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Comparative Study
. 2009 Aug;33(4):961-7.
doi: 10.1007/s00264-008-0580-5. Epub 2008 May 28.

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

Noha H Behairy  1 , Mohsen A Dorgham, Sherif A Khaled
Affiliations
Comparative Study

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

Noha H Behairy et al. Int Orthop. 2009 Aug.

Abstract
in English, French

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.

Le but de cette étude est de détecter un examen de routine l’IRM et la bonne correspondance entre ces constatations et les constatations arthroscopiques des lésions méniscales ou des lésions ligamentaires du genou. Nous avons réalisé une étude prospective de 70 patients âgés de 22 à 59 ans avec analyse de l’histoire clinique, des radiographies, de l’examen clinique, de l’examen IRM et des constatations arthroscopiques. La sensitivité, la spécificité et l’exactitude des constatations ont été évaluées de manière statistique. Nous avons trouvé respectivement une sensitivité de 47% et 100%, une spécificité de 95% et 75% et une exactitude des constatations de 73% et 78,5%, pour les lésions du ménisque interne ou du ménisque latéral. En ce qui concerne les ligaments croisés, la sensitivité est de 77,8%, la spécificité de 100% et l’exactitude des constatations de 94% avec une bonne correspondance Kappa (0,43 et 0,45) pour les ménisques et 0,84 pour le ligament croisé antérieur. L’IRM peut donc être utilisée comme un élément tout à fait sûr et routinier concernant le diagnostic primaire des lésions miniscales ou des lésions ligamentaires chez les patients devant bénéficier d’une arthroscopie. Niveau d’évidence : 4.

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Figures

Fig. 1
Fig. 1
Sagittal MRI showed normal lateral meniscus while arthroscopy detected a lateral meniscal tear (tool is seen within the tear)
Fig. 2
Fig. 2
MRI diagnosed complete ACL tear, arthroscopy confirmed the diagnosis showing buckling of the ACL with detached femoral attachment and reconstruction was performed
Fig. 3
Fig. 3
MRI showed degeneration of the posterior horn of the medial meniscus, while arthroscopy showed a normal medial meniscus
Fig. 4
Fig. 4
MRI diagnosed a partial tear of the ACL; however, arthroscopy showed a normal ACL
Fig. 5
Fig. 5
MRI showed posterior horn medial meniscal tear which was confirmed by arthroscopy
See this image and copyright information in PMC

References

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