Anterior cruciate ligament tears: MR imaging compared with arthroscopy and clinical tests.

Abstract

Seventy-nine magnetic resonance (MR) studies of the knee were reviewed in an evaluation of the ability of MR imaging to demonstrate arthroscopically proved anterior cruciate ligament (ACL) tears. MR findings were also compared with the findings of two commonly applied clinical tests of ACL instability: the Lachman test and the anterior drawer test. The sensitivity of MR imaging was 94% (17 of 18), compared with 78% (14 of 18) for the anterior drawer test and 89% (16 of 18) for the Lachman test. The specificity was 100% for all three. Three MR criteria were applied: irregularity or a wavy contour of the anterior margin of the ligament, high-signal-intensity change within the substance of the ligament on T2-weighted images, and discontinuity of that substance. The sagittal T2-weighted image was especially helpful, producing an "arthrographic" effect, in which the anterior margin of the ACL is outlined by high-signal-intensity joint fluid. By demonstrating ACL and other extrameniscal lesions, MR imaging may help clarify the mechanisms of knee injury.

Cruciate ligament integrity in osteoarthritis of the knee

“…Previous studies have shown that MRI has Ͼ94% sensitivity and 95-100% specificity for detecting acute ACL rupture, when compared with arthroscopic findings (19,20). However, it is likely that the diagnostic performance of MRI for chronic ACL tears may be lower due to their differing appearance from acute ACL tears (21,22).…”

MR imaging of tibial collateral ligament injury: comparison with clinical examination

“…1). The MR findings in ACL rupture (criterion 2), trabecular trauma (criterion 3), and meniscal tear (criterion 4) have been well described in the literature [1,2,12]. Discontinuity (criterion 5) was defined as focal absence or more diffuse non-visualization of normal low signal ligamentous fibers (Fig.…”

A Survey of Injuries to the Anterior Cruciate Ligament Among Makkah Population, Saudi Arabia: Prevalence and Observations on Injury Mechanism.

“…A systematic survey utilizing arthroscopy as the best quality level found MRI to have a sensitivity of 86 percent and a specificity of 95 percent for ACL tear [ 16 ] . Diagnostic studies, again utilizing arthroscopy as the gold standard, describe sensitivities as high as 92 to 100 percent and specificities as high as 95 to 100 percent [17,18 ] . MRI is less accurate in differentiating complete tears from partial tears, and in identifying chronic tears.…”