• ABSTRACT
    • Background The knee menisci are fibrocartilaginous structures that play a key biomechanical role in load transmission, shock absorption, stability, and, ultimately, preservation of articular cartilage. Magnetic resonance imaging (MRI) is vital in the assessment of meniscal pathology and guiding subsequent management options. This study aims to evaluate the diagnostic accuracy of MRI for isolated meniscal tears compared to subsequent arthroscopic findings. Methodology This observational study screened 334 patients who underwent arthroscopic knee surgery. Preoperative knee MRI scan results using standardized and uniform protocols were compared to arthroscopic surgical findings to assess the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of initial radiological reports. Results A total of 79 patients who underwent arthroscopy for isolated meniscal tears were included in the analysis. MRI demonstrated a sensitivity of 90%, specificity of 83%, PPV of 96%, NPV of 63%, and accuracy of 89% for medial meniscal tears. In lateral meniscal tears, preoperative MRI demonstrated a sensitivity of 65%, specificity of 88%, PPV of 68%, NPV of 87%, and accuracy of 81%. Conclusions This study demonstrated high diagnostic accuracy of MRI scans for both medial and lateral meniscal tears. However, radiological findings should not be used in isolation, but instead incorporated as a diagnostic adjunct in the wider clinical picture when making therapeutic decisions. Clinical acumen remains the priority in the context of evaluating these knee injuries.