In the Journals

Study: MRI preferred to confirm exam-based diagnosis of meniscal tear

Recently published data indicated the preferred and most cost-effective usage of MRI in the diagnosis of meniscal tears was as confirmation of a physical examiner’s diagnosis.

Researchers conducted a cost-utility analysis to determine the cost-effectiveness of both MRI and alternatives to MRI in combination with a patient’s physical history and examination as the primary tools to diagnose a meniscal tear. This model evaluated meniscal tears in both primary care and sports medicine clinic settings and compared all options via incremental cost-effectiveness ratio.

Using MRI to confirm exam-based diagnosis of a meniscal tear led to more than 10 times lower rates of unnecessary surgery than any alternative strategy. MRI utilization for all patients was found to be not clinically preferred. Instead, the clinically preferred method in both practice settings was physical history and examination, according to the researchers.

MRI confirmation of exam-based diagnosis of a meniscal tear was preferred when prevalence was less than 46.7% in traumatic tears and more than 74.2% in degenerative tears. MRI utilization to confirm negative diagnosis of meniscal tear stemming from physical examination led to unnecessary surgery rates 2.08 and 2.26 times higher than exam-based diagnosis alone in primary care and sports medicine settings, respectively, according to the researchers. – by Christian Ingram

Disclosures: The authors report no relevant financial disclosures.

Recently published data indicated the preferred and most cost-effective usage of MRI in the diagnosis of meniscal tears was as confirmation of a physical examiner’s diagnosis.

Researchers conducted a cost-utility analysis to determine the cost-effectiveness of both MRI and alternatives to MRI in combination with a patient’s physical history and examination as the primary tools to diagnose a meniscal tear. This model evaluated meniscal tears in both primary care and sports medicine clinic settings and compared all options via incremental cost-effectiveness ratio.

Using MRI to confirm exam-based diagnosis of a meniscal tear led to more than 10 times lower rates of unnecessary surgery than any alternative strategy. MRI utilization for all patients was found to be not clinically preferred. Instead, the clinically preferred method in both practice settings was physical history and examination, according to the researchers.

MRI confirmation of exam-based diagnosis of a meniscal tear was preferred when prevalence was less than 46.7% in traumatic tears and more than 74.2% in degenerative tears. MRI utilization to confirm negative diagnosis of meniscal tear stemming from physical examination led to unnecessary surgery rates 2.08 and 2.26 times higher than exam-based diagnosis alone in primary care and sports medicine settings, respectively, according to the researchers. – by Christian Ingram

Disclosures: The authors report no relevant financial disclosures.