The Diagnostic Value of Sonography in Bucket Handle Tear of Meniscus and Complete MCL Tear Compared with Arthroscopy

Background/ The concept of evaluating the musculoskeletal system with ultrasound was initially introduced in the late 1970s. For evaluating meniscal tears, which are a common injury in traumatic events of knee, linear probes with high resolution have been used. In this study, we compared the results of sonography with arthroscopy in diagnosing bucket handle tear of meniscus and MCL tear. Patients and 218 clinically symptomatic knee joints with clinical indication of arthro-scopy were examined by sonography in a referral sport medicine center. The patients eventually had arthroscopic exam. The results were compared, and statistically analyzed using Fisher’s exact. In this study, of 218 patient who had arthroscopy and sonography, the sensitivity and specificity of sonography in meniscal tear were 68.1% and 100%, respectively. 34 patients had bucket handle tear of the posterior horn of the medial meniscus on sonography; six cases (17.6%) of which had abnormally small posterior horns of medial meniscus (in favor of meniscal tear) but in 60 patients with other types of meniscal tear, sonography revealed tear in 58 (96.6%)(P<0.0001). Six patients had complete MCL tear in arthroscopy, while in sonography 4 complete MCL tears were shown. Sensitivity of ultrasound in diagnosing complete MCL tear was 66.6% and specificity of 98%. Ultrasound is easily applicable in evaluation of knee derangement: however, for bucket handle tears it has limited application. For MCL tears, sonography seems an accurate method. Ultrasonography is rapid, low-cost and non-invasive examination.