A prospective comparison of clinical examination, MRI, bone SPECT, and arthroscopy to detect meniscal tears

Recent studies have shown that SPECT bone scintigraphy is valuable to detec t meniscal tears of the knee. This has not been formally assessed in a pros pective study, and no substantive study has compared bone SPECT with other noninvasive diagnostic methods. One hundred consecutive patients referred t o an orthopedic surgeon with undiagnosed knee pain were assessed by clinica l examination, MRI, SPECT bone scintigraphy, and arthroscopy, The MRI and S PECT bone scan findings were reported blinded to other information, Using a rthroscopy as a gold standard, both MRI and SPECT showed high diagnostic ab ility to detect meniscal tears, with respective sensitivity rate, specifici ty rates, and positive and negative predictive accuracies of 80%, 71%, 84%, and 71% for MRI and 84%, 80%, 88%, and 76% for SPECT. Some meniscal tears were detected by MRI alone (n = 5) or SPECT alone (n = 8), SPECT bone scint igraphy is a suitable alternative to MRI to detect meniscal tears. The comp arable diagnostic ability of SPECT bone scintigraphy implies that it can be used successfully when MRI is unavailable or unsuitable.