Lateral Meniscus Tear Diagnosis and Management

The majority of people over 70 years have asymptomatic meniscal tears, and the likelihood of a meniscal tear being present in either a painful or asymptomatic knee is not significantly different in patients 45 to 55 years of age, according to the American College of Radiology 1, 2
The key distinguishing feature of a symptomatic tear is the presence of mechanical symptoms, such as locking, combined with focal tenderness, as suggested by the American College of Radiology, although this specific point is also mentioned by Praxis Medical Insights 3

Diagnostic Approach

Initial imaging should be plain radiographs (AP, lateral, tunnel, and tangential patellar views) to rule out other pathology, as recommended by Praxis Medical Insights, although the American College of Radiology also supports the use of radiographs in certain cases 3, 4
MRI without contrast is the next step if radiographs are normal or non-diagnostic and symptoms persist, with the American College of Radiology citing its high sensitivity and specificity for detecting meniscal tears 1, 2, 5
MRI accurately depicts meniscal abnormalities, articular cartilage damage, and associated bone marrow lesions, according to the American College of Radiology 1, 2
MRI has a pooled sensitivity of 88% and specificity of 90% for detecting meniscal tears, as reported by the American College of Radiology 6, 5