Diagnostic Performance of Musculoskeletal Ultrasound Compared with MRI in the Evaluation of Knee Joint Pathologies
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Keywords
pathologies, deep intra-articular, patient, meniscal tears, knee pathologies
Abstract
Background: The study investigates the diagnostic performance of musculoskeletal ultrasound (MSUS) compared to magnetic resonance imaging (MRI) for evaluating knee joint pathologies. Given the knee's complexity and its significance in weight-bearing activities, accurate imaging is crucial for diagnosing conditions such as ligament tears, meniscal injuries, and degenerative changes. While MRI is regarded as the gold standard due to its superior soft-tissue contrast and comprehensive visualization capabilities, it is hampered by accessibility issues, high costs, and patient-specific contraindications. MSUS presents a promising alternative due to its lower cost, wide availability, real-time imaging, and capability to detect conditions like joint effusions and tendon disorders effectively.
Materials and Methods: This prospective cross-sectional study at a tertiary care hospital included 86 patients symptomatic of knee pathologies, evaluated through both MSUS and MRI to establish a reference standard for comparison. The study found that MRI identified a total of 112 knee abnormalities, predominantly joint effusion (44.2%), meniscal tears (33.7%), and anterior cruciate ligament (ACL) injuries (20.9%). MSUS showed high sensitivity (84.6%) and specificity (92.8%), especially in identifying superficial structures, with notable diagnostic accuracy (89.5%).
Results indicated good concordance between MSUS and MRI for conditions like joint effusions and tendon abnormalities; however, ultrasound's performance was less reliable for deep intra-articular pathologies, such as meniscal and cruciate ligament injuries. The study's findings reaffirm the clinical role of MSUS as a reliable, cost-effective, and non-invasive first-line imaging tool, particularly beneficial for patients with superficial pathologies.
Conclusion: Despite its effectiveness, the limitations of the study include its single-center design and relatively small patient cohort, warranting further multicentric research to validate and potentially standardize ultrasound protocols for knee imaging. Overall, while MSUS can efficiently assess many common knee disorders, MRI remains superior for intricate evaluations of deep joint structures. Further studies are necessary to enhance the clinical application of MSUS in knee pathologies and improve patient management outcomes.
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