Clinical magnetic resonance imaging and arthroscopic findings in knees: a comparative prospective study of meniscus anterior cruciate ligament and cartilage lesions

Munk, Bo; Madsen, Frank; Lundorf, Erik; Staunstrup, Henrik; Schmidt, Steen Asmus; Bolvig, Lars; Hellfritzsch, MB; Jensen, John

doi:10.1016/s0749-8063(98)70036-2

Cited by 86 publications

(62 citation statements)

References 14 publications

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“…Our low detection rate of chondral lesions by MRI support a previous report suggesting these lesions are difficult to observe in the ankle [26] and in the knee using conventional MRI techniques [5,13,14,22]. Although meniscus and ligament injuries are easily imaged, arthroscopy is required to see articular cartilage injuries in the knee [5,14].…”

Section: Discussionsupporting

confidence: 81%

Is MRI Adequate to Detect Lesions in Patients with Ankle Instability?

O’Neill

Aman

Guyton

2010

Clinical Orthopaedics &Amp; Related Research

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Background Chondral lesions, peroneal tendon tears, and other disorders in patients with chronic ankle instability may not be detected by preoperative MRI. Also, MRI often is obtained and interpreted at the referring institution, leading to variability in reading. Questions/PurposesWe assessed the accuracy of the radiologists' and orthopaedic surgeon's reading of preoperative MRI for diagnosing ankle lesions in patients with ankle instability warranting surgery. Patients and Methods We retrospectively reviewed 133 patients who underwent 135 surgeries for lateral ankle ligament reconstruction with concomitant ankle arthroscopy and who had preoperative MRI. Results We found 72 associated lesions in 66 of the 135 surgeries, including 38 chondral injuries, 18 peroneus brevis tears, seven loose bodies, and nine other miscellaneous abnormalities. Eliminating eight lesions for which the decision to operate was not based on operative findings, there were 127 surgeries with 64 associated lesions that required intraoperative confirmation or were detected intraoperatively. In the original reports, the radiologists identified 39% (15) of the chondral injuries, 56% (10) of the peroneal tears, and 57% (four) of the loose bodies. Radiologists' MRI sensitivity for detecting lesions was 45%. The attending surgeon identified 47% (18) of the chondral injuries, 89% (16) of the loose bodies, 71% (five) of the peroneus brevis tears, and the posterior talus process lesion, with a sensitivity of 63%. ConclusionsOur data suggest orthopaedic surgeons should review preoperative MRIs and also suggest the sensitivity of MRI may not be adequate to detect lesions in these patients before surgery.

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Section: Discussionsupporting

confidence: 81%

Is MRI Adequate to Detect Lesions in Patients with Ankle Instability?

O’Neill

Aman

Guyton

2010

Clinical Orthopaedics &Amp; Related Research

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“…Rotary forces on the knee while weight bearing, for example a sudden or unintended change in direction in a skier or footballer, may also produce similar injuries. 5,12 Cartilage defects are usually diagnosed at arthroscopy, 13 although they may be seen on magnetic resonance imaging (MRI). Osteochondral fractures, because they involve bone, may be seen on X-rays.…”

Section: Underlying Health Problem Cartilage Injuriesmentioning

confidence: 99%

Clinical and cost-effectiveness of autologous chondrocyte implantation for cartilage defects in knee joints: systematic review and economic evaluation

Clar

Cummins²,

McIntyre³

et al. 2005

Health Technol Assess

190

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“…It has been proposed that enhancement of the magnetic resonance imaging accuracy with articular cartilage lesions is obtained by the introduction of a special contrast in the knee. 50 This procedure is called arthro-resonance (or arthro-MRI), and recent studies have demonstrated this innovation to have good accuracy.…”

Section: -48mentioning

confidence: 99%

Accuracy of Magnetic Resonance in Identifying Traumatic Intraarticular Knee Lesions

Vaz

Camargo

Santana

et al. 2005

Clinics

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PURPOSE:To evaluate the diagnostic accuracy of magnetic resonance imaging of the knee in identifying traumatic intraarticular knee lesions. METHOD: 300 patients with a clinical diagnosis of traumatic intraarticular knee lesions underwent prearthoscopic magnetic resonance imaging. The sensitivity, specificity, positive predictive value, negative predictive value, likelihood ratio for a positive test, likelihood ratio for a negative test, and accuracy of magnetic resonance imaging were calculated relative to the findings during arthroscopy in the studied structures of the knee (medial meniscus, lateral meniscus, anterior cruciate ligament, posterior cruciate ligament, and articular cartilage). RESULTS: Magnetic resonance imaging produced the following results regarding detection of lesions: medial meniscus: sensitivity 97.5%, specificity 92.9%, positive predictive value 93.9%, positive negative value 97%, likelihood positive ratio 13.7, likelihood negative ratio 0.02, and accuracy 95.3%; lateral meniscus: sensitivity 91.9%, specificity 93.6%, positive predictive value 92.7%, positive negative value 92.9%, likelihood positive ratio 14.3, likelihood negative ratio 0.08, and accuracy 93.6%; anterior cruciate ligament: sensitivity 99.0%, specificity 95.9%, positive predictive value 91.9%, positive negative value 99.5%, likelihood positive ratio 21.5, likelihood negative ratio 0.01, and accuracy 96.6%; posterior cruciate ligament: sensitivity 100%, specificity 99%, positive predictive value 80.0%, positive negative value 100%, likelihood positive ratio 100, likelihood negative ratio 0.01, and accuracy 99.6%; articular cartilage: sensitivity 76.1%, specificity 94.9%, positive predictive value 94.7%, positive negative value 76.9%, likelihood positive ratio 14.9, likelihood negative ratio 0.25, and accuracy 84.6%. CONCLUSION: Magnetic resonance imaging is a satisfactory diagnostic tool for evaluating meniscal and ligamentous lesions of the knee, but it is unable to clearly identify articular cartilage lesions.

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Clinical magnetic resonance imaging and arthroscopic findings in knees: a comparative prospective study of meniscus anterior cruciate ligament and cartilage lesions

Cited by 86 publications

References 14 publications

Is MRI Adequate to Detect Lesions in Patients with Ankle Instability?

Is MRI Adequate to Detect Lesions in Patients with Ankle Instability?

Clinical and cost-effectiveness of autologous chondrocyte implantation for cartilage defects in knee joints: systematic review and economic evaluation

Accuracy of Magnetic Resonance in Identifying Traumatic Intraarticular Knee Lesions

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