Where does magnetic resonance imaging stand in the diagnosis of knee injuries?

Rastegar, Shirvan; Motififard, Mehdi; Nemati, Amin; Hosseini, Naeime Sadat; Tahririan, Mohammad Ali; Rozati, Sayyed Alireza; Sepiani, Mahdi; Moezi, Mehdi M.

doi:10.4103/1735-1995.187256

Cited by 2 publications

(1 citation statement)

References 11 publications

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“…Magnetic resonance imaging (MRI) is the primary diagnostic imaging tool for the identification of meniscal lesions [11, 17]. It has been shown that MRI has a good ability to diagnose preoperative primary meniscal tears [17, 22, 23, 33, 34]. A study by Thomas et al [28] showed that even with the diagnosis of primary meniscal lesion, MRI is not always indicated if the clinical examination strongly suggests pathology.…”

Section: Introductionmentioning

confidence: 99%

Magnetic resonance imaging can increase the diagnostic accuracy in symptomatic meniscal repair patients

Faunø

Sørensen

Nielsen

et al. 2019

Knee Surg Sports Traumatol Arthrosc

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Purpose The purpose of this study was to evaluate meniscal repair healing in symptomatic patients through combined clinical assessment, magnetic resonance imaging (MRI) and re-arthroscopy. This study investigated the diagnostic accuracy of MRI and clinical assessment in determining failed meniscal repair in symptomatic meniscal repair patients, as verified by re-arthroscopy. Methods Eighty patients were included. All had undergone a primary meniscal repair followed by an MRI and re-arthroscopy due to clinical symptoms of a meniscal lesion. A validated semi-quantitative scoring system was employed for identifying MRI-diagnosed healing failure. The clinical assessment was divided into joint swelling, joint-line tenderness, locking and a positive McMurray's test. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of MRI and positive clinical findings were calculated using second-look arthroscopy as a standard. ResultsThe MRI results showed healing of 22 (27.5%) of the menisci and 58 (72.5%) unhealed menisci, whereas secondlook arthroscopy identified 15 (19%) healed menisci and 65 (81%) unhealed menisci. The isolated MRI findings were 0.85, 0.8, 0.95 and 0.55 for sensitivity, specificity, PPV and NPV, respectively. The PPVs of the clinical assessments were 0.78, 0.85 and 0.94, with one, two and three clinical findings, respectively. A grade 3 MRI combined with joint-line tenderness presented a PPV of 0.98. Conclusion A supplementary MRI will increase diagnostic accuracy when fewer than three clinical findings are present in a symptomatic meniscal repair patient. The clinical relevance of this finding is that MRI contributes to enhancing the diagnostic accuracy of an unhealed meniscal repair when there are limited clinical signs of meniscal pathology. Level of evidence III.

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