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
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