Diagnostic arthroscopy compared to magnetic resonance imaging in the evaluation of meniscal and ligament tears of the knee

ABSTRACT

Background: The knee joint gets injured commonly as it has less musculature anteriorly and due to external forces affecting knee movements in coronal and sagittal planes. Rotational injuries are also common at the knee. Aims and Objectives: We wanted to compare the diagnostic capabilities of magnetic resonance imaging (MRI) and diagnostic arthroscopy (DgAr) in the evaluation of anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial meniscus (MM), and lateral meniscus (LM) injuries etc., seek correlation among both MRI and DgAr knee and find the better modality. Materials and Methods: This prospective study involved 50 patients suffering from knee joint injuries in our tertiary care teaching hospital. MRI of the knee was done in knees with internal derangement; all patients went for arthroscopy under general/spinal anesthesia. Keeping DgAr as reference, MRI was compared on parameters such as sensitivity and specificity, positive and negative predictive value plus accuracy. Results: MRI had a high accuracy i.e. 91.1%, 94%, 86%, and 92% for ACL, PCL, MM, and LM, respectively. Furthermore, it had low positive predictive value (PPV) and High PPV for meniscal and cruciate injuries. Conclusion: MRI is commonly used to evaluate various structures of the knee. In cases where clinical findings favor meniscal or ACL injuries, MRI scan prior to arthroscopic examination does not offer additional advantage. We suggest early DgAr as appropriate intervention in such cases.