3-DIMENSIONAL SONOGRAPHY IN THE CLINICAL- DIAGNOSIS OF MENISCAL TEARS

Aim: To compare the significance of the two-dimensional and three-dime nsional sonography in the diagnostis of meniscal tears under clinical conditions. Methods: Sixty menisci of knees with clinical symptoms (44 medial and 16 lateral menisci) were examined by an identical transduc er in a two-and three-dimensional sonography technique. The findings w ere compared with the diagnosis made with subsequent arthroscopy. Resu lts: In the diagnosis of meniscal lesions the two-and three-dimensiona l sonography reached a sensitivity of 92% and 100% and a specificity o f 83% and 88%, respectively. The positive predictive value of these me thods was 58% and 67%. The negative predictive value was 98% and 100%. Because of the good results with the two-dimensional sonography, ther e were no statistically significant differences between both methods. The three-dimensional sonography, however, proved to be superior, to t he two-dimensional sonography in the analysis of subgroups (medial and lateral menisci, menisci with and without clinical symptoms). The neg ative predictive value of the three-dimensional sonography was 100% fo r all of these subgroups. Conclusion: Although this study shows no sig nificant difference in the results of two-and three-dimensional sonogr aphy, the analysis of subgroups displays a slightly improved significa nce for diagnosis of meniscal tears by three-dimensional sonography. T he high negative predictive value shows that three-dimensional sonogra phy, performed by an experienced examiner, may be useful to exclude me niscal tears. This result may help focus further cost-intensive or inv asive examinations.