{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T08:45:59Z","timestamp":1785746759336,"version":"3.56.0"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T00:00:00Z","timestamp":1783036800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction or background<\/jats:title>\n                    <jats:p>Meniscal tears are a common cause of knee morbidity and a frequent indication for arthroscopy. Whether clinical examination, magnetic resonance imaging (MRI), or both should be the first-line diagnostic test remains contested.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Sources of data<\/jats:title>\n                    <jats:p>We searched PubMed, CINAHL Complete, Medline, and Web of Science for paired-design studies in adults in which every patient underwent both composite clinical examination and MRI, with arthroscopy as the reference standard. Ten studies (1643 knees) met our inclusion criteria. Risk of bias was assessed with QUADAS-2; estimates were pooled with a random-effects model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Areas of agreement<\/jats:title>\n                    <jats:p>For medial meniscal tears, MRI achieved pooled sensitivity of 90% and specificity of 91%; composite clinical examination achieved 85% sensitivity and 95% specificity. For lateral meniscal tears, MRI yielded 81% sensitivity and 82% specificity; composite clinical examination yielded 75% sensitivity and 93% specificity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Areas of controversy<\/jats:title>\n                    <jats:p>Whether composite clinical examination is interchangeable with MRI as a first-line test; reduced MRI specificity in degenerative meniscal lesions and osteoarthritic knees; and the operator-dependence of clinical examination and the lack of a standardized composite-examination protocol.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Growing points<\/jats:title>\n                    <jats:p>Composite clinical examination by an experienced clinician retains diagnostic value alongside MRI. Paired-design synthesis with arthroscopic verification gives less biased estimates of comparative accuracy than unpaired designs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Areas timely for developing research<\/jats:title>\n                    <jats:p>Standardization of composite clinical examination protocols; consistent reporting of examiner experience; stratification of MRI accuracy by field strength and pulse sequence; and cost-effectiveness evaluation of clinical-examination-first diagnostic pathways.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/bmb\/ldag023","type":"journal-article","created":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T11:52:43Z","timestamp":1783684363000},"source":"Crossref","is-referenced-by-count":0,"title":["Diagnostic accuracy of clinical examination versus MRI for meniscal tears: a systematic review and meta-analysis"],"prefix":"10.1093","volume":"159","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9325-5656","authenticated-orcid":false,"given":"Rahul","family":"Rana","sequence":"first","affiliation":[{"name":"Department of Radiology, Sandwell & West Birmingham NHS Trust , Midland Metropolitan University Hospital, Grove Lane, Smethwick, B66 2QT, \u00a0","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-4343-6086","authenticated-orcid":false,"given":"Navjyot","family":"Mehan","sequence":"additional","affiliation":[{"name":"Department of Health, University of Bath , Claverton Down, Bath , BA2 7AY,","place":["United Kingdom"]},{"name":"Department of General Practice, Sandwell & West Birmingham NHS Trust , Sandwell General Hospital, Lyndon, West Bromwich, West Midlands, B71 4HG,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-3214-1931","authenticated-orcid":false,"given":"Rifat","family":"Hassan","sequence":"additional","affiliation":[{"name":"Department of Radiology, Royal Free London NHS Foundation Trust , Pond Street, London , NW3 2QG,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-3342-3061","authenticated-orcid":false,"given":"Yogeshwar","family":"Gohil","sequence":"additional","affiliation":[{"name":"Department of Radiology, Sandwell & West Birmingham NHS Trust , Midland Metropolitan University Hospital, Grove Lane, Smethwick, B66 2QT, \u00a0","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-4107-3843","authenticated-orcid":false,"given":"Anshika","family":"Tyagi","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Leeds Teaching Hospitals NHS Trust , St James's University Hospital, Beckett Street, Leeds , LS9 7TF,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5327-3702","authenticated-orcid":false,"given":"Nicola","family":"Maffulli","sequence":"additional","affiliation":[{"name":"Department of Trauma and Orthopaedic Surgery, Faculty of Medicine and Psychology, Sapienza University of Rome , Via di Grottarossa, 00189 Rome ,","place":["Italy"]},{"name":"Centre for Sports and Exercise Medicine, Queen Mary University of London , London E1 4DG,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,8,3]]},"reference":[{"key":"2026080304032582700_ref1","doi-asserted-by":"publisher","first-page":"e24","DOI":"10.1097\/JSA.0000000000000329","article-title":"The epidemiology of meniscus 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