Diagnostic Accuracy of Magnetic Resonance Imaging for the Assessment of Meniscal Tears Using Arthroscopic Findings as the Gold Standard
DOI:
https://doi.org/10.52206/jsmc.2026.16.1.1358Abstract
Background: Meniscal injuries are a frequent consequence of knee trauma and represent a common cause of pain, instability, and functional limitation. Accurate diagnosis is essential for appropriate surgical planning. Although arthroscopy remains the gold standard for detecting meniscal pathology, it is an invasive procedure. Magnetic resonance imaging (MRI) offers a non-invasive alternative with high diagnostic potential for evaluating meniscal and ligamentous injuries of the knee.
Objective: To determine the diagnostic accuracy of magnetic resonance imaging in the detection of meniscal tears, using arthroscopic findings as the gold standard.
Methodology: This prospective diagnostic accuracy study was conducted in the Diagnostic Radiology Department of Children’s Hospital and The Institute of Child Health, Multan, over a six-month period. A total of 200 patients aged 14–55 years with clinical suspicion of meniscal tear underwent knee MRI followed by arthroscopy. MRI examinations were performed using a 1.5-Tesla scanner and interpreted by a consultant radiologist. Arthroscopic evaluation was carried out by a single consultant orthopedic surgeon blinded to MRI findings. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall diagnostic accuracy of MRI were calculated using arthroscopy as the reference standard.
Results: The median age of participants was 30 years, and 58.5% were male. MRI detected medial and lateral meniscal tears in 46.5% and 22% of patients, respectively, while arthroscopy identified tears in 55% and 27%. For medial meniscal tears, MRI demonstrated a sensitivity of 84.6%, specificity of 100%, PPV of 100%, NPV of 84.1%, and accuracy of 91.5%. For lateral meniscal tears, sensitivity was 79.6%, specificity 99.3%, PPV 97.7%, NPV 92.9%, and accuracy 94%.
Conclusion: Magnetic resonance imaging demonstrated good diagnostic accuracy for both medial and lateral meniscal tears, with excellent specificity and positive predictive value, particularly for medial meniscal injuries. These findings support the use of MRI as a reliable, non-invasive diagnostic tool prior to arthroscopy.
Keywords: Arthroscopy, Diagnostic Accuracy, Knee Injury, Magnetic Resonance Imaging, Meniscal Tears.
References
Singh AK, Gattani CM, Kumar M, Singh R. To examine the reliability and validity of diagnosing a knee injury using magnetic resonance imaging. Int J Diagn Imaging. 2022;5(4):55-58. http://dx.doi.org/10.33545/26644436.2022.v5.i4a.287
Li X, Hou Q, Zhan X, Chang L, Ma X, Yuan H. The accuracy of MRI in diagnosing and classifying acute traumatic multiple ligament knee injuries. BMC Musculoskelet Disord. 2022;23:43. https://doi.org/10.1186/s12891-021-04976-1
Sanjay N, Shanthappa AH, Kurahatti A, Kumaar A. Comparison of clinical, magnetic resonance imaging (MRI) and arthroscopic findings in assessment of cartilage defects and internal derangement of knee. Cureus. 2023;15(6):e40110. https://doi.org/10.7759/cureus.40110
Zhang ZY, Wang C, Maimaitimin M, Huang HJ, Pan XY, Maimaitijiang P, et al. Anterior and rotational tibial subluxation in the setting of anterior cruciate ligament injuries: an MRI analysis. Knee. 2021;33:365-373. https://doi.org/10.1016/j.knee.2021.10.012
Siouras A, Moustakidis S, Giannakidis A, Chalatsis G, Liampas I, Vlychou M,et al. Knee injury detection using deep learning on MRI studies: a systematic review. Diagnostics. 2022;12(2):537. https://doi.org/10.3390/diagnostics12020537
Shantanu K, Singh S, Srivastava S, Saroj AK, Saroj Sr AK. The validation of clinical examination and MRI as a diagnostic tool for cruciate ligaments and meniscus injuries of the knee against diagnostic arthroscopy. Cureus. 2021;13(6):e15727. https://doi.org/10.7759/cureus.15727
Kinugasa T, Mutsuzaki H, Taniguchi Y, Sato Y, Watanabe A, Ikeda K. Utility of axial magnetic resonance images for detecting meniscal ramp lesions associated with anterior cruciate ligament injuries. Asia Pac J Sports Med Arthrosc Rehabil Technol. 2022;30:32-35. https://doi.org/10.1016/j.asmart.2022.09.001
Shahrukh Q, Khan OS, Azim Q, Mufti AJ, Askar Z. Diagnostic accuracy of plain magnetic resonance imaging of cruciate ligaments and meniscal injuries keeping arthroscopy as gold standard. Khyber Med Univ J. 2023;15(1):44-48. https://doi.org/10.35845/kmuj.2023.21908
Yaqoob J, Alam MS, Khalid N. Diagnostic accuracy of magnetic resonance imaging in assessment of meniscal and ACL tear: correlation with arthroscopy. Pak J Med Sci. 2015;31(2):263-268. https://doi.org/10.12669/pjms.312.6499
Ciliberti FK, Guerrini L, Gunnarsson AE, Recenti M, Jacob D, Cangiano V, et al. CT-and MRI-based 3D reconstruction of knee joint to assess cartilage and bone. Diagnostics. 2022;12(2):279. https://doi.org/10.3390/diagnostics1202027
Chou YT, Lin CT, Chang TA, Wu YL, Yu CE, Ho TY, et al. Development of artificial intelligence-based clinical decision support system for diagnosis of meniscal injury using magnetic resonance images. Biomed Signal Process Control. 2023;82:104523. https://doi.org/10.1016/j.bspc.2022.104523
Leland DP, Pareek A, Therrien E, Wilbur RR, Stuart MJ, Krych AJ, et al. Neurological complications following arthroscopic and related sports surgery: prevention, work-up, and treatment. Sports Med Arthrosc Rev. 2022;30(1):e1-8. https://doi.org/10.1097/JSA.0000000000000322
Razvi SM, Nayak AR, Kenganal PB, Bagewadi RM, Kulkarni S, Hublikar AA, et al. Comparing the diagnostic accuracy of magnetic resonance imaging and arthroscopy in ligamentous knee injuries. Int J Acad Med Pharm. 2023;5(3):1369-1374. https://doi.org/10.47009/jamp.2023.5.3.278
Kodi A, Rao SV. A study on correlation of MRI with arthoscopic findings in evaluation of meniscal and cruciate ligament injuries in traumatic knee joint. Int J Med Pharm Res. 2024;5(3):131-137. Available from: https://ijmpr.in/article/a-study-on-correlation-of-mri-with-arthoscopic-findings-in-evaluation-of-meniscal-and-cruciate-ligament-injuries-in-traumatic-knee-joint-576/
Shetty C, Rathod G, Raut N, Borole P, Gawali V. Co-relation between magnetic resonance imaging and arthroscopy findings in diagnosis of meniscus injuries based on location of the meniscus tear and radial position. Int Surg J. 2022;9(3):612-615. https://dx.doi.org/10.18203/2349-2902.isj20220630
Jhonatan FY, Li K, Chen J, Zhou L, Yang H, Huang L, et al. The diagnostic accuracy of different MRI sequences for different meniscus lesions: a meta-analysis. Curr Med Imaging Rev. 2023;19(11):1245-1257. https://doi.org/10.2174/1573405619666221223090050
Bhavani HG, Furtado R, Linyu V, Akami K, Naik S. Evaluation of ligament and meniscal injuries following knee trauma by MRI and its correlation with arthroscopy. J Med Sci Res. 2024;12(2):148-152. http://dx.doi.org/10.17727/JMSR.2024/12-28
Nasa A, Ahmed MA, Sasnur PA. Role of MRI in evaluation of knee joint injuries and its correlation with arthroscopic findings. Int J Radiol Res. 2024;6(2):56-61. Available from: https://radiologyjournal.in/assets/archives/2024/vol6issue2/6020.pdf
Prasad PS, Kaja A, Rao MH. Correlation between clinical findings MRI and arthoscopic findings in anterior cruciate ligament and meniscal injuries of the knee. Res J Med Sci. 2024;18(11):562-566. http://dx.doi.org/10.36478/makrjms.2024.11.562.566
Koch JEJ, Ben-Elyahu R, Khateeb B, Ringart M, Nyska M, Ohana N, et al. Accuracy measures of 1.5-tesla MRI for the diagnosis of ACL, meniscus and articular knee cartilage damage and characteristics of false negative lesions: a level III prognostic study. BMC Musculoskelet Disord. 2021;22(1):124. https://doi.org/10.1186/s12891-021-04011-3
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