Use of MRI by radiologists and orthopaedic surgeons to detect intra-articular injuries of the knee

Abstract

ObjectiveMagnetic resonance imaging (MRI) is paramount in the assessment of knee pathology, particularly when planning for a surgical procedure. This study compared the diagnostic accuracy in MRI reading of pathological knees by radiologists and orthopaedic surgeons.Materials and methodsCross-sectional study comprising 80 randomly selected patients previously submitted to arthroscopic surgery after clinical examination and MRI. A diagnosis by MRI interpretation was requested from the two teams, one of radiologists and another of orthopaedic surgeons. The conclusions of each team were later compared. Statistical significance was considered for p < 0.05.ResultsThe radiologists’ findings achieved statistical significance regarding osteochondral injuries, ACL, and medial meniscus (p < 0.05), and orthopaedic surgeons regarding ACL injuries and menisci (p < 0.05). ACL injuries demonstrated a statistically significant association between teams (p < 0.001).ConclusionsMRI appears to offer reliable readings of ACL injuries, regardless the specialty of the observer. The lateral compartment is scarcely well read.

Rates of Adverse Outcomes and Revision Surgery After Anterior Cruciate Ligament Reconstruction: A Study of 104,255 Procedures Using the National Hospital Episode Statistics Database for England, UK

“…Several studies have reported adverse events after ''arthroscopic knee surgery,'' but few have reported data specifically for ACL reconstruction in comparison with more commonly performed purely arthroscopic procedures such as arthroscopic partial meniscectomy. 4,12,19,20,22,[32][33][34]37 In comparison, ACL reconstruction is a more major intervention, associated with greater operative time and usually both open and arthroscopic incisions and techniques. 31 In our study, only pulmonary embolism and infections were found to occur at a greater rate than observed in comparative general population data.…”

“…6 Before this study, several studies have attempted to estimate the risk of adverse events after ACL reconstruction. 4,12,19,20,22,[32][33][34] The findings, however, have generally been limited by the small number of studies, small number of patients, nonrepresentative data sources, and concerns about incomplete data capture.…”

Are Health Care Services Shoppable? Evidence from the Consumption of Lower-Limb MRI Scans

“…Moreover, 84 percent of patients in our sample had follow-up visits with orthopedic surgeons in the six months after the taking of their MRI. Orthopedists tend to review MRI results themselves before they initiate surgery, and Kim et al (2008) and Figueiredo et al (2018) found no difference in the diagnoses made when scans were read by orthopedists versus radiologists. Recall that we limit our sample to patients who see an orthopedist within 3 months of their scan and whose scan is ordered by an orthopedist.…”

The Reliability of 3-T Magnetic Resonance Imaging to Identify Arthroscopic Features of Meniscal Tears and Its Utility to Predict Meniscal Tear Reparability

“…6,12,25 Matava et al 12 found no significant difference in accuracy between an orthopaedic surgeon and a radiologist when using 1.5-T MRI to predict meniscus tear reparability. In the investigation performed by Figueiredo et al, 6 radiologists and orthopaedic surgeons were found to be equally accurate in diagnosing meniscal injuries. Van der Wal et al 25 examined interobserver reliability between orthopaedic surgeons and radiologists when grading features of meniscal tears on 1.5-T MRI and found that radiologists were more likely to disagree compared with surgeons regarding tissue quality; however, there were no differences in reliability between these reviewers.…”