Meniscus Tear Symptoms and Ultrasound Accuracy in Diagnosis

Symptoms of a meniscus tear?

Hello, Doctor.
Two months ago, I experienced external pressure on the area near the patella at the top of my thigh while straightening my right knee.
A few days ago, I underwent a muscle ultrasound examination, and the doctor mentioned that there might be a meniscus tear.
I would like to ask about the accuracy of ultrasound in diagnosing meniscus tears, as the doctor later recommended an MRI for further evaluation.

Before the ultrasound, I was concerned about possible knee effusion or muscle-tendon strains, but the doctor did not mention these issues after the examination.
Does this mean those conditions have been ruled out?
Currently, my symptoms include an inability to fully flex my right knee (I can only bend it to about 150 degrees instead of the full 180 degrees).
I can squat, but if I need to bend my knee significantly, I experience soreness and pain on the inner and posterior sides near the thigh.
Initially, when sitting and bending my knee, I felt a catching sensation, but this has become less noticeable over the past month, unless I sit for a long time and then quickly extend my leg.

Since the injury, I have felt swelling around my knee, but it is not painful.
When lying down, I also feel tightness from the front of my lower leg to my ankle, and I need to slightly bend my knee to sleep comfortably on my side.
I would like to know if these symptoms are consistent with a meniscus tear.
If it is indeed a meniscus tear, should I continue with rehabilitation? Since the injury, my muscles have atrophied, and my rehabilitation exercises mainly involve leg raises, cycling, and brisk walking.
Thank you!

RDO, 20~29 year old female. Ask Date: 2016/08/09

Dr. Shi Guozheng reply Orthopedics

If there is a meniscus tear, an experienced physician can make a judgment based on a physical examination, but ultimately, an MRI is necessary for a definitive diagnosis.
If treatment is required, arthroscopy may be needed, and this should be discussed with the attending physician who performed the examination.

Reply Date: 2016/08/09

More Info

Meniscus tears are a common knee injury, particularly among athletes and individuals who engage in activities that involve twisting or heavy loading of the knee. The meniscus is a C-shaped cartilage that acts as a cushion between the femur (thigh bone) and the tibia (shin bone). When a meniscus tear occurs, it can lead to a variety of symptoms, including pain, swelling, stiffness, and difficulty bending or straightening the knee.

Based on your description, it seems that you are experiencing several symptoms that could indeed be associated with a meniscus tear. The inability to fully bend your knee, the sensation of "catching" or "locking" when moving the knee, and the pain on the inner and posterior aspects of the knee are all indicative of potential meniscal damage. Additionally, the swelling around the knee joint is a common response to injury, as the body sends fluid to the area to help with healing.

Regarding the accuracy of ultrasound in diagnosing meniscus tears, it is important to note that while ultrasound can be useful in assessing soft tissue injuries, including muscles and tendons, its effectiveness in diagnosing meniscus tears is somewhat limited. Ultrasound can sometimes identify abnormalities in the meniscus, but it is not as definitive as MRI. MRI (Magnetic Resonance Imaging) is considered the gold standard for diagnosing meniscus tears because it provides detailed images of the knee's internal structures, including the menisci, ligaments, and cartilage. Therefore, your doctor's recommendation for an MRI is appropriate and will likely provide a clearer picture of the extent of your injury.

As for the other conditions you mentioned, such as knee effusion (fluid accumulation) or muscle/tendon strains, the absence of these findings on ultrasound does suggest that these issues may have been ruled out. However, it is essential to understand that ultrasound is not always comprehensive, and some conditions may still exist without being detected.

In terms of your current symptoms and whether you should continue with rehabilitation, it is crucial to follow your healthcare provider's advice. If a meniscus tear is confirmed, the treatment plan may vary depending on the severity of the tear. Some meniscus tears can heal with conservative management, including physical therapy, rest, and anti-inflammatory medications. Rehabilitation exercises, such as leg raises and cycling, are beneficial for strengthening the muscles around the knee and improving range of motion. However, if the tear is significant or if you continue to experience pain and functional limitations, surgical intervention may be necessary.

In summary, your symptoms align with those of a meniscus tear, and while ultrasound can provide some insights, an MRI will give a more accurate diagnosis. Continuing with rehabilitation is advisable, as it can help improve your knee function and strength. Always consult with your healthcare provider for personalized advice and treatment options based on your specific condition.

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