The Predictive Value of Point-of-care Ultrasonography versus MRI in Assessing Medial Meniscal Tears in Patients with Acute Knee Injury.

Background:Musculoskeletal ultrasound is increasingly used as the modality of choice in diagnosing many medical situations. The present study aimed to compare the efficacy of point-of-care ultrasonography (POCUS) and magnetic resonance imaging (MRI) to detect acute medial meniscus knee tears. Materials and methods:The prospective study was conducted on patients with a suspected medial meniscus knee tear in the emergency department (ED). In the absence of a knee fracture in the X-ray, POCUS on the knee was done. All patients underwent POCUS and MRI of the knee followed by arthroscopy. POCUS findings were then compared to MRI findings to diagnose medial meniscus tear. Results:Finally, 157 patients with a mean age of 25.04±7.41 years were included. 94 (59.9%) of patients were male. Medial meniscus tears were detected in 89 patients (56.7%) using arthroscopy as the gold standard. The sensitivity, specificity, positive and negative predictive values (PPV and NPV), and accuracy of POCUS to detect medial meniscus tear were 88.8 [95% confidence interval (CI), 80.3 to 94.5], 89.7% [95% CI, 79.9 to 95.8], 91.9% [95% CI, 84.8 to 95.8], 85.9% [95% CI, 77.2 to 91.7], and 89.2% [95% CI, 83.3 to 93.6]. The diagnostic accuracy of MRI to detect medial meniscus injury was 93.0% [95% CI, 87.8 to 96.4). Conclusion:The present study demonstrated that POCUS is an accurate and reliable diagnostic tool alternative to MRI in detecting medial meniscal tears. POCUS had acceptable sensitivity, specificity, and accuracy in detecting meniscal injuries. Therefore, POCUS could be performed as an effective immediate investigation to guide further modalities in patients with acute knee trauma.