Confirming the Presence of Unrecognized Meniscal Injuries on Magnetic Resonance Imaging in Pediatric and Adolescent Patients With Anterior Cruciate Ligament Tears
Autor: | Emily M. Clarke, Alana M. Munger, Natalya Sarkisova, Curtis VandenBerg, J. Lee Pace, Nicholas R. Gonsalves |
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Rok vydání: | 2019 |
Předmět: |
Joint Instability
Male medicine.medical_specialty Adolescent Knee Joint Patients Anterior cruciate ligament reconstruction Anterior cruciate ligament medicine.medical_treatment Knee Injuries Lacerations Menisci Tibial Sensitivity and Specificity Cohort Studies Arthroscopy 03 medical and health sciences symbols.namesake 0302 clinical medicine Prevalence medicine Humans Orthopedics and Sports Medicine Anterior Cruciate Ligament Child Fisher's exact test Retrospective Studies Rupture 030222 orthopedics Anterior Cruciate Ligament Reconstruction medicine.diagnostic_test business.industry Anterior Cruciate Ligament Injuries Data Collection Magnetic resonance imaging Retrospective cohort study General Medicine Los Angeles Magnetic Resonance Imaging Tibial Meniscus Injuries medicine.anatomical_structure Pediatrics Perinatology and Child Health symbols Tears Female Radiology business Algorithms Cohort study |
Zdroj: | Journal of Pediatric Orthopaedics. 39:e661-e667 |
ISSN: | 0271-6798 |
DOI: | 10.1097/bpo.0000000000001331 |
Popis: | BACKGROUND Prior research has shown decreased accuracy of meniscal injury detection using magnetic resonance imaging (MRI) for anterior cruciate ligament (ACL)-deficient adult patients as well as ACL-deficient pediatric and adolescent patients. The objectives of this study were the following: (1) assess the diagnostic ability of MRI in detecting meniscal injuries for pediatric and adolescent patients undergoing arthroscopic ACL reconstruction and (2) characterize the unrecognized meniscal injuries. METHODS The sensitivity, specificity, positive predictive value, and negative predictive value of meniscal tears (medial, lateral, or both) on MRI were calculated for the 107 patients in this cohort. Fisher exact tests were used to compare event frequencies between medial meniscal (MM) and lateral meniscal (LM) tears. One-way analysis of variance tests were performed to compare event rates between the location and type of unrecognized meniscal tears. RESULTS The median age of the cohort was 15 (range: 7 to 18). The sensitivity, specificity, positive predictive value, and negative predictive value of MRI in detecting meniscal tears (medial, lateral, or both) in ACL-deficient pediatric and adolescent patients was 62.3%, 68.4%, 78.2%, and 50.0%, respectively. There were 26 (24.3%) cases in which a meniscal injury was not detected on MRI, but was discovered arthroscopically (MM: 5 knees, LM: 20 knees, both: 1 knee). These unrecognized meniscal injuries were more commonly the LM than the MM (77.8%, P-value=0.100), a vertical/longitudinal tear type (77.8%, P-value |
Databáze: | OpenAIRE |
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