DIAGNOSTIC ACCURACY OF MAGNETIC RESONANCE IMAGING FOR MENISCAL TEARS, TAKING ARTHROSCOPY AS THE GOLD STANDARD

Objective: To evaluate the accuracy of magnetic resonance imaging (MRI) in detecting meniscal injuries, with arthroscopy as the gold standard. Materials and Methods: We conducted this prospective observational study at Khyber Teaching Hospital from August 2024 to May 2025. A total of 263 adults, aged between 20 and 60 years, with symptoms suggestive of meniscal pathology, underwent MRI followed by arthroscopic confirmation. Diagnostic accuracy was evaluated using a 2×2 table to calculate diagnostic metrics for the medial and lateral meniscus separately. Statistical significance was assessed, and receiver operating characteristic (ROC) curves were constructed. Results: Of 263 patients, 76.8% were male; the average age was 30 ± 4.32 years. MRI detected meniscal tears in 65.0% of patients, while arthroscopy confirmed them in 73.4%. For medial meniscal injuries, MRI showed a sensitivity of 60.9%, specificity of 44.9%, PPV of 68.4%, NPV of 37.0%, and diagnostic accuracy of 55.5%. For lateral meniscal injuries, sensitivity was 55.6%, specificity 95.6%, positive predictive value 66.7%, negative predictive value 93.1%, and diagnostic accuracy 90.1%. ROC analysis indicated an area under the curve of 52.9% for medial and 75.6% for lateral meniscus tears. Conclusion MRI demonstrates greater diagnostic accuracy and specificity in detecting lateral meniscal tears compared to medial tears. Due to lower sensitivity and specificity for medial meniscal injuries, arthroscopy remains crucial for a definitive diagnosis, especially in symptomatic patients with negative or inconclusive MRI results. Keywords: Meniscal Injuries; Magnetic Resonance Imaging; Arthroscopy; Knee Joint; Diagnostic Accuracy; Sensitivity and Specificity; Medial Meniscus; Lateral Meniscus