Role of magnetic resonance imaging in the evaluation of knee joint injuries with arthroscopic correlation
Journal Title: Medpulse International Journal of Radiology - Year 2018, Vol 5, Issue 2
Abstract
Background: Trauma to the knee joint is a significant cause of morbidity in young active individuals especially in road traffic accidents and in athletes. An accurate diagnosis regarding the type and extent of injury is essential for early operative as well as non-operative treatment. The most widely used diagnostic modalities to assess knee joint injury are arthroscopy and MRI. Arthroscopy, though accurate, is invasive and can cause complications like infection and haemarthrosis. Magnetic resonance imaging has now been accepted as the best modality for non-invasive evaluation of knee injuries. MRI has excellent soft tissue delineation with additional advantages of multiplanar imaging and thin section capabilities to evaluate subchondral bone and bone marrow. Aims and Objectives: To detect various types of traumatic lesions of the knee using MRI and to determine the diagnostic accuracy of MRI in comparison with arthroscopy in the assessment of meniscal and ligamentous injuries of the knee joint. Materials and Methods: A Prospective study was conducted from September 2016 to May 2017 on 60 patients with knee injury were referred to the Department of Radio-Diagnosis for MRI evaluation and later underwent knee arthroscopy examination by an orthopedic surgeon. MR images were obtained using Siemens Magnetom Essenza 1.5 Tesla with proper patient positioning using a dedicated knee coil. The findings of MRI and arthroscopy were correlated. Statistical analysis was done to calculate the sensitivity, specificity, PPV, NPV and diagnostic accuracy of MRI in comparison with arthroscopy. Results :In our study the most common abnormal MRI finding was complete tear of ACL seen in 42 cases (73%), followed by joint effusion which was seen in 28 cases (46%).Most common type of meniscal injury was a Grade III tear involving posterior horn of medial meniscus(60%).The statistical analysis were as follows: for medial meniscus resulted in 94.3% sensitivity, 98 %specificity, 93%PPV, 94% NPV and accuracy of 95%,for lateral meniscus resulted in 83.33% sensitivity,98.4% specificity,86.65% PPV,96% NPV and 96% accuracy, for anterior cruciate ligament resulted in 97.42%,85.72%,84% PPV,97.56% NPV and93 % accuracy, for posterior cruciate ligament resulted in 88 % sensitivity, 98% specificity,83.3 % PPV,97.13%NPVand 98.4% accuracy. Conclusion: MRI is an excellent non-invasive modality with high level of accuracy in diagnosis of meniscal and ligamentous injuries of knee. It is an appropriate screening tool and helps to avoid unnecessary diagnostic arthroscopy in most cases of traumatic knee injuries.
Authors and Affiliations
T V Kishan, A Racherla, V Tummala, S Kisara, P V N Murthy
Keywords
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- EP ID EP533695
- DOI 10.26611/1013522
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