Magnetic resonance imaging versus arthroscopy in the diagnosis of knee pathology, concentrating on meniscal lesions and ACL tears: a systematic review

Crawford, Ruth; Walley, Gayle; Bridgman, Stephen; Maffulli, Nicola

doi:10.1093/bmb/ldm022

Cited by 257 publications

(224 citation statements)

References 61 publications

(43 reference statements)

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“…However, we agree with Crawford et al [6] who stated that MRI is the most appropriate screening tool before arthroscopy. It is preferable to diagnostic arthroscopy in most patients because it avoids the surgical risks [6].…”

Section: Discussionsupporting

confidence: 89%

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Accuracy of routine magnetic resonance imaging in meniscal and ligamentous injuries of the knee: comparison with arthroscopy

Behairy

Dorgham

Khaled

2008

International Orthopaedics (SICOT)

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The aim of this study was to detect the accuracy of routine magnetic resonance imaging (MRI) done in different centres and its agreement with arthroscopy in meniscal and ligamentous injuries of the knee. We prospectively examined 70 patients ranging in age between 22 and 59 years. History taking, plain X-ray, clinical examination, routine MRI and arthroscopy were done for all patients. Sensitivity, specificity, accuracy, positive and negative predictive values, P value and kappa agreement measures were calculated. We found a sensitivity of 47 and 100%, specificity of 95 and 75% and accuracy of 73 and 78.5%, respectively, for the medial and lateral meniscus. A sensitivity of 77.8%, specificity of 100% and accuracy of 94% was noted for the anterior cruciate ligament (ACL). We found good kappa agreements (0.43 and 0.45) for both menisci and excellent agreement (0.84) for the ACL. MRI shows high accuracy and should be used as the primary diagnostic tool for selection of candidates for arthroscopy. Level of evidence: 4.

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Section: Discussionsupporting

confidence: 89%

“…It is preferable to diagnostic arthroscopy in most patients because it avoids the surgical risks [6]. Also concerning the economic burden especially in a country like Egypt, MRI may decrease unjustified arthroscopies.…”

Section: Discussionmentioning

confidence: 99%

Accuracy of routine magnetic resonance imaging in meniscal and ligamentous injuries of the knee: comparison with arthroscopy

Behairy

Dorgham

Khaled

2008

International Orthopaedics (SICOT)

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“…MRI was considered to be a valid and ethical alternative because of its reported accuracy. 15 To indicate whether MRI results were affected, the results of participants receiving arthroscopy after MRI were requested. In the present sample only four of 41 identifiable participants receiving arthroscopy after MRI (9.8%) had a positive finding for a meniscal tear after a negative finding on MRI.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

A clinical prediction rule for meniscal tears in primary care: development and internal validation using a multicentre study

et al. 2015

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BackgroundIn primary care, meniscal tears are difficult to detect. A quick and easy clinical prediction rule based on patient history and a single meniscal test may help physicians to identify high-risk patients for referral for magnetic resonance imaging (MRI). AimThe study objective was to develop and internally validate a clinical prediction rule (CPR) for the detection of meniscal tears in primary care. Design and settingIn a cross-sectional multicentre study, 121 participants from primary care were included if they were aged 18-65 years with knee complaints that existed for <6 months, and who were suspected to suffer from a meniscal tear. MethodOne diagnostic physical meniscal test and 14 clinical variables were considered to be predictors of MRI outcome. Using known predictors for the presence of meniscal tears, a 'quick and easy' CPR was derived. ResultsThe final CPR included the variables sex, age, weight-bearing during trauma, performing sports, effusion, warmth, discolouration, and Deep Squat test. The final model had an AUC of 0.76 (95% CI = 0.72 to 0.80). A cut-point of 150 points yielded an overall sensitivity of 86.1% and a specificity of 45.5%. For this cutpoint, the positive predictive value was 55.0%, and the negative predictive value was 81.1%. A scoring system was provided including the corresponding predicted probabilities for a meniscal tear. ConclusionThe CPR improved the detection of meniscal tears in primary care. Further evaluation of the CPR in new primary care patients is needed, however, to assess its usefulness.

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“…Arthroscopy is a technical demanding procedure and the results are varying according to surgeons' experience, especially in difficult cases. Crawford et al, 2007 (18) stated that MRI is the most appropriate screening tool before arthroscopy. It is preferable to diagnostic arthroscopy in most patients because it avoids the surgical risks.…”

Section: Discussionmentioning

confidence: 99%

The Role of Magnetic Resonance Musculoskeletal Imaging in Evaluation of Sports Injuries of the Knee Joint

Khalil

Resnick

Zeid

et al. 2017

Zagazig University Medical Journal

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Aim: to evaluate the role of magnetic resonance imaging in the assessment of sport injuries of the knee joint as an integral part of the musculoskeletal system. Methods: This study was done as a combined study between the Radiology Department of Zagazig University and the Radiology Department of University of California San Diego. It was conducted on 50 patients who were referred to the Radiology Department of the University of California San Diego. The patients were examined after sustaining different sports injuries of the knee joint. All the 50 patients were subjected to full history taking and Magnetic Resonance Imaging on the knee joint. The Magnetic Resonance Imaging results of 33 of these patients were compared with the results of knee arthroscopy. Results: The study included 50 patients complaining of sports related knee pain. The age of the patients ranged from 15 to 55 years with a mean age of 29.68 years. Most of the patients were males (38 patients), while 12 patients were females. The leading sports for knee injuries in this study were soccer, American football and running. The most common knee lesions were anterior cruciate ligament lesions (19 patients) and meniscal lesions (18 patients). In comparison with knee arthroscopy, magnetic resonance imaging revealed an overall 93.9 % sensitivity and 66.6 % specificity. Conclusion: Although arthroscopy has been considered the gold standard in knee sports injuries evaluation, MRI remains a reliable non-invasive modality that can reduce the use of diagnostic arthroscopy for evaluation of ligamentous, meniscal, bony and cartilaginous lesions.

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Magnetic resonance imaging versus arthroscopy in the diagnosis of knee pathology, concentrating on meniscal lesions and ACL tears: a systematic review

Abstract: Study design characteristics should also be taken into account whenever a study on MRI assessing its diagnostic performance is designed or reviewed.

Cited by 257 publications

References 61 publications

Accuracy of routine magnetic resonance imaging in meniscal and ligamentous injuries of the knee: comparison with arthroscopy

Accuracy of routine magnetic resonance imaging in meniscal and ligamentous injuries of the knee: comparison with arthroscopy

A clinical prediction rule for meniscal tears in primary care: development and internal validation using a multicentre study

The Role of Magnetic Resonance Musculoskeletal Imaging in Evaluation of Sports Injuries of the Knee Joint

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