Muscle-bone ultrasonic detection system for teenager lateral discoid meniscus and detection method thereof

Abstract

The invention belongs to the technical field of meniscus measurement, and particularly relates to a muscle-bone ultrasonic detection system for teenager lateral discoid meniscus and a detection method of the muscle-bone ultrasonic detection system. The muscle-bone ultrasonic detection system provided by the invention is completed by using muscle-bone ultrasonic equipment and comprises an input module, a comparison module and an output module. The muscle-bone ultrasonic diagnosis method suitable for the lateral discoid meniscus of the teenager is optimized by screening leg knee bending angles (30 degrees, 60 degrees and 90 degrees), examination areas (the anterior angle, the body and the posterior angle of the meniscus) and measurement indexes (the width of the meniscus, the included angle of the free edge of the meniscus, the thickness of the meniscus and the thickness of the median of the meniscus) of the teenager. The method has high sensitivity, specificity and accuracy, provides a powerful basis for clinical diagnosis and early discovery of teenager lateral discoid meniscus, and has a good application prospect.

Description

Technical Field

[0001] The invention belongs to the technical field of meniscus measurement, and in particular relates to a musculoskeletal ultrasonic detection system and a detection method for the lateral discoid meniscus of adolescents. Background Art

[0002] The lateral discoid meniscus is the most common congenital lesion of the lateral meniscus. It refers to the abnormal enlargement and hypertrophy of the lateral meniscus into a disc shape. It is a developmental abnormality of the meniscus and an abnormal structure in the knee joint, which can lead to knee osteoarthritis. Lateral discoid meniscus is more common in adolescents, and the incidence rate in Asians is higher than in the West. Patients with lateral discoid meniscus may experience joint snapping, noose, pain, and limited movement. They are also prone to injuries such as meniscus tears and impacts during exercise. It is one of the common causes of sports injuries in adolescents. Therefore, early diagnosis of lateral discoid meniscus is a prerequisite for timely and effective treatment.

[0003] Musculoskeletal ultrasound has developed into a valuable tool in the diagnosis of meniscal pathology. In recent years, advances in high-frequency probes and high-resolution imaging have significantly improved the ability of ultrasound to diagnose meniscal injuries and abnormalities. As a non-invasive imaging method, ultrasound offers several advantages, including low price, ease of use, real-time dynamic assessment, and accessibility. Studies have shown that ultrasound can now achieve a level of sensitivity and specificity comparable to magnetic resonance imaging (MRI) in the diagnosis of certain meniscal pathologies.

[0004] Musculoskeletal ultrasound has also made significant progress in the diagnosis of discoid meniscus. Studies in recent years have shown that high-resolution ultrasound has shown potential in the diagnosis of discoid meniscus, especially in the diagnosis of lateral discoid meniscus, showing high sensitivity and specificity. The advantage of ultrasound is that it can dynamically observe the movement of the meniscus, which is particularly important for the diagnosis of discoid meniscus. Existing studies on the musculoskeletal ultrasound diagnosis of lateral discoid meniscus injuries in adults mainly use morphological indicators, such as whether abnormal angles and freezes appear under ultrasound, and measure the thickness of the synovial edge of the meniscus / discoid meniscus for diagnosis, and verify its diagnostic efficacy by comparing with MRI or arthroscopy.

[0005] The existing musculoskeletal ultrasound diagnosis technology of meniscus is still mainly based on the guidance of professional books in the field of musculoskeletal ultrasound, which still has important guiding value in terms of body positioning, probe placement and other factors. In "Musculoskeletal Ultrasound Diagnosis (Editor: Wang Yuexiang, Qu Wenchun)", the patient lies in the supine position, with a small pillow behind the knee to flex the knee joint 20~30° for measurement (such as Figure 1). The book does not introduce the measurement of the lateral meniscus. When measuring the medial meniscus, the knee joint is slightly valgus, and the probe is placed between the medial femoral condyle and the tibial plateau. The probe is moved back and forth to display the anterior horn, body, and posterior horn of the meniscus. In addition, "Abdomen and Superficial Tissue Color Doppler Ultrasound" also mentioned that when ultrasonically examining the medial and lateral sides of the knee joint, the anterior horn and posterior horn areas of the medial and lateral meniscus of the knee joint can be scanned respectively (such as Figure 2 ).

[0006] In the diagnosis of adolescent discoid meniscus, ultrasound examination has been proven to be an effective preliminary screening tool, which helps to reduce the length of MRI examinations. However, there are relatively few musculoskeletal ultrasound diagnoses of discoid meniscus in children and adolescents. Yang Hua et al. compared whether there are differences in the diagnostic efficacy of different musculoskeletal ultrasound probes for adolescent lateral discoid meniscus. Their ultrasound measurement indicators only include the width of the meniscus / discoid meniscus. Therefore, there are still some limitations in the ultrasound diagnosis of adolescent discoid meniscus: (1) The measurement indicators are single, and the accuracy or specificity is not high. Especially in some complex cases involving muscle, ligament and multiple soft tissue injuries, MRI may be needed for diagnosis; (2) The measurement method is not unified and highly dependent on the operator's experience.

[0007] In summary, how to select appropriate parameters for measurement so that the musculoskeletal ultrasound method can more accurately diagnose adolescent discoid meniscus is a major challenge in this field. Summary of the invention

[0008] In view of the defects of the prior art, the present invention provides a musculoskeletal ultrasonic measurement method for the lateral discoid meniscus of adolescents, aiming at accurately performing ultrasonic examination of the adolescent meniscus / discoid meniscus.

[0009] The present invention provides a musculoskeletal ultrasonic detection system for the lateral discoid meniscus of adolescents, which comprises: An input module is configured to input a measurement index, wherein the measurement index includes at least one of a meniscus width, a meniscus thickness, a median meniscus thickness, and a meniscus angle; The comparison module is configured to compare the data of the measurement index with the threshold values, wherein the threshold values ​​are: when the knee is flexed at 30°, the threshold value of the thickness of the anterior horn of the meniscus is 0.78 cm, the threshold value of the median thickness of the anterior horn of the meniscus is 0.36 cm, the threshold value of the thickness of the body of the meniscus is 0.80 cm, the threshold value of the median thickness of the body of the meniscus is 0.41 cm, the threshold value of the thickness of the posterior horn of the meniscus is 0.67 cm, and the threshold value of the median thickness of the posterior horn of the meniscus is 0.35 cm; when the knee is flexed at 90°, the threshold value of the thickness of the anterior horn of the meniscus is 0.76 cm, and the threshold value of the median thickness of the anterior horn of the meniscus is 0.32 cm; The output module is configured to output the lateral discoid meniscus if at least one of the measurement index data is greater than or equal to the threshold, and to output the normal meniscus if any of the measurement index data is less than the threshold.

[0010] Preferably, the measurement index is meniscus thickness and / or median meniscus thickness.

[0011] Preferably, the detection method of the measurement index is: the subject's leg to be measured is in the upper lateral position, with the knee flexed 30°, 60°, and 90° respectively, and the musculoskeletal ultrasound detection system is used to perform data detection of the measurement index in the inspection area, and the inspection area includes the anterior horn, body and posterior horn of the meniscus.

[0012] Preferably, the knee flexion is 30° and 90°; and the measurement index is the meniscus thickness and / or median thickness.

[0013] Preferably, the positions of the anterior horn, body and posterior horn of the meniscus are located according to the Gerdy tubercle of the tibia, the fibular head and the popliteal tendon groove of the lateral condyle of the femur.

[0014] Preferably, the inspection area of ​​the anterior horn of the meniscus is located at the intersection of the long axis extension line of the lateral edge of the patella and the tibiofemoral joint line; And / or, the inspection area of ​​the body of the meniscus is located in the area where the long axis tangent line in front of the fibular head intersects with the tibiofemoral joint line; And / or, the inspection area of ​​the posterior horn of the meniscus is located at the intersection of the posterior part of the fibular head and the tibiofemoral joint line along the long axis tangent.

[0015] Preferably, the leg to be tested is slightly internally rotated before knee flexion; and / or, during the test, the examiner performs the measurement on the right side of the subject; And / or, the subject is 10-19 years old.

[0016] Preferably, during the detection, the examiner performs a standard section examination according to the existing musculoskeletal ultrasound knee joint examination method; when performing an ultrasound examination of the lateral side of the knee joint, the ultrasound probe is placed along the long axis of the lower limb; when measuring the posterior horn of the meniscus, the ultrasound probe is placed on the posterolateral side.

[0017] Preferably, the meniscus width is the distance from the top to the bottom of the white triangular area of ​​the meniscus in the ultrasound image; the meniscus thickness is the distance between the two edges of the white triangular area of ​​the meniscus and the synovial margin in the ultrasound image; the median thickness of the meniscus is the thickness of the meniscus at 1 / 2 of the meniscus width; and the meniscus angle is the angle formed by the tangent of the meniscus close to the center of the joint cavity.

[0018] The present invention provides a detection method for non-diagnostic purposes using the musculoskeletal ultrasonic detection system described in any one of the above items, comprising: Inputting a measurement index, wherein the measurement index includes at least one of meniscus width, meniscus thickness, meniscus median thickness, and meniscus angle; The data of the measured indicators were compared with the threshold values, which were: at 30° knee flexion, the threshold value of the thickness of the anterior horn of the meniscus was 0.78 cm, the threshold value of the median thickness of the anterior horn of the meniscus was 0.36 cm, the threshold value of the thickness of the body of the meniscus was 0.80 cm, the threshold value of the median thickness of the body of the meniscus was 0.41 cm, the threshold value of the thickness of the posterior horn of the meniscus was 0.67 cm, and the threshold value of the median thickness of the posterior horn of the meniscus was 0.35 cm; at 90° knee flexion, the threshold value of the thickness of the anterior horn of the meniscus was 0.76 cm, and the threshold value of the median thickness of the anterior horn of the meniscus was 0.32 cm; If at least one of the measurement index data is greater than or equal to the threshold, the output is the lateral discoid meniscus. If any of the measurement index data is less than the threshold, the output is the normal meniscus.

[0019] The present invention provides a musculoskeletal ultrasound detection system and a detection method for the lateral discoid meniscus of adolescents. The present invention selects a musculoskeletal ultrasound diagnosis method suitable for the lateral discoid meniscus of adolescents by screening the knee flexion angle of the leg of the test subject (30°, 60°, 90°), the inspection area (the anterior angle, body, and posterior angle of the meniscus), and the measurement indexes (meniscus width, meniscus free edge angle, meniscus thickness, and meniscus median thickness). The selected musculoskeletal ultrasound diagnosis method has high sensitivity, specificity, and accuracy. The present invention proposes clear positioning points of surface bony structures, which can standardize the measurement and avoid the occurrence of selection bias when different operators select the anterior angle, body, or posterior angle. The method of the present invention provides a strong basis for the clinical diagnosis and early detection of the lateral discoid meniscus of adolescents and has good application prospects.

[0020] Obviously, according to the above contents of the present invention, in accordance with common technical knowledge and customary means in the art, without departing from the above basic technical ideas of the present invention, other various forms of modification, replacement or change may be made.

[0021] The above contents of the present invention are further described in detail below through specific implementation methods in the form of embodiments. However, this should not be understood as the scope of the above subject matter of the present invention being limited to the following examples. All technologies realized based on the above contents of the present invention belong to the scope of the present invention. BRIEF DESCRIPTION OF THE DRAWINGS

[0022] Figure 1This is a schematic diagram of the ultrasound imaging of the medial meniscus and tibial collateral ligament of the knee joint in the book "Musculoskeletal Ultrasound Diagnosis"; the long arrow indicates the ultrasound imaging of the medial meniscus of the knee joint; the short arrow indicates the ultrasound imaging of the tibial collateral ligament.

[0023] Figure 2 These are schematic diagrams of ultrasound imaging of the meniscus of the knee joint in the book "Color Doppler Ultrasound of the Abdomen and Superficial Tissues"; Figure A is a schematic diagram of ultrasound imaging of the medial meniscus of the knee joint, with the arrow indicating the meniscus triangular area; Figure B is a schematic diagram of ultrasound imaging of the lateral meniscus of the knee joint, with the arrow indicating the meniscus triangular area.

[0024] Figure 3 Figure 1 is a schematic diagram of body position when the knee is flexed; Figure A is a schematic diagram of body position when the knee is flexed 30°; Figure B is a schematic diagram of body position when the knee is flexed 60°; Figure C is a schematic diagram of body position when the knee is flexed 90°.

[0025] Figure 4 Schematic diagram of the positioning of the ultrasound probe during musculoskeletal ultrasound examination of the lateral meniscus / discoid meniscus; wherein, 1 is an indication diagram of the tibiofemoral joint line; 2 is an indication diagram of the patella; 3 is an indication diagram of the fibular head; 4 is an indication diagram of the tangent of the lateral edge of the patella; 5 is an indication diagram of the tangent along the long axis in front of the fibular head; 6 is an indication diagram of the posterolateral tangent of the fibular head; 7 is an indication diagram of the measurement area of ​​the anterior angle of the lateral meniscus; 8 is an indication diagram of the measurement area of ​​the body of the lateral meniscus; 9 is an indication diagram of the measurement area of ​​the posterior angle of the lateral meniscus.

[0026] Figure 5 This is a schematic diagram of the measurement indicators when measuring the lateral meniscus / discoid meniscus of the knee joint by musculoskeletal ultrasound; Figure a is a schematic diagram of measurement indicator 1: meniscus thickness, 2: median meniscus thickness, 3: meniscus width; Figure b is a schematic diagram of measurement indicator 4: meniscus angle.

[0027] Figure 6 This is an ultrasound scan of the normal meniscus body with the knee flexed at 30°.

[0028] Figure 7 This is an ultrasound scan of the normal anterior horn of the meniscus with the knee flexed at 30°.

[0029] Figure 8 These are ultrasound scans of the body of the lateral discoid meniscus of four patients with the knee flexed at 30°; Figure A is an ultrasound scan of the lateral discoid meniscus of patient A (uninjured); Figure B is an ultrasound scan of the lateral discoid meniscus of patient B (uninjured); Figure C is an ultrasound scan of the lateral discoid meniscus of patient C (injured); Figure D is an ultrasound scan of the lateral discoid meniscus of patient D (injured); the arrow indicates the tear site. DETAILED DESCRIPTION

[0030] In the following examples and experimental examples, reagents and materials not particularly described are all commercially available.

[0031] The present invention uses a domestic color Doppler ultrasonic diagnostic instrument (product model: LOGIQ e), a linear array probe is used for inspection, the probe frequency is 2.0~5.0MHz, a c1-5 probe is used, the inspection mode is B-mode, and the skeletal muscle mode of the instrument is uniformly used to inspect the knee joint. All inspections are repeated to collect images twice, and the images are stored and measured.

[0032] Example 1 A method for musculoskeletal ultrasound detection of the lateral discoid meniscus in adolescents This embodiment establishes a lateral discoid meniscus inspection process and plan for adolescents, and the detailed steps are as follows: 1. Body Positioning like Figure 3 As shown, the patient adopts the lateral decubitus position with the affected side on top and the healthy leg flexed to maintain a stable lateral decubitus position. The affected leg is slightly internally rotated and measurements are taken at 30° and 90° knee flexion, respectively. When the patient flexes the knee at 90°, a cushion is placed under the affected side.

[0033] 2. Confirmation of body surface landmarks Use bony landmarks for localization, such as Figure 4 As shown in the figure, the anterior horn, body and posterior horn of the meniscus are located according to the Gerdy tubercle of the tibia, the fibular head and the popliteal tendon groove of the lateral femoral condyle. The inspection area of ​​the anterior horn of the lateral meniscus is located at the intersection of the long axis extension line of the lateral edge of the patella and the tibiofemoral joint line; the inspection area of ​​the body is located at the intersection of the long axis tangent line of the anterior part of the fibular head and the joint line; the inspection area of ​​the posterior horn is located at the intersection of the long axis tangent line of the posterior part of the fibular head and the joint line.

[0034] 3. Confirmation of inspection indicators Examination indicators include meniscus thickness (cm) and median meniscus thickness (cm). Figure 5 As shown, the meniscus thickness is Figure 5 The distance between the two edges of the middle white triangle and the synovial margin; the median thickness of the meniscus is the thickness of the meniscus at 1 / 2 of the meniscus width. Figure 5 The distance from the top to the bottom of the medium white triangle.

[0035] V. Measurement Method The examiner is located on the right side of the patient and performs standard section examinations according to existing musculoskeletal ultrasound knee examination methods. When performing ultrasound examinations on the lateral side of the knee, the ultrasound probe usually uses long-axis sonography (i.e., coronal imaging, with the ultrasound probe placed along the long axis of the lower limb) for structural examination. When measuring the posterior horn of the meniscus, the probe should be placed posterolaterally.

[0036] 6. Diagnosis of Lateral Discoid Meniscus (1) Qualitative evaluation The normal lateral meniscus has equal signal echo and uniform echo. When the meniscus is damaged, there is a strip-shaped low echo area inside the meniscus.

[0037] The discoid meniscus is thicker and wider than the normal meniscus. On ultrasound imaging, the image of the lateral discoid meniscus is a trapezoid or irregular trapezoid, while the normal meniscus is a triangle with uniform signal.

[0038] (2) Quantitative evaluation With the knee flexed at 30°, the threshold for the thickness of the anterior horn of the meniscus was 0.78 cm, the threshold for the median thickness of the anterior horn of the meniscus was 0.36 cm, the threshold for the thickness of the body of the meniscus was 0.80 cm, the threshold for the median thickness of the body of the meniscus was 0.41 cm, the threshold for the thickness of the posterior horn of the meniscus was 0.67 cm, and the threshold for the median thickness of the posterior horn of the meniscus was 0.35 cm.

[0039] With the knee flexed at 90°, the threshold for the thickness of the anterior horn of the meniscus was 0.76 cm, and the threshold for the median thickness of the anterior horn of the meniscus was 0.32 cm.

[0040] If the test result of any of the above indicators exceeds the threshold, it indicates that there is a risk of developing lateral discoid meniscus; the more examination indicators that exceed the threshold and / or the higher the degree of exceeding the threshold, the higher the risk of developing lateral discoid meniscus.

[0041] Example 2 Non-diagnostic use of the musculoskeletal ultrasound detection system for the lateral discoid meniscus of adolescents The meniscus of adolescent volunteers was tested according to the testing method described in Example 1 to develop a knee joint protector that is more suitable for adolescents with discoid meniscus.

[0042] Example 3 Non-diagnostic use of the musculoskeletal ultrasound detection system for the lateral discoid meniscus of adolescents The meniscus of adolescent volunteers was tested according to the testing method described in Example 1 to prepare a 3D printed meniscus model for teaching purposes.

[0043] The technical solution of the present invention is further illustrated by experiments below.

[0044] Experimental Example 1 Screening of measurement indicators for musculoskeletal ultrasound method 1. Experimental Methods (1) Body positioning The patient lies on the affected side with the unaffected leg flexed, and the lateral position is maintained stable. The affected leg is slightly internally rotated, and the measurement is performed at 30°, 60°, and 90° of knee flexion (eg Figure 3), the patient places a cushion under the affected side when the knee is flexed 90°. The examiner is located on the right side of the patient for examination, and the examiner performs standard section examination according to the existing musculoskeletal ultrasound knee examination method. When performing ultrasound examination of the lateral knee joint, the ultrasound probe usually uses long-axis sonography (i.e., coronal imaging, with the ultrasound probe placed along the long axis of the lower limb) for structural examination. The basic structures of the lateral knee joint include the lateral collateral ligament, iliotibial band, biceps femoris tendon and lateral meniscus.

[0045] (2) Confirmation of body surface landmarks During the examination, bone landmarks are used for positioning, and the anterior horn, body, and posterior horn of the meniscus are located according to the Gerdy tubercle of the tibia, the fibular head, and the popliteal tendon groove of the lateral femoral condyle. The anterior horn inspection area of ​​the lateral meniscus is located at the intersection of the long axis extension line of the lateral edge of the patella and the tibiofemoral joint line; the body inspection area is located in the intersection of the long axis tangent line of the anterior part of the fibular head and the joint line; the posterior horn inspection area is located in the intersection of the long axis tangent line of the posterior part of the fibular head and the joint line (such as Figure 4 ).

[0046] (3) Confirmation of scanned images The normal lateral meniscus has equal signal echoes and uniform echoes. When the meniscus is damaged, a strip-shaped low-echo area can be seen inside the meniscus. When measuring the body of the normal lateral meniscus, there may be uneven echoes, which is caused by the influence of the lateral femoral condyle. The probe should be fine-tuned and imaged multiple times to distinguish it from damage. In addition, when measuring the posterior horn of the meniscus, the probe should be placed posterolaterally, and because there are popliteal tendons and posterior articular recesses between the middle and posterior parts of the lateral meniscus and the joint capsule, the probe should be fine-tuned and imaged multiple times to distinguish the low-echo area between the meniscus and the joint capsule from meniscus damage.

[0047] (4) Confirmation of ultrasound image indicators The examination indicators include meniscus width (cm), meniscus thickness (cm), median meniscus thickness (cm), and meniscus angle (°). Figure 5 The distance from the top to the bottom of the middle white triangle; the meniscus thickness is the distance between the two edges of the white triangle and the synovial margin; the median thickness of the meniscus is the thickness of the meniscus at 1 / 2 of the meniscus width; the meniscus angle is the angle formed by the tangent of the meniscus close to the center of the joint cavity.

[0048] (5) Measurement method Each indicator was measured three times and the average value was taken. All indicators were measured twice by the same person, and the interval between the two measurements was 1 month. The consistency analysis of the two measurement data was performed. If the consistency was good, the analysis could be continued. If the consistency difference was large, the third measurement was performed one month apart. All images and data were saved.

[0049] (6) Target population The test population was derived from patients scheduled for surgery for lateral meniscus injury at the Sports Medicine Center of West China Hospital, aged 4-19 years, with a total of 60 cases.

[0050] (7) Data processing method The collected data were statistically analyzed using SPSS23.0 (Statistical Product and Service Solutions) software. Continuous variables were recorded as mean ± standard deviation, and non-continuous variables were recorded as number of cases or percentages. The measurement indicators were measured twice continuously, and the diagnostic value analysis calculated the threshold by drawing the ROC curve and recorded its AUC area. Diagnostic indicators include diagnostic accuracy, sensitivity, and specificity. Accuracy evaluates the percentage of true positives and true negatives diagnosed in the total number, sensitivity evaluates the percentage of true illness diagnosed in the actual true illness, and specificity evaluates the percentage of true health diagnosed in the actual true health.

[0051] 2. Experimental Results (1) Qualitative evaluation The discoid meniscus is thicker and wider than the normal meniscus. On ultrasound imaging, the normal meniscus is mostly a uniform signal triangle (such as Figure 6 , 7 ); The width, thickness, angle, etc. of the discoid meniscus are different from those of the normal lateral meniscus. Compared with the normal meniscus, the image of the lateral discoid meniscus is trapezoidal or irregular trapezoidal (such as Figure 8 ).

[0052] (2) Quantitative results The AUC and threshold results of the measurement indicators are shown in Table 1: When the knee is flexed 30°, the measurement indicators with AUC values ​​greater than 0.7 are: the meniscus thickness and median thickness measured in the anterior horn, body, and posterior horn inspection areas, and the meniscus width measured in the posterior horn inspection area; when the knee is flexed 60°, the measurement indicators with AUC values ​​greater than 0.7 are: the median meniscus thickness measured in the body inspection area; when the knee is flexed 90°, the measurement indicators with AUC values ​​greater than 0.7 are: the meniscus thickness, median thickness, and angle measured in the anterior horn inspection area. This shows that under these selected measurement indicators and corresponding thresholds, normal meniscus and lateral discoid meniscus can be identified more accurately.

[0053] Table 1 AUC and threshold results of measurement indicators The results of sensitivity, specificity and accuracy are shown in Table 2. It can be seen that the measurement indicators with sensitivity, specificity and accuracy greater than 65% are: the meniscus thickness and median thickness measured in the anterior angle, body and posterior angle inspection areas when the knee is flexed 30°. It shows that under these measurement indicators, according to the measurement method of the present invention, good results in sensitivity, specificity and accuracy can be obtained, which can provide doctors with a reliable basis for diagnosis. Among them, the measurement indicator with sensitivity, specificity and accuracy greater than 75% is: the meniscus thickness measured in the anterior angle inspection area when the knee is flexed 30°. It shows that this measurement indicator has a higher diagnostic value.

[0054] Table 2 Sensitivity, specificity and accuracy results of measurement indicators In addition, in the field of medical diagnosis, specificity is extremely important, which can reduce misdiagnosis and improve the reliability of diagnosis. Therefore, the present invention also screens out measurement indicators with high specificity (over 80%), which are: when the knee is flexed 30°, the meniscus width measured in the anterior angle inspection area, the meniscus angle measured in the body inspection area, and the meniscus thickness and angle measured in the posterior angle inspection area; when the knee is flexed 60°, the median thickness of the meniscus measured in the body inspection area; when the knee is flexed 90°, the meniscus thickness and median thickness measured in the anterior angle inspection area.

[0055] Based on the above screening results of AUC, sensitivity, specificity and accuracy, the measurement indicators with higher diagnostic value are: the meniscus thickness and median thickness measured in the anterior horn, body and posterior horn inspection areas when the knee is flexed 30°. Among them, in particular, when the meniscus thickness measured in the anterior horn inspection area is used as an indicator when the knee is flexed 30°, the various effects are optimal, which can provide a reliable basis for the diagnosis of lateral discoid meniscus in adolescents. In addition, considering the high specificity, the two measurement indicators of meniscus thickness and median thickness measured in the anterior horn inspection area when the knee is flexed 90° also have high diagnostic value.

[0056] Since the flexion angle of underage patients changes and they move constantly during the measurement process, the diagnostic value of the measurement index at 60° flexion still needs further study. The sensitivity of the measurement index at 90° flexion is low, but the specificity and accuracy are high. Excessive flexion may cause muscle compression, which may affect the imaging of the probe. Therefore, when conducting ultrasound diagnosis and measurement of the lateral discoid meniscus in adolescents, it is preferred to fully incorporate the thickness and median thickness of the anterior horn, body and posterior horn of the meniscus in the 30° flexion position, combined with the thickness and median thickness of the anterior horn in the 90° flexion position.

[0057] The above results show that in the ultrasound diagnosis of the lateral discoid meniscus muscle and bone in adolescents, the present invention screens out examination indicators with high sensitivity, specificity and accuracy, and determines the threshold value of the examination indicators.

[0058] Through the above embodiments and experimental examples, it can be seen that the present invention provides a musculoskeletal ultrasonic detection system and detection method for the lateral discoid meniscus of adolescents. The present invention performs multi-position measurement and evaluation at 30°, 60°, and 90° of knee flexion, respectively, and performs it in the lateral position, providing different conditions of compression of the meniscus by the surrounding structures under different knee flexion angles, and analyzing the musculoskeletal ultrasonic imaging; the present invention incorporates morphological indicators, meniscus width, meniscus free edge angle, meniscus thickness and meniscus median thickness, and measures all quantitative indicators in the anterior horn, body, and posterior horn of the meniscus / discoid meniscus, respectively, and provides multi-plane detailed data; the present invention proposes a clear body surface bone structure positioning point, which can make the measurement standardized, and avoid the occurrence of selection bias and the like when different operators select the anterior horn, body or posterior horn. After calculation and comparison of the test data, the quantitative inspection index suitable for the musculoskeletal ultrasonic diagnosis of the lateral discoid meniscus of adolescents is selected, which provides a strong basis for the clinical diagnosis and early detection of the lateral discoid meniscus of adolescents, and has a good application prospect.

Claims

1. A musculoskeletal ultrasonic detection system for the lateral discoid meniscus of adolescents, characterized in that: include: An input module is configured to input a measurement index, wherein the measurement index includes at least one of a meniscus width, a meniscus thickness, a median meniscus thickness, and a meniscus angle; The comparison module is configured to compare the data of the measurement index with the threshold values, wherein the threshold values ​​are: when the knee is flexed at 30°, the threshold value of the thickness of the anterior horn of the meniscus is 0.78 cm, the threshold value of the median thickness of the anterior horn of the meniscus is 0.36 cm, the threshold value of the thickness of the body of the meniscus is 0.80 cm, the threshold value of the median thickness of the body of the meniscus is 0.41 cm, the threshold value of the thickness of the posterior horn of the meniscus is 0.67 cm, and the threshold value of the median thickness of the posterior horn of the meniscus is 0.35 cm; when the knee is flexed at 90°, the threshold value of the thickness of the anterior horn of the meniscus is 0.76 cm, and the threshold value of the median thickness of the anterior horn of the meniscus is 0.32 cm; The output module is configured to output the lateral discoid meniscus if at least one of the measurement index data is greater than or equal to the threshold, and to output the normal meniscus if any of the measurement index data is less than the threshold.

2. The musculoskeletal ultrasonic detection system for the lateral discoid meniscus of adolescents according to claim 1, characterized in that: The measurement index is meniscus thickness and / or median meniscus thickness.

3. The musculoskeletal ultrasonic detection system for the lateral discoid meniscus of adolescents according to claim 1, characterized in that: The detection method of the measurement index is as follows: the subject's leg to be measured is in the upper lateral position, with the knee flexed 30°, 60°, and 90° respectively, and the data of the measurement index is detected in the inspection area through a musculoskeletal ultrasound detection system, and the inspection area includes the anterior horn, body and posterior horn of the meniscus.

4. The musculoskeletal ultrasonic detection system for the lateral discoid meniscus of adolescents according to claim 3, characterized in that: The knee flexion is 30° and 90°; the measurement index is the meniscus thickness and / or median thickness.

5. The musculoskeletal ultrasonic detection system for the lateral discoid meniscus of adolescents according to claim 3, characterized in that: The positions of the anterior horn, body and posterior horn of the meniscus are located according to the Gerdy tubercle of the tibia, the fibular head and the popliteal tendon groove of the lateral condyle of the femur.

6. The musculoskeletal ultrasonic detection system for the lateral discoid meniscus of adolescents according to claim 5, characterized in that: The inspection area of ​​the anterior horn of the meniscus is located at the intersection of the long axis extension line of the lateral edge of the patella and the tibiofemoral joint line; And / or, the inspection area of ​​the body of the meniscus is located in the area where the long axis tangent line in front of the fibular head intersects with the tibiofemoral joint line; And / or, the inspection area of ​​the posterior horn of the meniscus is located at the intersection of the posterior part of the fibular head and the tibiofemoral joint line along the long axis tangent.

7. The musculoskeletal ultrasonic detection system for the lateral discoid meniscus of adolescents according to claim 3, characterized in that: The leg to be tested is slightly internally rotated before knee flexion; and / or, during the test, the examiner performs the measurement on the right side of the subject; And / or, the subject is 10-19 years old.

8. The musculoskeletal ultrasonic detection system for the lateral discoid meniscus of adolescents according to claim 3, characterized in that: During the test, the examiner performs a standard section examination according to the existing musculoskeletal ultrasound knee joint examination method; when performing an ultrasound examination of the lateral side of the knee joint, the ultrasound probe is placed along the long axis of the lower limb; when measuring the posterior horn of the meniscus, the ultrasound probe is placed on the posterolateral side.

9. The musculoskeletal ultrasonic detection system for the lateral discoid meniscus of adolescents according to claim 1, characterized in that: The meniscus width is the distance from the top to the bottom of the white triangular area of ​​the meniscus in the ultrasound image; the meniscus thickness is the distance between the two edges of the white triangular area of ​​the meniscus and the synovial edge in the ultrasound image; the median thickness of the meniscus is the thickness of the meniscus at 1 / 2 of the meniscus width; the meniscus angle is the angle formed by the tangent of the meniscus close to the center of the joint cavity.

10. The non-diagnostic detection method for the musculoskeletal ultrasonic detection system of the lateral discoid meniscus of adolescents according to any one of claims 1 to 9, characterized in that: Inputting a measurement index, wherein the measurement index includes at least one of meniscus width, meniscus thickness, meniscus median thickness, and meniscus angle; The data of the measured indicators were compared with the threshold values, which were: at 30° knee flexion, the threshold value of the thickness of the anterior horn of the meniscus was 0.78 cm, the threshold value of the median thickness of the anterior horn of the meniscus was 0.36 cm, the threshold value of the thickness of the body of the meniscus was 0.80 cm, the threshold value of the median thickness of the body of the meniscus was 0.41 cm, the threshold value of the thickness of the posterior horn of the meniscus was 0.67 cm, and the threshold value of the median thickness of the posterior horn of the meniscus was 0.35 cm; at 90° knee flexion, the threshold value of the thickness of the anterior horn of the meniscus was 0.76 cm, and the threshold value of the median thickness of the anterior horn of the meniscus was 0.32 cm; If at least one of the measurement index data is greater than or equal to the threshold, the output is the lateral discoid meniscus. If any of the measurement index data is less than the threshold, the output is the normal meniscus.

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