This means that in some anatomical locations, some tear will heal quickly even spontaneously, and in some types of tears, healing would need surgical interventions (Ballas & Stillman, 2009). Therefore, prior diagnosis of the location, disposition, depth, orientation, and extent of the meniscal tear becomes of utmost importance, since this would facilitate the optimum treatment and outcomes within the shortest possible time.
This specific dilemma has two parts, one questionable accuracy magnetic resonance imaging studies and failure of appropriate interpretation of the images to lead to a definitive diagnosis unequivocally (Luhmann, Schootman, Gordon, & Wright, 2005). On the other hand, delay for allowance of development of suggestive clinical signs or symptoms may lead to permanent damage. Before going into the details of these issues, it would thus be necessary to establish the facts that are known in each of these issues with an attempt to find relevance between these two, so the evidence base may be available for guiding practice. This issue has been dealt with in adequate detail in prior researches, and thus there is a need for extended literature review to glean what is known. Apart from establishing evidence from the known, it would also serve the purpose of identification of the gaps, so further research may be conducted on these suggestions.
Rationale of the Literature Review
Mesiha et al. (2006) indicated the tricky nature of human meniscal healing following injury. It has been observed that meniscus often fails to heal when the injury has caused a tear of more than 1 cm. similar phenomena have been observed when the tear involves the internal two-thirds of the meniscus (Mesiha, Zurakowski, Soriano, Nielson, Zarins, & Murray, 2006). Menetrey and colleagues (2002) reported failure of healing of peripheral meniscal tears. The failure of recognition of meniscal tears is so rife that, some authors suggested very high meniscal repair failure rates (Menetrey, Siegrist, & Fritschy, 2002). As Venkatachalam et al. (2001) indicated the healing failure may be very high since many patients remain asymptomatic even with an existing tear of the meniscus (Venkatachalam, Godsiff, & Harding, 2001) .
It can be deduced from these studies that although magnetic resonance imaging is available as a diagnostic imaging modality for meniscal injuries, it is questionable whether routine magnetic resonance imaging would be advisable for all suspected cases of meniscal injury or whether in all such cases even after the imaging is done, it would be rational for a radiologist to interpret the image in order to arrive at a diagnosis.
This leads to the research question for this study which is whether routine magnetic resonance imaging for all suspected cases of meniscal tears is optimal, appropriate, or necessary diagnostic modality