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Validity of squatting test versus magnetic resonance and arthroscopy for meniscus injures of the knee
Husham A. Salih1, Ali K. Mohialdeen2, Laith K. Omar3, Bara H. Abdulkareem4, Riyadh K. Lafta5
1Assistant Professor, Department of Surgery, Mosul Medical College, Teaching Hospital Iraq.
2Lecturer, Department of surgery, Ninevah Medical College Mosul University, Mosul, Iraq.
3Specialist, Orthopedic Surgeon, Al-Jumhory Teaching Hospital, Iraq.
4Registrar, Mosul Medical College/Teaching Hospital Iraq.
5MD, PhD, Professor, College of Medicine/ Mustansiriya University, Iraq, Affiliated Prof., Global Health, University of Washington, USA.

Article ID: 100004O03HS2016
doi:10.5348/O03-2016-4-OA-2

Address correspondence to:
Husham A. Salih
Assistant Professor, Department of Surgery
Mosul Medical College/ Teaching Hospital
Iraq

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How to cite this article
Salih HA, Mohialdeen AK, Omar LK, Abdulkareem BH, Lafta RK. Validity of squatting test versus magnetic resonance and arthroscopy for meniscus injures of the knee. Edorium J Orthop 2016;2:9–15.


Abstract
Aims: Squatting clinical tests used for the detection of meniscal tears in the knee do not present acceptable diagnostic validity values. Diagnostic accuracy is improved by arthroscopic evaluation or magnetic resonance imaging studies. The objective of this study was to evaluate the validity of squatting clinical examination test for detection of meniscal tears.
Methods: This case series study was conducted in Aljumhoori teaching hospital, Mosul city, Iraq during the period from January 2010 through December 2011, the study sample consisted of a series of 159 patients (127 males and 32 females), age between 15–56 years. Sensitivity of squatting test (as a screening test) was measured versus MRI and knee arthroscopy (as the gold standards).
Results: The results revealed that the sensitivity of the squatting test versus MRI scan was 87% and 55% respectively for the medial meniscus, and (57% and 90%) for the lateral meniscus. The positive and negative predictive values for the medial and lateral menisci were (78%, 63%, and 55%, 90%) respectively with an accuracy of 74% for the medial and 84% for the lateral meniscus. Using arthroscopy as a gold standard gave a sensitivity of 84% and specificity of 54% for the medial meniscus with a positive and negative predictive value of the screening test of 76% and 66% respectively, while the lateral meniscus showed a sensitivity and specificity of 63% and 87%, and positive and negative predictive values of 41% and 94% respectively. The accuracy was 63% for the medial and 85% for the lateral meniscus.
Conclusion: Squatting test is helpful (but not sufficient) in diagnosing meniscus injure, while MRI and knee arthroscopy increase the validity of the test and are necessary for confirming the diagnosis.

Keywords: Arthroscopy, Iraq, Knee joint, Meniscus injure, Squatting test


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Author Contributions:
Husham A. Salih – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Ali K. Mohialdeen – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Laith K. Omar – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Bara H. Abdulkareem – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Riyadh K. Lafta – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of submission
The corresponding author is the guarantor of submission.
Source of support
None
Conflict of interest
Authors declare no conflict of interest.
Copyright
© 2016 Husham A. Salih et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.