the original MR interpretations. There was a significant association between a missed lateral tear and a posterior horn tear or a tear involving only one third of the meniscus. There was no association between a missed lateral meniscal tear and the other variables. Review of the 36 missed tears revealed that 10 tears were visible retrospectively, six of which were longitudinal peripheral tears in the posterior horn.CONCLUSION. Lateral meniscal tears are more likely to be missed if the tear involves only one third of the meniscus or is in the posterior horn. Longitudinal peripheral tears of the posterior horn were the most commonly missed tears that could be seen in retrospect.