Accuracy of Ultrasonography in Comparison with Magnetic Resonance Imaging to Detect Meniscal Tears in Knee Injuries
DOI:
https://doi.org/10.54112/bcsrj.v6i6.2017Keywords:
Ultrasonography; Meniscal Tear; Knee Injury; Magnetic Resonance Imaging; Diagnostic Accuracy; Sensitivity; Specificity; ROC CurveAbstract
Meniscal tears are common in active adults, and timely imaging guides triage to conservative care or arthroscopy. While MRI is the reference standard, ultrasonography (US) offers a low-cost, accessible alternative. Objective: To determine the diagnostic accuracy of high-resolution US for detecting meniscal tears using MRI as the reference standard. Methods: We conducted a cross-sectional diagnostic-accuracy study of 304 participants (mean age 29.9 ± 7.57 years; 61% male). At radiology department of JPMC karachi from 1st August 2024 till 31st January 2025.All underwent standardized knee US followed by MRI. Meniscal tear status on US was compared with MRI using 2×2 tables to compute sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall accuracy. Discrimination was assessed with receiver operating characteristic (ROC) analysis. Results: US identified tears in 207/304 (68.1%), while MRI showed tears in 222/304 (73.0%). Cross-tabulation yielded 193 true positives, 14 false positives, 68 true negatives, and 29 false negatives. Using MRI as reference, US achieved sensitivity 86.9%, specificity 82.9%, PPV 93.2%, NPV 70.1%, and accuracy 85.9%. ROC analysis demonstrated AUC 0.847 with p < 0.0001, indicating good overall discrimination. Conclusion: High-resolution ultrasonography showed good diagnostic performance versus MRI, with particularly strong rule-in value given its high PPV. In resource-constrained or high-throughput settings, US can function as an effective first-line triage tool, reserving MRI for equivocal cases or when clinical suspicion persists after a negative US.
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Copyright (c) 2025 Anam Riaz, Sumera Tabassum, Shazia Kadri, Maria Riaz, Sanjna Motwani, Kinza Ayyaz
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