A Comparison between the Role of MRI and Arthroscopy in the Diagnosis of Traumatic Knee Lesions

Authors

1 Assistant professor of Orthopaedic surgery, Mashhad University of Medical Sciences, Mashhad, Iran

2 Radiologist, Sabzevar, Iran

3 Residentof Orthopaedic Surgery, Mashhad University of Medical Sciences, Mashhad, Iran

Abstract

Introduction
The knee is one of the most frequently injured joints. Clinical tests in the diagnosis of meniscus and ligament injuries have limitations and it may not be possible to elicit objective signs repeatedly. MRI, has been shown to improve diagnostic accuracy in many knee disorders. Its principal attractiveness over arthroscopy is that it is noninvasive. To determine the effectiveness of magnetic resonance imaging in the appropriate identification of traumatic intra articular knee lesions, we compared its findings with clinical examination and arthroscopy as a gold standard technique in a descriptive cross sectional study.
Materials and Methods
Overall 100 patients with knee trauma were entered and completed the study. All patients had thorough clinical examination By experienced physicians. An MRI of the affected knee was requested in all patients. Arthroscopies were performed for all of them.
Results
Overall 55 knees were reported to have ACL tear arthroscopically, Meniscal injuries were found in 75 cases. We found correlation between posterior drawer test, MRI report of PCL tear and arthroscopic PCL tear. The sensitivity of MRI for detecting Meniscal tear: represented high, for bucket handle tear of medial meniscus, and high specificity for Lateral meniscal tear.
Conclusion
It is concluded that arthroscopy still remains the gold standard technique. More powerful MRI scan equipments with better soft wares will be needed in order to have much better diagnosis.

Keywords


1- Lee JK, Yao L, Phelps CT, Wirth CR, Czajka J, Lozman J. Anterior cruciate ligament tears: MR imaging compared
with arthroscopy and clinical tests. Radiology 1988; 166:861–864.
2- Gelb HJ, Glasgow SG, Sapega AA, Torg JS. Magnetic resonance imaging of knee disorders. Clinical value and costeffectiveness
in a sports medicine practice. Am J Sports Med 1996; 24:99–103.
3- Fischer SP, Fox JM, Del Pizzo W, Friedman MJ, Snyder SJ, Ferkel RD. Accuracy of diagnoses from magnetic
resonance imaging of the knee. A multi-center analysis of one thousand and fourteen patients. J Bone Joint Surg Am
1991; 73:2–10.
4- Weinstabl R, Muellner T, Vecsei V, Kainberger F, Kramer M. Economic considerations for the diagnosis and
therapy of meniscal lesions: can magnetic resonance imaging help reduce the expense? World J Surg 1997; 21:363–368.
5- Marthe Grenier J, Wessely M, Knee MRI, Part II. MR imaging of common internal derangements affecting the
knee. Clin Chiropract 2004; 7:131-140.
6- Watanabe AT, Carter BC, Teitelbaum GP, Bradley WG Jr. Common pitfalls in magnetic resonance imaging of the
knee. J Bone Joint Surg Am 1989; 71:857–862.
7- Frobell RB, Roos HB, Roos EM, Graverand MP, Buck R. The acutely ACL injured knee assessed by MRI : are
large volume traumatic bone marrow lesions a sign of severe compression injury? Can Assoc Radiol J 2010; 61:80-89.
8- Ben-Galim P, Steinberg E, Amir H, Ash N, Dekel S, Arbel R. Accuracy of magnetic resonance imaging of the knee
and unjustified surgery.Clin Orthop Relat Res 2006; 447:100-104.
9- Rubin DA, Kettering JM, Towers JD, Britton CA. MR imaging of knees having isolated and combined ligament
injuries.AJR Am J Roentgenol 1998; 170:1207-1213.
10- Jonsson T, Althoff B, Peterson L.Clinical diagnosis of ruptures of the anterior cruciate ligament:Acomparative
study of the lachman test and the anterior drawer sign. Am J sports Med 1982; 10:100-102.