Publication: Clinical, MRI and Arthroscopic Correlation in Internal Derangement of Knee
Date
2011
Journal Title
Journal ISSN
Volume Title
Publisher
Kathmandu University
Abstract
ABSTRACT
Background
The traumatic or degenerative internal derangement of the knee requires certain
investigations for the establishment of diagnosis, in addition to clinical history and a
thorough physical examination. The use of arthrography and arthroscopy improves
the accuracy of the diagnosis. MRI scanning of the knee joint has often been
regarded as the noninvasive alternative to diagnostic arthroscopy.
Objective
The purpose of the study was to correlate clinical and low field MRI findings with
arthroscopy in internal derangement of the knee.
Methods
Forty one patients with suspected internal derangement of the knee were subjected
to MR examination followed by arthroscopy. Clinical criteria used were history,
mode of injury, Mc Murray’s, Apley’s grinding, Thessaly’s test for meniscal injury.
Drawer test was considered to be essential for clinical diagnosis of cruciate ligament
injury. MRI of the knee was performed in low field open magnet (0.35T, Magnetom
C, Seimens). Arthroscopy was done within two months of MR examination and was
considered gold standard for the internal derangement of the knee.
Results
The sensitivity, specificity, diagnostic accuracy of clinical examination were 96.1%,
33.3% and 73.1% respectively for medial meniscal tear; 38.4%, 96.4% and 78.1%
respectively for lateral meniscal tear. The sensitivity, specificity, diagnostic accuracy
of MRI were 92.3%,100% and 95.1% for medial meniscal tear; 84.6%96.4% and
92.6% respectively for lateral meniscal tear.
Conclusion
Clinical examination showed higher sensitivity for medial meniscal tear compared
to MRI, however with low specificity and diagnostic accuracy. Low field MRI showed
high sensitivity, specificity, diagnostic accuracy for meniscal and cruciate ligament
injury, in addition to associated derangement like articular cartilage damage,
synovial thickening.
KEY WORDS
arthroscospy, knee, MRI.
Description
Sharma UK,1 Shrestha BK,2 Rijal S,2 Bijukachhe B,2 Barakoti R,2 Banskota B,2 Pradhan I,2 Banskota AK2
1Department of Radiology
2Department of Orthopaedics B&B Teaching Hospital Lalitpur, Nepal.