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Knudsen et al: Diagnosis of medial meniscal lesions in the canine stifle using multidetector computed tomographic positive-contrast arthrography
Veterinary Surgery 1, 2024

🔍 Key Findings Summary

  • Study Design: Prospective case series of 52 scans from 44 dogs with CCL injury.
  • Main Technique: 16-slice CTA; evaluated by 3 observers with varying experience; validated against surgical mini-medial arthrotomy findings.
  • Diagnostic Metrics (Reading 2):
    • Sensitivity: 1.00 (Observers 1 & 2), 0.93 (Observer 3)
    • Specificity: 0.78–0.91
    • Positive Likelihood Ratio: Up to 10.71
    • Negative Likelihood Ratio: As low as 0.08
    • Accuracy: 90%+ for all in Reading 2
  • Observer Effect: Significant improvement between first and second reading for less experienced observers (p < 0.05); learning curve evident.
  • Meniscal lesions found:
    • 9/12 in suspected late meniscal injury cases
    • 19/40 in newly diagnosed CCL cases
    • Most common = bucket handle tears
  • Conclusion: Multidetector CTA is a clinically useful, non-invasive tool for identifying medial meniscal lesions in dogs with CCL disease.

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← Articles

Knudsen et al: Diagnosis of medial meniscal lesions in the canine stifle using multidetector computed tomographic positive-contrast arthrography
Veterinary Surgery 1, 2024

🔍 Key Findings Summary

  • Study Design: Prospective case series of 52 scans from 44 dogs with CCL injury.
  • Main Technique: 16-slice CTA; evaluated by 3 observers with varying experience; validated against surgical mini-medial arthrotomy findings.
  • Diagnostic Metrics (Reading 2):
    • Sensitivity: 1.00 (Observers 1 & 2), 0.93 (Observer 3)
    • Specificity: 0.78–0.91
    • Positive Likelihood Ratio: Up to 10.71
    • Negative Likelihood Ratio: As low as 0.08
    • Accuracy: 90%+ for all in Reading 2
  • Observer Effect: Significant improvement between first and second reading for less experienced observers (p < 0.05); learning curve evident.
  • Meniscal lesions found:
    • 9/12 in suspected late meniscal injury cases
    • 19/40 in newly diagnosed CCL cases
    • Most common = bucket handle tears
  • Conclusion: Multidetector CTA is a clinically useful, non-invasive tool for identifying medial meniscal lesions in dogs with CCL disease.

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Multiple Choice Questions on this study

In Knudsen 2024 et al., on observer performance, which observer factor significantly influenced diagnostic accuracy?

A. Prior MRI experience
B. Board certification
C. Number of surgeries performed
D. Experience level and training
E. Reading device model

Answer: Experience level and training

Explanation: Inexperienced observers showed significant improvement from Reading 1 to 2; experience had a direct effect on performance.
In Knudsen 2024 et al., on clinical application, what was the negative predictive value of CTA during second reading for experienced observers?

A. 60–70%
B. 71–80%
C. 81–90%
D. 91–100%
E. 100%

Answer: 91–100%

Explanation: NPV was reported as ≥91% in the second reading for all observers, indicating strong ability to rule out meniscal injury.
In Knudsen 2024 et al., on CTA diagnostic accuracy, what was the combined sensitivity and specificity range in the second reading?

A. 1.0–1.5
B. 1.3–1.6
C. 1.5–1.7
D. 1.6–1.9
E. 2.0–2.2

Answer: 1.6–1.9

Explanation: The article reported sums of sensitivity and specificity of approximately 1.8 in the second reading, indicating clinically useful performance.
In Knudsen 2024 et al., on lesion types found, which meniscal injury was most commonly identified during surgery?

A. Radial tear
B. Bucket handle tear
C. Complete meniscal extrusion
D. Cystic degeneration
E. Macerated margin tear

Answer: Bucket handle tear

Explanation: Bucket handle tears were the most common lesion type, especially in newly diagnosed CCL cases.
In Knudsen 2024 et al., on CT imaging protocol, what was the maximum volume of contrast solution injected per stifle?

A. 3 mL
B. 4 mL
C. 5 mL
D. 6 mL
E. 7 mL

Answer: 5 mL

Explanation: CTA contrast solution volume per stifle was capped at 5 mL to achieve joint distension without leakage.

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