ArticleLife (Basel, Switzerland)2026
A Multimodal Diagnostic Algorithm for Focal Knee Chondral Defects: Correlating Clinical Tests, Musculoskeletal Ultrasound, and MRI-Based ICRS Grading.
Article in Life (Basel, Switzerland), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Influence of Concomitant Articular Cartilage Injury on the Diagnostic Performance of Physical Examination Tests for Meniscal Tears.Orthopaedic journal of sports medicine · 2026Article
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10 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundFocal chondral lesions of the knee are frequently underdiagnosed, and their clinical presentation does not always correlate with structural severity. This study aimed to evaluate the diagnostic utility of clinical examination tests and musculoskeletal ultrasound (MSK-US) in identifying high-grade chondral defects, using MRI-based ICRS grading as the reference standard.
methodsIn this observational cross-sectional study, 57 consecutive patients with mechanical knee pain and MRI-confirmed focal chondral lesions were evaluated through standardized clinical examination, MSK-US, and MRI. Clinical maneuvers-including Wilson's test, McMurray's test, and ligamentous stability tests-were analyzed using Chi-square tests, Pearson correlations, and odds ratios (OR). Statistical processing was performed in Python.
resultsAccording to MRI grading, 87.7% of lesions were ICRS 3, and 12.3% were ICRS 4. Pain and functional impairment (as measured by the WOMAC) were moderate and comparable across lesion grades. Wilson's test showed high sensitivity in both ICRS 3 (66%) and ICRS 4 (100%) lesions, but no statistical association with lesion severity (
conclusionsSymptom severity alone does not reliably distinguish between ICRS Grade 3 and Grade 4 focal chondral lesions. McMurray's test, while not cartilage-specific, was associated with lesion complexity due to its reflection of concomitant meniscal pathology rather than cartilage depth itself. Accordingly, McMurray's test should be interpreted as an indirect clinical indicator of combined osteochondral-meniscal involvement. The integration of targeted clinical tests (Wilson's and McMurray's), MSK-US and MRI-based ICRS grading may support clinical orientation and preoperative risk stratification, forming a pragmatic diagnostic framework rather than a definitive staging tool.
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