No abstract

Background: Knee joint is the largest and complex joint of the body consisting of two condylar joint between the corresponding condyles of femur and tibia and a sellar joint between patella and femur. Objective: to observe the sensitivity and specificity of MRI in detecting meniscal tears, confirmed subsequently with arthroscopy. Methodology: Following approval from the Hospital Ethical Committee, this prospective, comparative observational study was conducted at Ramkrishna Care Hospital, Raipur, Chhattisgarh. Informed consent was taken from all patients undergoing this study. We prospectively studied 67 patients with complaints of knee pain or instability/locking/giving away sensation with history of knee injury between the age group of 15-60 years over a period of 24 months starting from November 2014 to October 2016. Results: MRI finding showed MM injury in 33(49.25%) patients while 23(34.33%) had positive result arthroscopically. 20 (29.85%) patients showed MRI positivity for LM injury out of which 18(26.87%) were positive arthroscopically. The accuracy of medial meniscal injury by MRI examination in concordance with arthroscopic finding was found to be 73.13% while sensitivity was 82.61% and specificity 68.18%. In our study MRI examination for lateral meniscal injury was found to have accuracy of 88.06%, with sensitivity of 83.33% and specificity of 89.80%. Conclusion: It was concluded that MRI has high accuracy in diagnosing meniscal injuries. This makes it most appropriate screening tool for therapeautic arthroscopy.

Background: Incidence of distal femur fractures is approximately 37/ one lakh person-years. Distal femoral fractures mainly arise from two different injury mechanisms by high energy trauma and low energy trauma. Objective: To find out the causes of Non Union of distal femur and progress of such nonunion. Methodology: Total 35 cases of distal femur fracture nonunion satisfying inclusion and exclusion criteria treated and followed up in post graduate institute of swasthiyog pratishthan, miraj from May 2012 to September 2014 are taken in the study and all patients were followed up according to post-operative follow up protocol. Results: Among the 35 cases 31 were male and 04 were female. The mean age of case presenting to us at the detection of Non Union was 38.5 years. Symmetrical distribution of cases in the age group from 20-49 years which accounted for 29 cases (82.85%). Right limb was involved in more number of cases. Accidents were noted to be the main cause of primary fractures. Most of the cases had a compound injury initially. Aseptic Non Union was seen in 60% and infected Non Union in 40% of cases. The most common cause of non-union was found to be infection Conclusion: Commonest cause of non-union was found to be infection and most common injury associated was found to be Ipsilateral lower limb injuries.

Background: The stability of the joint is highly dependent on its supporting ligamentous structures, therefore injuries of ligaments and menisci are extremely common. Objective: To categorize discrepancies in findings of menisci and cruciate ligament between arthroscopy and MRI. Methodology: This prospective, comparative observational study was conducted at Ramkrishna Care Hospital, Raipur, Chhattisgarh. Informed consent was taken from all patients undergoing this study. We prospectively studied 67 patients with complaints of knee pain or instability/locking/giving away sensation with history of knee injury between the age group of 15-60 years over a period of 24 months starting from November 2014 to October 2016. Results: MRI showed 100% sensitivity and negative predictive value for ACL tear while specificity was 66.67% and accuracy of 95.52% with positive predictive value of 95.08%. MRI showed 100% positive predictive value for PCL tear while negative predictive value was 98.48%, alongwith sensitivity of 50% with specificity of 100% and accuracy of 98.51%. MRI showed positive predictive value of 57.58% for MM tear while negative predictive value was 88.24%, alongwith sensitivity of 82.61%, specificity of 68.18% and accuracy of 73.13%. MRI showed 75% positive predictive value for LM tear with a negative predictive value of 93.62%, alongwith sensitivity of 83.33%, specificity of 89.80% and accuracy of 88.06%. Conclusion: It was concluded MRI has high accuracy in diagnosing both meniscal and cruciate ligament injuries. The sensitivity for ACL tear is higher as compared to PCL while that of meniscal tear are almost equal.