Abstract

Purpose

To investigate the diagnostic accuracy of radiographic signs for complete discoid lateral meniscus and whether a predictive model combining the radiographic signs can improve its diagnostic accuracy in adults.

Methods

A total of adult 119 knees with complete discoid lateral meniscus confirmed by arthroscopy and 119 age- and sex-matched knees with normal meniscus were included. The radiographic signs of lateral joint space, fibular head height, lateral tibial spine height, lateral tibial plateau obliquity, lateral femoral condyle squaring, lateral tibial plateau cupping, lateral femoral condyle notching, and the condylar cut-off sign were evaluated. The receiver-operating characteristic (ROC) curves and area under the curve (AUC) were evaluated for best accuracy. A prediction model was developed by multivariable regression with generalized estimating models, and was validated using data from 111 knees of children with complete discoid lateral meniscus and 111 normal controls.

Results

The fibular head height, lateral joint space, lateral tibial plateau obliquity, and the condylar cut-off sign were significantly different between the complete discoid lateral meniscus and the normal groups (p < 0.05). Among the four radiographic signs, the fibular head height showed the highest accuracy with 78.9% sensitivity and 57.3% specificity. The prediction models developed by logistic regression showed significantly improved accuracy for complete discoid lateral meniscus compared to the fibular head height (sensitivity: 69.8%, specificity: 82.9%, p = 0.001). For validation, the AUC of children seemed to be larger than that of adults, which indicated that the prediction models could be applied for children to detect complete discoid lateral meniscus.

Conclusion

Among several radiographic signs, the fibular head height can be used as a screening tool for complete discoid lateral meniscus. The prediction models combined with lateral joint space, fibular head height, lateral tibial plateau obliquity, and/or the condylar cut-off sign yielded a much higher diagnostic value than each radiographic sign. Therefore, fibular head height and prediction models combined with radiographic signs can provide improved diagnostic value for complete discoid lateral meniscus.

Level of evidence

III.

中文翻译：

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具有放射线体征的预测模型可以是成人完整盘状半月板的有用的辅助诊断工具

摘要

目的

调查完整的盘状外侧半月板的放射线体征的诊断准确性，以及结合放射线体征的预测模型是否可以提高其在成人中的诊断准确性。

方法

经关节镜检查证实，总共有成年的119个膝关节完全盘状外侧半月板，并且有119个年龄和性别相匹配的半月板膝关节。评估了外侧关节间隙，腓骨头部高度，外侧胫骨脊柱高度，外侧胫骨平台倾斜度，外侧股骨con突，胫骨平台外侧拔罐，外侧股骨con突和not突切开征象的影像学征象。评估接收器工作特性（ROC）曲线和曲线下面积（AUC）以获得最佳精度。通过多变量回归和广义估计模型开发了预测模型，并使用来自完整盘状外侧半月板患儿的111个膝盖和111个正常对照的数据进行了验证。

结果

完整的盘状外侧半月板和正常组之间的腓骨头高度，外侧关节间隙，胫骨外侧平台倾斜度和con突切开征象有显着差异（p  <0.05）。在这四个影像学征象中，腓骨头部的高度显示出最高的准确性，灵敏度为78.9％，特异性为57.3％。通过逻辑回归开发的预测模型显示，与腓骨头部高度相比，完全盘状外侧半月板的准确性显着提高（敏感性：69.8％，特异性：82.9％，p  = 0.001）。为了验证，儿童的AUC似乎比成人的AUC大，这表明可以将预测模型应用于儿童以检测完整的盘状外侧半月板。

结论

在一些放射线征象中，腓骨头部的高度可以用作筛查完整盘状半月板的工具。预测模型与外侧关节间隙，腓骨头部高度，胫骨外侧平台倾斜度和/或con突切除标志相结合，产生的诊断价值远高于每个放射线照相征象。因此，腓骨头部高度和预测模型结合放射线征象可以为完整的盘状外侧半月板提供改进的诊断价值。

证据水平

三，