Accuracy of Point-Of-Care Knee Sonography for Diagnosis of Traumatic Anterior / Posterior Cruciate Ligament Tears Taking Magnetic Resonance Imaging as Gold Standard: A Systematic Review and Meta-Analysis

Accuracy of Point-Of-Care Knee Sonography

Authors

  • Irum Raheem Department of Radiological Sciences and Medical Imaging Technology, University of Lahore, Pakistan
  • Iqra Manzoor Department of Radiological Sciences and Medical Imaging Technology, University of Lahore, Pakistan
  • Bakht Rokhan Department of Radiology, Saidu Group of Teaching Hospital, Swat, Pakistan
  • Majid Iqbal Department of Radiology, Saidu Group of Teaching Hospital, Swat, Pakistan
  • Zareen Fatima Department of Radiological Sciences and Medical Imaging Technology, University of Lahore, Pakistan
  • Amjad Ali Khan Department of Radiological Sciences and Medical Imaging Technology, University of Lahore, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v4i03.471

Keywords:

Anterior Cruciate Ligament(ACL), Posterior Cruciate Ligament(PCL), Knee Injury, Point-Of-Care Ultrasound(POCUS), Magnetic Resonance Imaging(MRI)

Abstract

Knee joint is among the all the body's joints that are much prone to sustains injuries. Injury to the knee ligaments followed by instability can lead to serious deformity. The diagnosis of ligament injuries is frequently performed by using magnetic resonance imaging (MRI), but the use of ultrasonography remains controversial. This article reviews the current literature regarding the viability of point-of-care knee ultrasonography (POCUS) in comparison to knee magnetic resonance imaging (MRI) for the diagnosis of anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) injuries in those individuals who have experienced sudden knee trauma. The data span from 2000 to 2022 was used for the electronic database search (PubMed, Science Direct, Google Scholar). The systematic review included all studies that evaluated the diagnostic efficacy of ultrasound (U/S) compared to MRI as the gold standard and were completely available in English. The meta-analysis reviewing the efficacy of MSK-POCUS for anterior and posterior cruciate ligament injuries includes 30 papers. The overall ultrasonography sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were 76.02%, 92.77%, 92.25%, and 81.91% (95% CI), respectively. By assuring MRI as the gold standard in the diagnosis of ACL and PCL injuries, Point-of-care ultrasound (POCUS) reveals high accuracy. In individuals who have sustained acute knee injuries, the results of POCUS imaging might be serve to provide an initial diagnosis for additional pre-operative work-up.

References

Lee SH and Yun SJ. Diagnosis of simultaneous acute ruptures of the anterior cruciate ligament and posterior cruciate ligament using point-of-care ultrasound in the emergency department. The Journal of Emergency Medicine. 2018 Mar; 54(3): 335-8. doi: 10.1016/j.jemermed.2017.11.014

Lee SH and Yun SJ. Feasibility of point-of-care knee ultrasonography for diagnosing anterior cruciate and posterior cruciate ligament tears in the ED. The American Journal of Emergency Medicine. 2020 Feb; 38(2): 237-42. doi: 10.1016/j.ajem.2019.04.040

Knutson T, Bothwell J, Durbin R. Evaluation and management of traumatic knee injuries in the emergency department. Emergency Medicine Clinics. 2015 May; 33(2): 345-62. doi: 10.1016/j.emc.2014.12.007

Tintinalli J. Tintinallis emergency medicine A comprehensive study guide: McGraw-Hill Education; 2015.

Wang J, Wu H, Dong F, Li B, Wei Z, Peng Q, Dong D, et al. The role of ultrasonography in the diagnosis of anterior cruciate ligament injury: a systematic review and meta-analysis. European journal of sport science. 2018 Apr; 18(4): 579-86. doi: 10.1080/17461391.2018.1436196

Sorrentino F, Iovane A, Nicosia A, Candela F, Midiri M, Lagalla R. Role of high-resolution ultrasonography without and with real-time spatial compound imaging in evaluating the injured posterior cruciate ligament: preliminary study. La radiologia medica. 2009 Mar; 114(2): 312-20. doi: 10.1007/s11547-008-0355-5

Wang LY, Yang TH, Huang YC, Chou WY, Huang CC, Wang CJ. Evaluating posterior cruciate ligament injury by using two-dimensional ultrasonography and sonoelastography. Knee Surgery, Sports Traumatology, Arthroscopy. 2017 Oct; 25(10): 3108-15. doi: 10.1007/s00167-016-4139-5

Phelan N, Rowland P, Galvin R, O'Byrne JM. A systematic review and meta-analysis of the diagnostic accuracy of MRI for suspected ACL and meniscal tears of the knee. Journal of Knee Surgery, Sports Traumatology, Arthroscopy.2016; 24(5): 1525-39. doi: 10.1007/s00167-015-3861-8

Beyzadeoglu T, Demirel M, Circi E. Simultaneous ACL-PCL reconstructions with high tibial osteotomy: salvage for an unstable arthritic knee. Case Reports. 2016 Jan; 2016. doi: 10.1136/bcr-2015-210053

Perera NS, Joel J, Bunola JA. Anterior cruciate ligament rupture: delay to diagnosis. Injury. 2013 Dec; 44(12): 1862-5. doi: 10.1016/j.injury.2013.07.024

James EW, Williams BT, LaPrade RF. Stress radiography for the diagnosis of knee ligament injuries: a systematic review. Clinical Orthopaedics and Related Research. 2014 Sep; 472(9): 2644-57. doi: 10.1007/s11999-014-3470-8

Qayyum A, Adil R, Amin Z, Azhar A, Aziz T, Khan S. Accuracy Of Ultrasound In Detection Of Anterior Cruciate Ligament Tear Of Knee In Ccompaison To Magnetic Resonance Imaging. Pakistan Armed Forces Medical Journal. 2019 Dec; 69(6): 1315-9.

Mautner K, Sussman WI, Nanos K, Blazuk J, Brigham C, Sarros E. Validity of indirect ultrasound findings in acute anterior cruciate ligament ruptures. Journal of Ultrasound in Medicine. 2019 Jul; 38(7): 1685-92. doi: 10.1002/jum.14853

Barzin M, Abdi R, Golmohammadi H. Diagnostic accuracy of ultrasonography in comparison with magnetic resonance imaging in patients with knee trauma. Journal of Gorgan University of Medical Sciences. 2012 Sep; 14(3): 92-7.

Gilani SA. 2205: Ultrasonographic estimation of posterior cruciate ligament. Ultrasound in Medicine and Biology. 2006 May; 32(5): P129-30. doi: 10.1016/j.ultrasmedbio.2006.02.498

Grzelak P, Podgórski MT, Stefańczyk L, Domżalski M. Ultrasonographic test for complete anterior cruciate ligament injury. Indian journal of orthopaedics. 2015 Apr; 49: 143-9. doi: 10.4103/0019-5413.152432

Stoianov AG, Pătrașcu JM, Hogea BG, Andor B, Mișcă LC, Florescu S, et al. Dynamic Ultrasound Assessment of the Anterior Tibial Translation for Anterior Cruciate Ligament Tears Diagnostic. Journal of Clinical Medicine. 2022 Apr; 11(8): 2152. doi: 10.3390/jcm11082152

Palm H-G, Bergenthal G, Ehry P, Schwarz W, Schmidt R, Friemert B. Functional ultrasonography in the diagnosis of acute anterior cruciate ligament injuries: a field study.The knee 2009; 16(6): 441-6. doi: 10.1016/j.knee.2009.04.012

Lee SH and Yun SJ. Efficiency of knee ultrasound for diagnosing anterior cruciate ligament and posterior cruciate ligament injuries: a systematic review and meta-analysis. Skeletal Radiology. 2019 Oct; 48: 1599-610. doi: 10.1007/s00256-019-03225-w

Breukers M, Haase D, Konijnenberg S, Klos TV, Dinant GJ, Ottenheijm RP. Diagnostic accuracy of dynamic ultrasound imaging in partial and complete anterior cruciate ligament tears: a retrospective study in 247 patients. BMJ Open Sport & Exercise Medicine. 2019 Dec; 5(1): e000605. doi: 10.1136/bmjsem-2019-000605

Larsen LP and Rasmussen OS. Diagnosis of acute rupture of the anterior cruciate ligament of the knee by sonography. European journal of ultrasound. 2000 Dec; 12(2): 163-7. doi: 10.1016/S0929-8266(00)00109-9

Wang CY, Shih TT, Wang HK, Chiu YN, Wang TG. The accuracy of ultrasonographic examination of injured posterior cruciate ligament. Journal of Medical Ultrasound. 2009 Jan; 17(4): 187-92. doi: 10.1016/S0929-6441(09)60127-2

Marwa IF, Sally MH, Ali AM. Role of ultrasound in assessment of menisco-ligamentous injuries of knee joint in comparison with magnetic resonance imaging. The Medical Journal of Cairo University. 2019 Dec; 87(12): 4571-7. doi: 10.21608/mjcu.2019.80706

Singh A, Mangat I, Thukral C, Gupta K. Diagnostic accuracy of ultrasonography in evaluation of knee injuries with magnetic resonance imaging correlation. International journal of anatomy radiology & surgery. 2018; 7(1): 50-5.

Ptasznik R, Feller J, Bartlett J, Fitt G, Mitchell A, Hennessy O. The value of sonography in the diagnosis of traumatic rupture of the anterior cruciate ligament of the knee. AJR. American journal of roentgenology. 1995 Jun; 164(6): 1461-3. doi: 10.2214/ajr.164.6.7754893

Attya MS. Evaluation of role of non ionized radiology tools in knee soft tissue injuries. Al-Azhar Assiut Medical Journal. 2015 Jul; 13(1).

Cho KH, Lee DC, Chhem RK, Kim SD, Bouffard JA, Cardinal E, et al. Normal and acutely torn posterior cruciate ligament of the knee at US evaluation: preliminary experience. Radiology. 2001 May; 219(2): 375-80. doi: 10.1148/radiology.219.2.r01ma22375

Singh AP, Chandak S, Agarwal A, Malhotra A, Jain A, Khan AA. Utility of high-resolution sonography for evaluation of knee joint pathologies as a screening tool. Journal of Diagnostic Medical Sonography. 2021 Nov; 37(6): 556-67. doi: 10.1177/87564793211035773

Singh B, Pawar KN, Kachewar S, Ghule SS, Lakhkar DL. Evaluation of knee joint by ultrasound and MRI. IOSR J Dent Med Sci. 2016; 15(10): 122-31.

Fuchs S and Chylarecki C. Sonographic evaluation of ACL rupture signs compared to arthroscopic findings in acutely injured knees. Ultrasound in medicine & biology. 2002 Feb; 28(2): 149-54. doi: 10.1016/S0301-5629(01)00507-5

Sharma VK and Grewal TS. Sonographic evaluation of pathologies of knee joint with MRI correlation. 2020

Sekiya JK, Swaringen JC, Wojtys EM, Jacobson JA. Diagnostic ultrasound evaluation of posterolateral corner knee injuries. Arthroscopy: The Journal of Arthroscopic & Related Surgery. 2010 Apr; 26(4): 494-9. doi: 10.1016/j.arthro.2009.08.023

Lalitha P, Reddy MC, Reddy KJ, Kumari V. Ultrasound evaluation of normal and abnormal posterior cruciate ligament-A prospective study. Pakistan Journal of Radiology. 2016 Jul; 20(3).

Zaka KH, Faruqui Z, Ogyunbiyi O, Rosset G, Iqbal J. Ultrasound assessment of internal derangement of the knee. Acta orthopaedica belgica. 2006; 72(1): 72-6.

Sageer Pk Sa, Mohan R, Ts G. Diagnostic Test Evaluation Of Ultra Sound And Mri Compared To Arthroscopy In Clinically Positive Meniscal And Ligamentous Injuries Of Knee. Kerala Journal Of Orthopaedics. 2015 Jan; 28(1): 37-41.

Gupta SV and Aditya SS. Is Ultrasound Effective in Diagnosing Internal Derangements of the Knee?. Open Journal of Orthopedics. 2013 Dec; 3(08): 321-4. doi: 10.4236/ojo.2013.38059

Maheshwari M, Yadav PK, Jain S, Batham IK, Gupta A, Swaika S. Imaging of Knee Joint Pathologies: A Comparative Study of Ultrasound and Magnetic Resonance Imaging. Journal of Medical Sciences. 2022 Sep; 8(3): 222-8. doi: 10.46347/jmsh.v8i3.22.168

Suzuki S, Kasahara K, Futami T, Iwasaki R, Ueo T, Yamamuro T. Ultrasound diagnosis of pathology of the anterior and posterior cruciate ligaments of the knee joint. Archives of orthopaedic and trauma surgery. 1991 Jul; 110(4): 200-3. doi: 10.1007/BF00571059

Kim DH, Kim YS, Oh HW, Koh KH. Sonographic evaluation of anterior and posterior cruciate ligament rupture signs in acutely injured knees: Comparison with arthroscopic findings. Ultrasound in Medicine and Biology. 2006 May; 32(5): P252-3.

Kam CK, Chee DW, Peh WC. Magnetic resonance imaging of cruciate ligament injuries of the knee. Canadian Association of Radiologists Journal. 2010 Apr; 61(2): 80-9. doi: 10.1016/j.carj.2009.11.003

Downloads

Published

2023-03-31
CITATION
DOI: 10.54393/pjhs.v4i03.471
Published: 2023-03-31

How to Cite

Raheem, I., Manzoor, I., Rokhan, B., Iqbal, M., Fatima, Z., & Ali Khan, A. (2023). Accuracy of Point-Of-Care Knee Sonography for Diagnosis of Traumatic Anterior / Posterior Cruciate Ligament Tears Taking Magnetic Resonance Imaging as Gold Standard: A Systematic Review and Meta-Analysis: Accuracy of Point-Of-Care Knee Sonography. Pakistan Journal of Health Sciences, 4(03). https://doi.org/10.54393/pjhs.v4i03.471

Issue

Section

Systematic Review

Plaudit

Most read articles by the same author(s)