MRI preferable to diagnostic arthroscopy in knee joint injuries a double-blind comparison of 47 patients

Rappeport, Eli D; Wieslander, S.; Stephensen, Snorre; Lausten, Gunnar Schwarz; Thomsen, Henrik S.

doi:10.3109/17453679708996701

Cited by 54 publications

(31 citation statements)

References 16 publications

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“…[21][22][23][24][25][26][27] During the last decade, magnetic resonance imaging has been confirmed as the ideal approach for primary diagnosis of traumatic intraarticular knee lesions. [28][29][30][31] It is noninvasive, fast, can be done on an outpatient basis, and is free of complications. Despite this, magnetic resonance imaging is a new technology, 32 which means that clinical experience is still lacking.…”

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confidence: 99%

Accuracy of Magnetic Resonance in Identifying Traumatic Intraarticular Knee Lesions

Vaz

Camargo

Santana

et al. 2005

Clinics

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PURPOSE:To evaluate the diagnostic accuracy of magnetic resonance imaging of the knee in identifying traumatic intraarticular knee lesions. METHOD: 300 patients with a clinical diagnosis of traumatic intraarticular knee lesions underwent prearthoscopic magnetic resonance imaging. The sensitivity, specificity, positive predictive value, negative predictive value, likelihood ratio for a positive test, likelihood ratio for a negative test, and accuracy of magnetic resonance imaging were calculated relative to the findings during arthroscopy in the studied structures of the knee (medial meniscus, lateral meniscus, anterior cruciate ligament, posterior cruciate ligament, and articular cartilage). RESULTS: Magnetic resonance imaging produced the following results regarding detection of lesions: medial meniscus: sensitivity 97.5%, specificity 92.9%, positive predictive value 93.9%, positive negative value 97%, likelihood positive ratio 13.7, likelihood negative ratio 0.02, and accuracy 95.3%; lateral meniscus: sensitivity 91.9%, specificity 93.6%, positive predictive value 92.7%, positive negative value 92.9%, likelihood positive ratio 14.3, likelihood negative ratio 0.08, and accuracy 93.6%; anterior cruciate ligament: sensitivity 99.0%, specificity 95.9%, positive predictive value 91.9%, positive negative value 99.5%, likelihood positive ratio 21.5, likelihood negative ratio 0.01, and accuracy 96.6%; posterior cruciate ligament: sensitivity 100%, specificity 99%, positive predictive value 80.0%, positive negative value 100%, likelihood positive ratio 100, likelihood negative ratio 0.01, and accuracy 99.6%; articular cartilage: sensitivity 76.1%, specificity 94.9%, positive predictive value 94.7%, positive negative value 76.9%, likelihood positive ratio 14.9, likelihood negative ratio 0.25, and accuracy 84.6%. CONCLUSION: Magnetic resonance imaging is a satisfactory diagnostic tool for evaluating meniscal and ligamentous lesions of the knee, but it is unable to clearly identify articular cartilage lesions.

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mentioning

confidence: 99%

Accuracy of Magnetic Resonance in Identifying Traumatic Intraarticular Knee Lesions

Vaz

Camargo

Santana

et al. 2005

Clinics

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“…6 However, in this study, the sensitivity of SPECT scan for ACL injuries was only 33%. The low sensitivity value in our study may be explained by unreliability as a result of a small sample number of ACL lesions.…”

Section: Discussionmentioning

confidence: 80%

“…3,4 MRI has established its role for non-invasive investigation. 1,[6][7][8][9][10][11][12][13][14] However, MRI is time-consuming and has a high false-positive rate. [21][22][23] Bone SPECT scan has been shown to be a useful tool [15][16][17][18][19][20] in limited series.…”

Section: Discussionmentioning

confidence: 99%

“…Published evidence suggests that magnetic resonance imaging (MRI) 1,[6][7][8][9][10][11][12][13][14] and single photon emission computed tomography (SPECT) scans [15][16][17][18][19][20] are useful tools to delineate the lesions prearthroscopically. MRI has established itself as the investigation of choice as it gives good anatomical detail.…”

Section: Introductionmentioning

confidence: 99%

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Single Photon Emission Computed Tomography Scanning in the Diagnosis of Knee Pathology

Vellala

Manjure

Ryan

2004

J Orthop Surg (Hong Kong)

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“…Similarly, Feller and Webster [3] suggested that a negative MR scan is most beneficial in preventing the patient from undergoing an unnecessary diagnostic arthroscopic procedure. This position is reinforced by a number of other authors from both surgical and radiological fields [4][5][6][7][8][9].…”

Section: Introductionmentioning

confidence: 94%

MRI-negative bucket-handle tears of the lateral meniscus in athletes: a case series

Makdissi

Eriksson

Morris

et al. 2005

Knee Surg Sports Traumatol Arthrosc

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Magnetic resonance imaging (MRI) is the most widely used non-invasive test for assessing intra-articular injuries of the knee. It has been suggested that a negative MRI can be useful in avoiding the need for diagnostic arthroscopy in cases where clinical examination is equivocal. However, the sensitivity and specificity of MRI is not 100%, particularly for tears of the lateral meniscus. Furthermore, a false negative MRI scan may result in premature return to play in athletes, resulting in increased risk of further damage to a torn meniscus. To illustrate this issue, we present a case series of eight elite athletes who all presented with mechanical knee symptoms and where MRI scans revealed no significant intra-articular pathology. Five of the athletes were allowed to return to sport on the basis of a negative MRI. All patients were subsequently found to have a bucket-handle tear of their lateral meniscus at arthroscopy. Two independent, experienced musculoskeletal radiologists were asked to review the MRI films without being given any clinical history of the cases. Although injuries to the popliteus tendon were noted in two of the athletes who had sustained a recent acute injury to their knee, no meniscal tears were identified. Thus arthroscopy remains the gold standard for the assessment and management of high-demand patients with a clinical suspicion of meniscal pathology.

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MRI preferable to diagnostic arthroscopy in knee joint injuries a double-blind comparison of 47 patients

Cited by 54 publications

References 16 publications

Accuracy of Magnetic Resonance in Identifying Traumatic Intraarticular Knee Lesions

Accuracy of Magnetic Resonance in Identifying Traumatic Intraarticular Knee Lesions

Single Photon Emission Computed Tomography Scanning in the Diagnosis of Knee Pathology

MRI-negative bucket-handle tears of the lateral meniscus in athletes: a case series

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