Peer-reviewed veterinary case report
How well meniscal click detects meniscal tears in dogs with CCL injury
By Neal, Brittany A et al.·Published in Veterinary surgery : VS·2015·Animal Specialty Center, United States·View original on PubMed →
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Original publication title: Evaluation of meniscal click for detecting meniscal tears in stifles with cranial cruciate ligament disease.
- Species:
- dog
Plain-English summary
A group of 56 dogs with cranial cruciate ligament (CCL) injuries were examined for a specific symptom called a palpable meniscal click, which can indicate a meniscal tear in the knee. The results showed that while this click was a good sign of a tear, it wasn't perfect; it had a sensitivity of about 58% during surgery, meaning it missed some tears. However, when the click was present, it was a strong indicator of a meniscal tear. Ultimately, the study highlighted the importance of checking the meniscus during surgery, even if the click isn't felt beforehand, as some tears can still be present without it.
People also search for: dog knee pain meniscal tear · CCL injury in dogs · dog surgery for knee problems
Abstract
OBJECTIVE: To assess the diagnostic efficacy of palpable meniscal click by evaluating the sensitivity, specificity, positive and negative predictive values, and diagnostic accuracy of preoperative palpable meniscal click compared with examination during surgery. STUDY DESIGN: Prospective case series. SAMPLE POPULATION: Dogs (n = 56) with cranial cruciate ligament (CCL) injury. METHODS: Stifles were examined before anesthesia (EBA) and during anesthesia (EDA) before surgery for palpable meniscal click. Sensitivity, specificity, positive and negative predictive values, and diagnostic accuracy were calculated for EBA and EDA using examination during surgery as the gold standard. RESULTS: EBA was 45.8% sensitive and 94.4% specific for meniscal tear. EDA was 58.3% sensitive and 94.4% specific for meniscal tear. Positive predictive value for palpable meniscal click during EBA was 84.6%, negative predictive value was 72.3%, and diagnostic accuracy was 75.0%. Positive predictive value for palpable meniscal click during EDA was 87.5%, negative predictive value was 77.3%, and diagnostic accuracy was 80.0%. EBA and EDA were significantly associated with the presence of intra-operative meniscal injury (P = .0002 and P < .0001, respectively). Meniscal tears were seen more often in stifles with a full CCL tear as compared to partial CCL tears at a ratio of 11:1. CONCLUSIONS: Presence of a palpable meniscal click during physical examination is strongly indicative of a meniscal tear diagnosed at surgery. The meniscus should always be carefully examined at surgery despite preoperative findings, because the absence of a palpable meniscal click is not a strong indicator for a normal meniscus.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/25255826/