The condylar cutoff sign: quantifying lateral femoral condylar hypoplasia in a complete discoid meniscus.

UNLABELLED: We describe the condylar cutoff sign, a radiographic sign in knees with a discoid lateral meniscus, for diagnosis of complete discoid meniscus. We retrospectively reviewed tunnel-view radiographs of 100 patients (100) knees including 50 with complete discoid lateral meniscus and 50 with normal menisci. All patients were 18 years of age or older. All of the knees were arthroscopically examined. We developed a method to measure the prominence of the femoral condyle adjacent to the intercondylar notch on a tunnel view of the knee. The prominence ratio, the ratio of the medial and lateral condylar prominence, was compared and analyzed. The measurements were performed by three observers on two separate occasions to determine reliability. The intraobserver and interobserver variability study revealed high reliability with correlation coefficients ranging from 0.86 to 0.99. Using a cutoff ratio of 0.8, we observed a major difference between the two groups and found the ratio had 76% sensitivity, 96% specificity, 95% positive predictive value, and 80% negative predictive value in every set of measurements. The sign has high specificity and reliability but might not apply to younger patients. LEVEL OF EVIDENCE: Level II, diagnostic study. See the Guidelines for Authors for a complete description of levels of evidence.