DIAGNOSTIC ACCURACY OF MAGNETIC RESONANCE IMAGING IN MENISCAL INJURIES OF KNEE JOINT AND ITS ROLE IN SELECTION OF PATIENTS FOR ARTHROSCOPY

Asif Rahman, Muhammad Nafees, Muhammad Hamid Akram, Atif Hussain Andrabi, Muhammad Zahid

Abstract


Background: Magnetic Resonance Imaging (MRI) is frequently advised to evaluate clinically suspected
cases of meniscal injuries in our setup. The objective was to determine the diagnostic accuracy of MRI in
meniscal injuries of knee joint and its effectiveness in selection of patients for arthroscopy. Methods: A
Cross-sectional comparative study was conducted at Radiology Department Military Hospital (MH)
Rawalpindi in collaboration with Orthopaedic Department Combined Military Hospital (CMH)
Rawalpindi from 31 Jan 2007 to 1 Aug 2007. Fifty-seven patients with clinical suspicion of meniscal
injuries were subjected to MRI. Arthroscopy was done only in 34 patients while 23 were excluded on the
basis of MRI findings. MRI findings were compared with arthroscopic findings. Medial and lateral
menisci were considered separately in each case. Results: Among 57 patients only 30 showed significant
tear on MRI. Arthroscopy was done in these cases. Arthroscopy was considered on clinical grounds only
in 4 patients who did not show significant tear on MRI. MRI showed Medial Meniscus (MM) injury in
23 patients and Lateral Meniscus (LM) injury in 10 patients. Arthroscopy confirmed MM injury in 17
patients and LM injury in 7 patients. MRI missed two MM and one LM injuries. This showed that MRI
has sensitivity of 89.4% and specificity of 62% in diagnosing injuries of MM, while sensitivity of 87%
and specificity of 88% in diagnosing injuries of LM. Diagnostic accuracy of MRI in MM and LM
injuries was 76.4% and 88.2% respectively. Conclusion: MRI is accurate in diagnosing meniscal
injuries of knee joint and is effective in selection of patients for arthroscopy.
Keywords: Magnetic Resonance Imaging, Meniscal injuries, Arthroscopy

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