Point-Of-Care Ultrasonography for Diagnosis of Medial Collateral Ligament Tears in Acute Knee Trauma; a Diagnostic Accuracy Study

The use of point-of-care ultrasonography (POCUS) for identifying medial collateral ligament(MCL) tears has increased in recent years. This study aimed to evaluate the diagnostic accuracy of POCUS inthe diagnosis of acute MCL tears of the knee.

This prospective cross-sectional study was performedon patients with suspected MCL tear of the knee in the emergency department (ED). After history taking andprimary physical examination, radiographic imaging of the knee was done. If there was no fracture in the kneeX-ray, the POCUS examination was done. All of the patients were asked to refer to an orthopedic clinic, 7-10 daysafter discharge from ED, for Magnetic Resonance Imaging (MRI) evaluation. The second POCUS was done in theorthopedic clinic. Finally, the findings of POCUS and MRI were compared in diagnosing MCL injury.

Two hundred and fifty patients with a mean age of 25.05 ± 9.12 years were analyzed (86.8% male). Accordingto the MRI findings, as the gold standard, 55(22.0%) patients had MCL injury. The sensitivity, specificity, pos-itive and negative predictive values (PPV and NPV ), and accuracy of ultrasound in detection of MCL injury, incomparison with MRI were 83.64 (95% CI, 71.20 to 92.23), 94.36% (95% CI, 90.13 to 97.15), 80.70% (95% CI, 69.95to 88.25), 95.34% (95% CI, 91.83 to 97.38), and 92.00% (95% CI, 87.92 to 95.05), respectively. The area under thereceiver operating characteristic (ROC) curve of POCUS was 0.890 (95% CI, 0.844 to 0.926).

It seemsthat POCUS can be applied in screening patients with MCL tears following blunt knee trauma.