Prediction Models to Improve the Diagnostic Value of Plain Radiographs in Children With Complete Discoid Lateral Meniscus

To develop prediction models to improve the diagnostic utility of plain radiographs for the diagnosis of complete discoid lateral meniscus by combining previously reported radiographic findings. Patients ages 5 to 16 years with complete discoid lateral meniscus confirmed by arthroscopy or magnetic r...

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Vydané v:Arthroscopy Ročník 34; číslo 2; s. 479
Hlavní autori: Park, Yong-Beom, Ha, Chul-Won, Jang, Jae Won, Kim, Manyoung, Lee, Han-Jun, Park, Yong-Geun
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: United States 01.02.2018
Predmet:
Adolescent
Adult
Arthroscopy - methods
Child
Child, Preschool
Female
Femur - diagnostic imaging
Femur - pathology
Fibula - diagnostic imaging
Fibula - pathology
Humans
Joint Diseases - diagnostic imaging
Knee Joint - diagnostic imaging
Knee Joint - pathology
Magnetic Resonance Imaging - methods
Male
Menisci, Tibial - abnormalities
Menisci, Tibial - diagnostic imaging
Menisci, Tibial - pathology
Predictive Value of Tests
Radiography
Retrospective Studies
Sensitivity and Specificity
ISSN:1526-3231, 1526-3231
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Popis
Shrnutí:To develop prediction models to improve the diagnostic utility of plain radiographs for the diagnosis of complete discoid lateral meniscus by combining previously reported radiographic findings. Patients ages 5 to 16 years with complete discoid lateral meniscus confirmed by arthroscopy or magnetic resonance imaging were included. Patients with insufficient radiographs were excluded. Normal control subjects were randomly sampled by age and sex matching. Subjects were divided into 2 groups considering skeletal maturation (5-9 and 10-16 years). Radiographic variables included were lateral joint space, height of the fibular head, height of the lateral tibial spine, obliquity and cupping of the lateral tibial plateau, condylar cutoff sign, and squaring and notching of the lateral femoral condyle. Prediction models were developed by regression analyses. The cutoff value (COV) for best accuracy was determined with its sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). A total of 162 knees (126 patients) with complete discoid lateral meniscus and 151 age- and sex-matched knees (151 subjects) with normal meniscus were included. In subjects 5 to 9 years old, the prediction model was risk score = [-20.08 * height of the fibular head/femoral interepicondylar distance (FIED)] + [-42.26 * height of the lateral tibial spine/FIED]. The COV of -8.47 showed the best accuracy (74.4%), with sensitivity of 85.9%; specificity, 60.4%; PPV, 72.4%; and NPV, 78.0%. In subjects 10 to 16 years old, the prediction model was risk score = [77.04 * lateral joint space/FIED] + [-34.55 * height of the fibular head/FIED] + [-56.58 * height of the lateral tibial spine/FIED] + [-16.44 * condylar cutoff sign]. The COV of -18.03 showed the best accuracy (85.4%), with sensitivity of 79.6%; specificity, 90.4%; PPV, 87.6%; and NPV, 83.9%. The prediction models combining the plain radiographic findings showed higher diagnostic values than the diagnostic values of the individual radiographic findings. The results of this study provide improved diagnostic utility of plain radiography for the detection of completed discoid lateral meniscus in children. Level III, diagnostic study.
Bibliografia:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
ISSN:1526-3231
1526-3231
DOI:10.1016/j.arthro.2017.08.252