Scrutinizing the cut-off for “pathological” meniscal body extrusion on knee MRI
Svensson, F. LU ; Felson, D. T. ; Turkiewicz, A. LU ; Guermazi, A. ; Roemer, F. W. LU ; Neuman, P. LU and Englund, M. LU
(2019)
In European Radiology
29(5).
p.2616-2623
- Abstract
Objectives: Medial meniscal body extrusion ≥ 3 mm on MRI is often considered “pathologic.” The aims of this study were to (1) assess the adequacy of 3 mm as cut-off for “pathological” extrusion and (2) find an optimal cut-off for meniscal extrusion cross-sectionally associated with radiographic knee osteoarthritis, bone marrow lesions (BMLs), and cartilage damage. Methods: Nine hundred fifty-eight persons, aged 50–90 years from Framingham, MA, USA, had readable 1.5 T MRI scans of the right knee for meniscal body extrusion (measured in mm). BMLs and cartilage damage were read using the whole organ magnetic resonance imaging score (WORMS). Knee X-rays were read according to the Kellgren and Lawrence (KL) scale. We evaluated the... (More)
Objectives: Medial meniscal body extrusion ≥ 3 mm on MRI is often considered “pathologic.” The aims of this study were to (1) assess the adequacy of 3 mm as cut-off for “pathological” extrusion and (2) find an optimal cut-off for meniscal extrusion cross-sectionally associated with radiographic knee osteoarthritis, bone marrow lesions (BMLs), and cartilage damage. Methods: Nine hundred fifty-eight persons, aged 50–90 years from Framingham, MA, USA, had readable 1.5 T MRI scans of the right knee for meniscal body extrusion (measured in mm). BMLs and cartilage damage were read using the whole organ magnetic resonance imaging score (WORMS). Knee X-rays were read according to the Kellgren and Lawrence (KL) scale. We evaluated the performance of the 3-mm cut-off with respect to the three outcomes and estimated a new cut-off maximizing the sum of sensitivity and specificity. Results: The study persons had mean age of 62.2 years, 57.0% were women and the mean body mass index was 28.5 kg/m2. Knees with radiographic osteoarthritis, BMLs, and cartilage damage had overall more meniscal extrusion than knees without. The 3-mm cut-off had moderate sensitivity and low specificity for all three outcomes (sensitivity between 0.68 [95% CI 0.63–0.73] and 0.81 [0.73–0.87], specificity between 0.49 [0.45–0.52] and 0.54 [0.49–0.58]). Using 4 mm maximized the sum of sensitivity and specificity and improved the percentage of correctly classified subjects (from between 54 and 61% to between 64 and 79%). Conclusions: The 4-mm cut-off may be used as an alternative cut-off for denoting pathological meniscal extrusion. Key Points: • Medial meniscal body extrusion is strongly associated with osteoarthritis. • The 3-mm cut-off for medial meniscal body extrusion has high sensitivity but low specificity with respect to bone marrow lesions, cartilage damage, and radiographic osteoarthritis. • The 4-mm cut-off maximizes the sensitivity and specificity with respect to all three osteoarthritis features.
(Less)
- author
- Svensson, F.
LU
; Felson, D. T.
; Turkiewicz, A.
LU
; Guermazi, A.
; Roemer, F. W.
LU
; Neuman, P.
LU
and Englund, M.
LU
- organization
- publishing date
- 2019-01-10
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Cartilage, Knee joint, Magnetic resonance imaging, Meniscus, Osteoarthritis
- in
- European Radiology
- volume
- 29
- issue
- 5
- pages
- 2616 - 2623
- publisher
- Springer
- external identifiers
-
- pmid:30631922
- scopus:85059847462
- ISSN
- 0938-7994
- DOI
- 10.1007/s00330-018-5914-0
- language
- English
- LU publication?
- yes
- id
- a4fd157b-7096-4a6b-aa58-044aa1127f64
- date added to LUP
- 2019-01-24 10:29:17
- date last changed
- 2024-04-15 21:25:43
@article{a4fd157b-7096-4a6b-aa58-044aa1127f64,
abstract = {{<p>Objectives: Medial meniscal body extrusion ≥ 3 mm on MRI is often considered “pathologic.” The aims of this study were to (1) assess the adequacy of 3 mm as cut-off for “pathological” extrusion and (2) find an optimal cut-off for meniscal extrusion cross-sectionally associated with radiographic knee osteoarthritis, bone marrow lesions (BMLs), and cartilage damage. Methods: Nine hundred fifty-eight persons, aged 50–90 years from Framingham, MA, USA, had readable 1.5 T MRI scans of the right knee for meniscal body extrusion (measured in mm). BMLs and cartilage damage were read using the whole organ magnetic resonance imaging score (WORMS). Knee X-rays were read according to the Kellgren and Lawrence (KL) scale. We evaluated the performance of the 3-mm cut-off with respect to the three outcomes and estimated a new cut-off maximizing the sum of sensitivity and specificity. Results: The study persons had mean age of 62.2 years, 57.0% were women and the mean body mass index was 28.5 kg/m<sup>2</sup>. Knees with radiographic osteoarthritis, BMLs, and cartilage damage had overall more meniscal extrusion than knees without. The 3-mm cut-off had moderate sensitivity and low specificity for all three outcomes (sensitivity between 0.68 [95% CI 0.63–0.73] and 0.81 [0.73–0.87], specificity between 0.49 [0.45–0.52] and 0.54 [0.49–0.58]). Using 4 mm maximized the sum of sensitivity and specificity and improved the percentage of correctly classified subjects (from between 54 and 61% to between 64 and 79%). Conclusions: The 4-mm cut-off may be used as an alternative cut-off for denoting pathological meniscal extrusion. Key Points: • Medial meniscal body extrusion is strongly associated with osteoarthritis. • The 3-mm cut-off for medial meniscal body extrusion has high sensitivity but low specificity with respect to bone marrow lesions, cartilage damage, and radiographic osteoarthritis. • The 4-mm cut-off maximizes the sensitivity and specificity with respect to all three osteoarthritis features.</p>}},
author = {{Svensson, F. and Felson, D. T. and Turkiewicz, A. and Guermazi, A. and Roemer, F. W. and Neuman, P. and Englund, M.}},
issn = {{0938-7994}},
keywords = {{Cartilage; Knee joint; Magnetic resonance imaging; Meniscus; Osteoarthritis}},
language = {{eng}},
month = {{01}},
number = {{5}},
pages = {{2616--2623}},
publisher = {{Springer}},
series = {{European Radiology}},
title = {{Scrutinizing the cut-off for “pathological” meniscal body extrusion on knee MRI}},
url = {{http://dx.doi.org/10.1007/s00330-018-5914-0}},
doi = {{10.1007/s00330-018-5914-0}},
volume = {{29}},
year = {{2019}},
}