Clinical decision making in the acutely injured knee based on repeat clinical examination and MRI

Abstract

To determine the correlation between Magnetic Resonance Imaging (MRI) and clinical examination of the knee after an acute injury, and to see to what extent MRI affected the planned treatment, we examined 90 consecutive patients in a prospective study, clinically and with an extremity Magnetic Resonance (MR) scanner. The number of meniscal lesions, bone bruises and osteochondral lesions found on MRI was significantly higher than the clinical examinations indicated. Despite this, the treatment was only changed in 6 cases. In no case did MRI prevent a planned arthroscopy. MRI may reveal many clinically silent changes in the knee, also after minor injuries. The significance of these MRI findings must await long-term follow-up.

Epidemiology of intra- and peri-articular structural injuries in traumatic knee joint hemarthrosis – data from 1145 consecutive knees with subacute MRI

“…To improve diagnostic precision, different strategies have been advocated. Repeat examination performed by a skilled specialist as well as routine arthroscopy with examination under anesthesia will reduce the rate of overlooked injuries 1,11,12 . Magnetic resonance imaging (MRI) may however be considered a cost effective non-invasive gold standard for assessing post trauma knee joint derangement 13e17 .…”

How sensitive and specific is 1.5 Tesla MRI for diagnosing injuries in patients with knee dislocation?

“…The exact anatomical pattern of lesions can be difficult to identify [20]. Conventional plain radiographs (anterior-posterior, lateral, patella skyline view) remain the first-line radiological investigation allowing identification of fractures, bony avulsions of…”

Efficacy of Repeat Magnetic Resonance Imaging of the Knee

“…MRI is a valuable method for clinicians to accurately detect pathology within the knee in a safe, noninvasive manner. 2,3,[6][7][8][9][10][11][12][13] However, the indications for obtaining a knee MRI have not been standardized. 14 [15][16][17] believe that a knee MRI is indicated for acute knee trauma, painful range of motion, or mechanical knee symptoms, whereas others suggest that this imaging modality should be restricted to situations in which an experienced clinician requires further information before arriving at a diagnosis or when conservative treatment seems possible.…”