The value of magnetic resonance imaging in our current management of ACL and meniscal injuries

Thomas, Shl; Pullagura, Mohan; Robinson, Elizabeth; Cohen, Ari J.; Banaszkiewicz, Paul A.

doi:10.1007/s00167-006-0259-7

Cited by 63 publications

(40 citation statements)

References 12 publications

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“…In a study in Mashhad on 92 patients with knee injuries, Mazlomy et al noted similar results and reported a high accuracy for clinical examinations [17]. Behairy et al is an Egyptian study of 70 patients that noted high diagnostic accuracy of both physical examination and MRI, and in most cases, only small differences existed between the two methods, which was also confirmed in a study by Thomas et al [5,18]. Major causes for the differences in the results were related to different skill levels of staff involved in MRI interpretation, arthroscopy and clinical examination.…”

Section: Discussionsupporting

confidence: 69%

The role of MRI in the diagnosis of intra articular knee derangement: A prospective study

Hassan¹,

Al-edani²

2016

Int Arch Med

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Background: Magnetic resonance imaging (MRI) has several advantages compared with other modalities in evaluating internal derangement of the knee & it has practically replaced conventional arthrography in the evaluation of menisci & cruciate ligaments as it is non invasive, painless and give excellent soft tissue contrast.Objective: To assess the role of MRI in internal derangement of the knee.Methods: Thirty patients with suspected internal derangement of the knee were subjected to a dedicated MR knee study and correlated knee arthroscopy and surgery. MRI of the knee was performed in closed magnet (1.5 Tesla, Seimens). Arthroscopy was done within two months of MR examination and was considered gold standard for the internal derangement of the knee. Results:The sensitivity, specificity, diagnostic accuracy of MRI were 94.1%, 84.6% and 90% respectively for medial meniscal tear; 71.4%, 95.6% and 90% respectively for lateral meniscal tear and 85.7%, 91.3% and 90% respectively for anterior cruciate ligament tear. Conclusion:MRI represents the optimal imaging tool in the evaluation of internal knee derangement as it showed high sensitivity, specificity, diagnostic accuracy for meniscal and cruciate ligament injury, in addition to associated derangement like articular cartilage damage and synovial effusion. IntroductionThe knee is a complex structure and one of the most stressed joints in the body. It is a large joint, vital for movement, and susceptible to injury. Knee injuries represent roughly 6% of all acute injuries treated at emergency department and approximately one-third of these have been reported to be sports related [1]. The principal intra articular structures in knee are the two menisci, the two cruciate ligaments, and the two collateral ligaments. The injury to these intra articular structures is generally termed as " Meniscal tear and degeneration are manifested as increased signal intensity on T1 & T2 weighted images within the substance of meniscus. Meniscal abnormalities on MRI have been classified by grading system [5,6] into 4 grades as in figures 1-4. Clinical significant of intra meniscal signal uncertain, it likely that MRI is more sensitive than arthroscopy and the decision to perform menisectomy currently is based exclusively on the presence of a surface tear.The normal anterior cruciate ligament (ACL) should have a taut, low to intermediate signal intensity with continuous fibres in all planes and sequences. Tears of ACL typically occur in the middle portion of the ligament. The diagnosis of ACL tear is made on MRI by either Identifying disruption of the ligament along its normal course (figure 5) or as a focus of increased signal intensity within the substance of the ligament often best seen by T2-weighted image [7][8][9][10][11].Tears of the posterior cruciate ligament (PCL) are diagnosed by disruption along the course of the ligament or by areas of increased signal intensity within the substance of the ligament. Most of PCL tears involve the mid substance of the ligament [12,1...

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Section: Discussionsupporting

confidence: 69%

The role of MRI in the diagnosis of intra articular knee derangement: A prospective study

Hassan¹,

Al-edani²

2016

Int Arch Med

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“…The current practice of requesting scans to confirm the diagnosis should be altered. Unnecessary MRI increases the financial burden and delays treatment [14].…”

Section: Discussionmentioning

confidence: 99%

“…Thomas et al [14] suggested that when symptoms and clinical findings support the presence of meniscal or ligamentous injuries and arthroscopic therapeutic intervention is contemplated MRI is not always beneficial. The current practice of requesting scans to confirm the diagnosis should be altered.…”

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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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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“…In a study in Mashhad on 92 patients with knee injuries, Mazlomy et al, 2007 (15) noted similar results and reported a high accuracy for clinical examinations. Behairy et al, 2009 (16) is an Egyptian study of 70 patients noted high diagnostic accuracy of both physical examination and MRI, and in most cases, only slight differences existed between the two methods, which was also confirmed in a study by Thomas et al, 2007 (17).…”

Section: Discussionmentioning

confidence: 74%

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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The value of magnetic resonance imaging in our current management of ACL and meniscal injuries

Cited by 63 publications

References 12 publications

The role of MRI in the diagnosis of intra articular knee derangement: A prospective study

The role of MRI in the diagnosis of intra articular knee derangement: A prospective study

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

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

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