Causes of early misdiagnosis of knee meniscal injury without a documented history of acute trauma
ZHAO Shengkun
WANG Zhonghai
XUE Junmin
DAI Yujian
ZHANG Pengdong
Abstract：Objective To analyze the clinical characteristics and imaging manifestations of knee meniscal injuries without a documented history of acute trauma,and to summarize the causes of early misdiagnosis and preventive measures.Methods A retrospective analysis was conducted on the clinical data of 5 patients with knee meniscal injuries who were misdiagnosed in the early stage from February to March 2025,and the diagnosis was confirmed by arthroscopic surgery.Results All 5 patients sought medical attention mainly due to knee pain.Among them,4 patients were accompanied by a definite feeling of"weak legs",2 patients had a history of"joint locking",and 1 patient complained of"audible clicking".All physical examinations revealed tenderness in the joint space.McMurray's test was positive or suspiciously positive in four patients upon admission,and none of them had a documented history of acute trauma.The X-ray examination results were mostly negative or only indicated degenerative changes.One patient was misdiagnosed as knee osteoarthritis(KOA)combined with knee synovitis,2 patients as KOA,and 2 patients as knee pain for further investigation that was considered to be related to the lumbar vertebrae.The misdiagnosis period ranges from 10 d to 5 years.All patients were eventually indicated to have meniscal injury by magnetic resonance imaging(MRI)of the knee joint which was confirmed by arthroscopic surgery.All patients recovered smoothly after the operation,with primary wound healing and no complications such as infection or deep vein thrombosis,showing satisfactory therapeutic effect.Conclusion The early symptoms of knee meniscal injury are often atypical,especially in middle-aged and elderly patients without a documented history of trauma,which can be easily confused with degenerative diseases such as KOA.A detailed inquiry of the medical history,emphasis on suggestive symptoms such as"weak legs"and"joint locking",standardized and meticulous physical examination,and early MRI of the knee joint when the symptoms do not match the X-ray manifestations are the keys to reducing misdiagnosis.
Keywords：knee meniscal injurymisdiagnosisknee osteoarthritisknee synovitisknee joint lockingmagnetic resonance imagingX-ray examination
Publication Date：2025-11-28
Online Publishing Date：2025-12-11(First online date of this platform, not the publication date of the document)
Pages：5( 11-15 )