Evaluation of medial meniscal injury and anterior cruciate ligament tear by MRI with arthroscopic correlation

Authors

  • Chiranjib Murmu Department of Radiodiagnosis, Command Hospital, Kolkata, West Bengal, India
  • Pushpakant Tiwari Department of Radiodiagnosis, Command Hospital, Kolkata, West Bengal, India
  • Vijender Kumar Agrawal Department of Community Medicine, Rajshree Medical Research Institute, Bareilly, Uttar Pradesh, India

DOI:

https://doi.org/10.18203/2349-2902.isj20170197

Keywords:

Arthroscopy, Knee injuries, MRI

Abstract

Background: Apart from clinical examination multiple modalities (conventional radiography, MRI and arthroscopy) are currently used to evaluate knee injuries. This study is intended to compare the sensitivity and specificity of MRI in correlation of arthroscopy in diagnosing of knee injuries.

Methods: This is a prospective study involving 51 patients with history of knee injuries who were admitted in the Department of Orthopaedics, Command Hospital, Kolkata, India from April 2013 to June 2014. MRI of the knee joint was done for all these patients either before or after admission. The patients were then subjected to diagnostic and therapeutic arthroscopy. Statistical analysis was used to calculate the sensitivity, specificity, positive predictive value and the negative predictive value, in order to assess the reliability of the MRI results.

Results: The sensitivity and specificity of MRI with respect to arthroscopy in anterior cruciate ligament tear is 87.5% and 66.6%. Positive predictive value is 87.5%. Negative predictive value is 66.6%. Accuracy is 81.82%. The sensitivity and specificity of MRI with respect to arthroscopy in medial meniscal tears is 85.7% and 70.8% respectively. Positive predictive value is 63%, negative predictive value is 89.4%, accuracy is 76.3%.

Conclusions: The present study supports that MRI is helpful in diagnosing medial meniscal and anterior cruciate ligament injuries. The negative predictive value of a MRI was found to be high for all structures of the knee joint and hence a MRI can be used to exclude pathology, thus sparing patients from expensive and unnecessary surgery. 

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References

Gray SD, Kalpan PA, Dussalt RG. Imaging of Knee: current status. OCNA. 1997;28(4):643-58.

Kaplan PA, Walker CW, Kilcoyne RF, Brown DE, Tusek D, Dussault RG. Occult fractures patterns of the knee associated with ACL tears. Assessment with MR imaging. Radiology. 1992;183:835-8.

Kean DM, Worthington BS, Preston BJ. Nuclear MRI of knee: examples of normal anatomy and pathology. Br J Radiol. 1983;56:355-61.

Boden SD, Labropoulos PA, Vailas JC. MR Scanning of the acutely injured knee: sensitive, but is cost effective? Arthroscopy. 1990;6:306-8.

Rubin DA, Kettering JM, Towers JD, Britton CA, MR imaging of knee having isolated and combined ligament injuries. AJR. 1998;170:1207-13.

Fisher SP, Fox JM, Pizzo DW, Freidman MJ, Snyder SJ, Ferkel RD. Accuracy of diagnosis from magnetic resonance imaging of the knee; a multicentric analysis of one thousand and fourteen patients. JBJS. 1991;73:2-10.

Miller RH. In Campbell’s operative orthopaedics. S. Terry Canale. St LouisMosby.1998:23-28.

Ryan PJ, Reddy K, Fleeteroft J. A prospective comparison of clinical examination, MRI, bone SPECT, and arthroscopy to detect meniscal tears. Clin Nucl Med. 1999;23:803-6.

Imhoff A, Buess E, Holder J. Comparison between magnetic resonance imaging and arthroscopy for the diagnosis of knee meniscal lesion. Rev Chir Orthop. 1997;83.

Dixon AK. Magnetic resonance imaging of meniscal tears of the knee. JBJS Br. 1996;78:174-6.

Tyrrell RL, Gluckert K, Pathria M, Modic MT. Fast three dimensional MR imaging of the knee: comparison with arthroscopy. Radiology. 1988;166:865-72.

Herman LJ, Beltran J. Pitfalls in MR imaging of the knee. Radiology. 1988;167:775-81.

Watanabe AT, Carter BC, Teitelbaum GP, Bradley WG. Common pitfalls in magnetic resonance imaging of the knee. JBJS Am. 1989;71:857-62.

Mackenzie R, Keene GS, Lomas DJ, Dixon AK. Errors at knee magnetic resonance imaging: true or false? Br J Radiol. 1995;68:1045-51.

Ireland J, Trickey EL, Stoker DJ. Arthroscopy and arthrography of the knee: a critical review. JBJS Br. 1980;62:3-6.

Lee JK, Yao L. Phelps CT, Wirth CR, Czajka J, Lozman J. Anterior cruciate ligament tears. MR imaging compared with arthroscopy and clinical tests. Radiology. 1998;166:861-4.

Ochi M, Sumen Y, Kanda T, Ikuta Y, Itoh K. The diagnostic value and limitation of magnetic resonance imaging on chondral lesions of the knee joint. Arthroscopy. 1994;10:176-83.

Mori R, Ochi M, Sakai Y, Adachi N, Uchio Y. Clinical significance of magnetic resonance imaging (MRI) for local chondral lesions. Magn Reson Imaging. 1999;17:1135-40.

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Published

2017-01-25

How to Cite

Murmu, C., Tiwari, P., & Agrawal, V. K. (2017). Evaluation of medial meniscal injury and anterior cruciate ligament tear by MRI with arthroscopic correlation. International Surgery Journal, 4(2), 589–592. https://doi.org/10.18203/2349-2902.isj20170197

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Original Research Articles