MR imaging of the knee. Part I. Traumatic disorders.

Reicher, Murray A.; Hartzman, S; Bassett, L W; Mandelbaum, Bert R.; Duckwiler, Gary; Gold, Richard H.

doi:10.1148/radiology.162.2.3797670

Cited by 122 publications

(32 citation statements)

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“…A small proportion of tom 'menisci are not, however, demonstrated on MR imaging. A good correlation between clinical outcome and MR appearances of normal menisci or low grade changes has been reported (34). In one study already mentioned (37), of 103 consecutive patients with knee injury that otherwise justified diagnostic arthroscopy, 59 were treated conservatively on the basis of MR findings.…”

Section: Discussionmentioning

confidence: 90%

“…MR images seem to possess a high ability to predict the presence of lesions remediable by arthroscopic surgeryIn one of the double-blinded studies (41) it was concluded that if the decision to perform arthroscopy had been based on the MR result rather than on the clinical judgement then 29% of the arthroscopies would have been avoided without overlooking any mechanical lesion treatable by arthroscopy. As mentioned earlier, at least 2 studies (34,37) have shown that when it comes to meniscal tears, MR images have a high ability to predict the clinical outcome and reduce the number of negative arthroscopies. If, on the basis of clinical findings and an MR examination, arthroscopy has been considered unnecessary, an unsatisfactory clinical course should evoke suspicion of a lesion not revealed by MR investigation.…”

Section: Discussionmentioning

confidence: 99%

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MR Imaging before Arthroscopy in Knee Joint Disorders?

Rappeport¹,

Mehta²,

Wieslander³

et al. 1996

Acta Radiol

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Purpose: To review the current literature examining the relative merits of arthroscopy and MR imaging of the knee.Material and Methods: Allgapers comparing MR imaging with arthroscopy published within the last 10 years according to Medline were collected and read.Results: Technology has improved considerably during recent years allowing detailed non-invasive visualization of the knee. In particular, the development of cheaper whole-body and dedicated low-field MR units has opened up for non-invasive inspection of the knee at reasonable cost. Meniscal tears can be detected with accuracy rates of around 90% and rupture of the anterior cruciate ligament with accuracy rates of around 93% compared to arthroscopy. However, arthroscopy is not the ideal gold standard, since it has weak points, e.g. peripheral meniscal tears or osteochondritis without apparent damage to the cartilage.Conclusion: Based on the overwhelming literature it seems safe to conclude that MR examinations of the knee should be performed before arthroscopy is undertaken.The knee joint is a common site for morbidity as a result of trauma or degenerative disease with resultant temporary or permanent disability characterized by pain, immobility or reduction in previous sporting activity. Symptomatology, clinical examination and conventional film studies are often insufficient for an accurate diagnosis (12,40). Supplementary diagnostic procedures are often required to determine prognosis and allow appropriate management including conservative therapy.During the 1970s and the 1980s arthroscopy of the knee joint became the gold standard in diagnosing knee disorders. The advent of MR imaging has, in most institutions, led to the virtual abandonment of arthrography as a diagnostic procedure in the knee. Over the last 10 years MR has gained worldwide acceptance as the imaging method of choice for the non-invasive evaluation of the knee (21). It provides excellent anatomical detail (Fig. 1) unobtainable by any other imaging modality (Fig. 2).A vast number of papers have been published that examine the diagnostic accuracy of MR examinations of the knee but the exact role of MR remains unclear. In some institutions, diagnostic arthroscopy is not performed in the presence of a normal MR examination (22). This role for MR has been disputed (30, 37, 39) by some orthopaedic surgeons who favour arthroscopy. The purpose of this article is to review the current literature to examine the relative merits of arthroscopy and MR of the knee.The central question in this debate is the diagnostic accuracy of the 2 procedures but other issues such as time, patient comfort, risk and cost need to be taken into account. Arthroscopy is an invasive procedure requiring anaesthesia, carrying a small risk of infection and produces variable pain and reduction in movement in the days following the procedure. MR is non-invasive without known risk to the patient. It can be uncomfortable for the patient owing to prolonged examination time or claustrophobia but such problems are r...

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

MR Imaging before Arthroscopy in Knee Joint Disorders?

Rappeport¹,

Mehta²,

Wieslander³

et al. 1996

Acta Radiol

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“…for noninvasive detection of me niscal tears [1][2][3][4]. Furthermore, the diagnostic criteriafor a discoid meniscus with MR imag ing have been firmly established [5â€ "8].…”

Section: R Imaging Has Been Shown To Be a Sensitive And Specific Tementioning

confidence: 99%

MR imaging of tears of discoid lateral menisci.

Ryu¹,

Kim²,

Kim³

et al. 1998

American Journal of Roentgenology

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OBJECTIVE. The purposeof this study was to determinethe positivepredictivevalue (PPV) for diagnosis of discoid lateral meniscal tear using MR imaging and to describe various patterns of such tears in the knee.SUBJECTS AND METHODS. MR reportsof 77 patients(10â€"67 yearsold) who under went prospective MR imaging that led to a diagnosis of discoid lateral meniscal tear were cor related with arthroscopic results. MR images obtained in 71 patients confirmed to have discoid lateral meniscial tear were retrospectively reviewed for the presence, site, and pattern of discoid lateral meniscal tear, including type of displacement of the torn segment. MR ab normalities were correlated with arthroscopic findings. RESULTS. For the prospective MR interpretations, the PPV for discoidmeniscus was92%. ppv for discoid meniscal tear was 57%. PPVs for individual types ofdiscoid meniscal tears were 46% (peripheral tear, 19/41), 76% (peripheral tear with horizontal tears, 16/21), 56% (horizontal tear, 5/9), 50% (transverse tear, 1/2), 67% (horizontal tear combined with transverse tear, 2/3), and 100% (longitudinal tear, 1/1). Peripheral tear alone and peripheral tear with horizontal tear were the most common types oftears (n = 20, 28%). Multiple tears (n = 34, 48%) were common. Displacement ofthe torn segments was seen in 51 patients (72%).CONCLUSION. MR imaging has a low PPV for diagnosingdiscoid lateral meniscal tear. Peripheral tear alone and peripheral tear with horizontal tear were the most common types of tears, and displacement of the torn segment was frequent. Because of its abnormal structure, the discoid meniscus sustains increased stress, which in creases the incidence of tears and cystic degen eration [15]. MMR imaging of the knee is commonly used to diagnosediscoidmenisci;however,to our knowledge, its reliability has not been criti cally studied. Because of regional anatomic features, the MR imaging pattern of such a tear may be atypical [16].In our practice in Korea, we have encountered repeated instances in which MR findings it ported to represent discoid lateral meniscal tear have not correlated with arthroscopic abnoimali ties. To address these issues, we designed a study to calculate the positive predictive value (PPV) ofMR imagingandtodetermine thevarious pat tems of discoid lateral meniscal tear, with ar throscopy as the standard of reference. Subjects and MethodsFrom 1991 through 1996, 1802 patients at our institution underwent MR imaging of the knee. A database search yielded reports of 156(8.1%) who had evidence of a discoid lateral meniscus with a tearon prospectiveMR imaging.Arthroscopywas subsequently performed in 11 patients (49%, 11 knees) at our institution; these patients (38 males, 39 females; 10â€"61 years old; mean age, 27 years old) form the basis of this study. The right knee was examined in 31 patients and the left knee in 40 patients.

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“…1, 2 Stone et al 3 developed & evaluated a MRI technique to measure volume of menisci in 1994. Reicher et al 4 began a revolution in knee diagnosis in 1985 with MRI.…”

Section: Introductionmentioning

confidence: 99%

Magnetic Resonance Imaging Study of Normal Menisci

Pawar¹,

Natarajan²

2014

jemds

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AIMS:The purpose of this study is to determine dimensions of menisci on MRI. The standard dimensions of lateral and medial menisci shall help us to differentiate between normal and abnormal menisci, and this may be important for planning surgical interventions in knee joint. METHODS AND MATERIALS: 100 Indian patients with history of knee pain were subjected to MRI. None of the patients had any pathological signal intensity suggesting meniscal tear. Patients were scanned in supine position with knees extended. All patients were studied in sagittal and coronal planes. The Anterior horn, Posterior horn and Mid-body of menisci were examined in sagittal and coronal plane for the following parameters: Height and width of Anterior and Posterior horn of lateral and medial meniscus on sagittal plane. Height and width of mid-body of lateral and medial menisci on coronal plane. Height and width of anterior and posterior horn were measured on sagittal plane where the highest and widest meniscal size was observed. The mid-body was measured at the level of intercondylar eminence, in the coronal plane. STATISTICAL ANALYSIS: Comparison of variables was done with paired sample t-test. Two-tailed p-values <0.05 were considered as significant. The SPSS 10.0 program was used for the purpose of statistical analyses. Data, presented as mean +-SD. RESULT: Following results were seen: Height of anterior and posterior horn of medial meniscus was greater than lateral. Width of anterior horn and mid-body of lateral meniscus was greater than medial. Posterior horn of medial meniscus is the widest part and greater than lateral. In the anterior and posterior thirds, the medial meniscus was significantly more thick (p <0.05) than the lateral. Posterior third part of medial meniscus was the widest. (p <0.05). Results of this study showed an important relation between morphometric data of menisci and clinical data, i.e. it was seen that, more meniscal tears were seen where height and width of meniscus was less. This study shall also be useful for tissue banks and surgeons, for meniscal sizing during transplantation.

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MR imaging of the knee. Part I. Traumatic disorders.

Cited by 122 publications

References 0 publications

MR Imaging before Arthroscopy in Knee Joint Disorders?

MR Imaging before Arthroscopy in Knee Joint Disorders?

MR imaging of tears of discoid lateral menisci.

Magnetic Resonance Imaging Study of Normal Menisci

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