Arthroscopy: The Journal of Arthroscopic & Related Surgery
The value of clinical examination versus magnetic resonance imaging in the diagnosis of meniscal tears and anterior cruciate ligament rupture
Section snippets
Methods
From August 2001 to December 2001, the authors evaluated 50 consecutive patients (37 male, 13 female) with an average age of 22 years (range, 12 to 42 years) with 65 pathologies of the knee. The inclusion criteria were restricted to patients with clinical diagnoses of either meniscal tears and/or ACL rupture. Patients with other coexistent pathologies were excluded from this study group. The mean time to surgery from initial evaluation was 5 weeks (range, 5 days to 5 months).
Each patient
Results
There were 65 pathologies of the knee identified by arthroscopy in these 50 patients. There were 26 ACL tears, 31 medial meniscal tears, and 8 lateral meniscal tears. The distribution of the true-positives and true-negatives, and false-positives and false-negative results are summarized in Table 1. There was no significant difference between the accuracy of clinical examination and MRI in diagnosing medial or lateral meniscal tears or ACL ruptures (P > .05). The accuracy, sensitivity,
Discussion
The necessity of MRI for evaluating knee injuries has been called into question because of its high cost and the presumed reliability of clinical examination. Despite the cost, the number of MRI examinations of the knee ordered each year continues to rise. Current cost-cutting trends have marked eliminating expensive high-tech tests such as MRI as a potential way to lower medical costs. Physicians are now being held responsible for proving that therapies and diagnostic studies are both
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