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The Journal of Bone and Joint Surgery, Vol 61, Issue 3 343-346, Copyright © 1979 by Journal of Bone and Joint Surgery, Inc
Precision in the diagnosis of meniscal lesions: a comparison of clinical evaluation, arthrography, and arthroscopy
H Gillies and D Seligson
We assessed the accuracy of clinical evaluation, arthrography, and
arthroscopy in the diagnosis of meniscal lesions in fifty knees in which
arthrotomy was performed for disabling symptoms after evaluation by these
three methods. At surgery, forty-seven menisci were removed, of which
forty-four were abnormal and three were normal. In three patients with
normal menisci, loose bodies were found in two and the exploration was
negative in one. In the forty-four knees with a meniscal lesion, a correct
diagnosis was made clinically forty time, arthrographically thirty-nine
times, and arthroscopically thirty-two times. Most errors occurred in the
knees with posterior horn lesions of the medial meniscus. Clinical
diagnosis was least accurate for lesions of the lateral meniscus (four
missed) and arthroscopy was least accurate for lesions of the posterior
horn of the medial meniscus (ten missed). Arthrography appeared to provide
collateral evidence of lesions not seen directly. Based on this study it
was concluded that even with negative findings by arthroscopy and
arthrography it still may be necessary occasionally to remove a meniscus on
the basis of the clinical evaluation.
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