Diagnostic accuracy of Magnetic Resonance Imaging in assessment of Meniscal and ACL tear: correlation with arthroscopy

To determine the diagnostic accuracy of magnetic resonance imaging [MRI] in injuries related to anterior cruciate ligament and menisci and compare its effectiveness with that of arthroscopy. This retrospective cross-sectional study was conducted in the department of Radiology and Medical Imaging of Dallah Hospital, Riyadh, Kingdom of Saudi Arabia from September 2012 to March 2014. Fifty four patients [including 30 men and 24 women] with internal derangement of knee referred from the orthopedic consulting clinics underwent MR imaging followed by arthroscopic evaluation. The presence of meniscal and ligamentous abnormality on the imaging was documented by two trained radiologist. Findings were later compared with arthroscopic findings. The sensitivity, specificity and accuracy of MR imaging for menisci and ACL injury were calculated: 100% sensitivity, 88.4% specificity, 90% positive predictive value, 100% negative predictive value, and 94.4% accuracy were noted for medial meniscal injury. Similarly, MR had sensitivity of 85.7%, specificity of 95%, positive predictive value of 85.7%, negative predictive value of 95%, and accuracy of 92.5% for lateral meniscal injuries. Likewise, anterior cruciate ligament had 91.6% sensitivity, 95.2% specificity, 84.6% positive predictive value, 97.5% negative predictive value, and 94.4% accuracy. MRI is extremely helpful in identifying meniscal and anterior cruciate ligaments tears. MR imaging has high negative predictive value making it better choice as screening tool compared to diagnostic arthroscopic evaluation in most patients with soft tissue trauma to knee

Preliminary experience with intramedullary interlocking nail system

This is the preliminary report of an ongoing study where 23 cases of simple and compound fractures have been fixed with interlocking mail system, from Feb. to Nov. 1995. The results were good, even when compound fractures were fixed after 6 hours of initial injury. We recommend fixation of such compound injures after taking tissue samples for culture and thorough wound excision/debridement under cover of parenteral 3rd generation cephalosporins. Solid nails without reaming are ideal for use in compound fractures while reaming with band is better