Diagnosis
The first suspected diagnosis usually results from the symptoms described, possibly in connection with the possible course of the injury. In order to confirm this suspicion, the knee is mainly moved during the examination. Thus, the meniscus contusion can cause restrictions and pain during certain movements.
For example, the inner meniscus is particularly painful when the foot is turned outwards while the knee is bent. The outer meniscus when the foot is turned inwards. In this respect, even this simple examination can give an indication.
Also, pressing on the respective joint gap usually causes pain, which indicates a damage in the meniscus of the corresponding side. Also a lateral load of the stretched leg inwards or outwards can cause typical symptoms. With a trained examiner, these tests show very good accuracy.
Nevertheless, the diagnosis is then usually supplemented by radiological procedures. In most cases, an X-ray of the knee is first taken to allow an initial assessment of the damage. This is particularly important if damage to the bone is suspected.
In order to then assess more precisely which therapy is necessary, an MRI is the method of choice. In many cases, however, it may be necessary to perform a diagnostic arthroscopy, i.e. knee arthroscopy, despite an MRI image. Only by looking directly into the knee is it often possible to determine the exact extent of the damage and the best therapeutic procedure.
When looking into the knee, an intervention is often already performed on the affected parts of the knee in order to avoid another therapeutic arthroscopy. The MRI is the most accurate imaging method for visualizing meniscus damage. It is the best way to examine the soft tissue and cartilage parts of the knee.
In most cases, tears can be detected here or separated from pure bruising and swelling.About 90% of the tears in the meniscus are detectable with the MRT. However, the MRI also has its limitations. It is not uncommon that even after the MRI image has been taken, it is still not possible to make a hundred percent assessment.
However, since the MRI does not involve radiation exposure or other side effects, this does not have any major disadvantages. The problem with the MRI image is that the image is only a snapshot and it is therefore difficult to estimate the consequences of a torn meniscus, for example. Also an exact determination of the irritation state of the tissue is not possible.
Even if the tear can be depicted well, it is often difficult to assess the impairment in everyday life. For example, it is quite possible that a meniscus lesion is assessed as very minor in the MRI, but still causes many complaints in everyday life, or vice versa. Therefore, although MRI of the knee is the best imaging option, it cannot always replace arthroscopy of the knee.
