Muhammad Saqib, Muhammad Siraj, Shakir Ullah, Muhammad Ayaz Khan, Muhammad Imran Khan.
Diagnostic accuracy of joint line tenderness in medial meniscal tears using magnetic resonance imaging as gold standard.
Pak J Surg Jan ;31(4):242-7.

Introduction: Th e menisci are wedge-shaped, semilunar (C-shaped), fibrocartilage structures composed of thick collagen fibers primarily arranged circumferentially, with radial fibers extending from the capsule, between the circumferential fibers. Th e menisci cover 50% of the medial and 70% of the lateral surface of the tibial plateau. Typically, the medial meniscus is larger, has a wider posterior horn, and is more ‘‘open’’ toward the intercondylar notch, with the lateral meniscus typically smaller and more ‘‘closed’’ toward the notch. In adults, the vascularized area, commonly known as the ‘‘red zone,’’ involves the outer 10% to 30% of the meniscus. Objective: To determine the diagnostic accuracy of joint line tenderness in medial meniscal tears using magnetic resonance imaging as gold standard. Material and Methods: Th is study was conducted at Department of Orthopedics, Khyber Teaching Hospital, Peshawar. Study design was cross sectional (Validation) study. Duration of study was 6 months from 25 July 2013 to 24 January 2014 in which 147 patients were observed by using 60% sensitivity, 60% specifi city and 44% proportion of meniscal tears with 10% margin of error under WHO soft ware. More over non probability consecutive sampling was used for sample collection. Results: In this study 65% patients were in age range 20-30 years follow by 28% patients were in age range 31-40 years. Mean age was 30 years with SD ± 1.35. Ninety percent patients were male while 10% patients were female. Diagnostic accuracy of Joint Line Tenderness ( JLT) test was 77.55%, Sensitivity 76.59%, Specifi city 81.25%, Positive predictive value 97.11%, Negative predictive value 29.54%. Conclusion: Our study concluded that diagnostic accuracy of joint line tenderness ( JLT) test is 77.61%. Joint line tenderness ( JLT) test is a useful and important diagnostic technique as MRI to diagnose meniscal tears. We recommend the use of joint line tenderness ( JLT) test as well as MRI for more doubtful, diffi cult and complex knee injuries.

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