DIAGNOSTIC ACCURACY OF PLAIN MAGNETIC RESONANCE IMAGING OF CRUCIATE LIGAMENTS AND MENISCAL INJURIES KEEPING ARTHROSCOPY AS GOLD STANDARD
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Abstract
OBJECTIVE: To find out the accuracy of plain Magnetic Resonance imaging (MRI) in comparison with arthroscopy in diagnosing cruciate ligaments and meniscal injuries.
METHODS: This prospective study was conducted from June 2019 to June 2020 at Khyber teaching hospital Peshawar, Pakistan. All patients, aging 14-55 years, with history of trauma to knee and suspected meniscal and ligament injuries were included. Patients with positive findings on clinical examination and MRI were sent for arthroscopy. Findings on MRI and arthroscopy were compared for diagnostic accuracy.
RESULTS: Out of 100 patients, 87 were males. Fifty-nine patients had anterior cruciate ligament injuries (ACLI), one patient had posterior cruciate ligament injuries (PCLI), 49 patients had medial meniscus injuries (MMI) and 8 had lateral meniscal injuries (LMI) respectively. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of MRI was 93.4%, 71.4%, 82.35% & 88.23% respectively for ACLI and 100%, 96%, 20% and 100% respectively for PCLI. Similarly, sensitivity, specificity, PPV and NPV of MRI was 81.6%, 45.3%, 57.97% & 72.72% respectively for MMI and 37.5%, 91.5%, 27.27% and 94.5% respectively for LMI. There was no statistically significant difference for gender (p=0.43) and side of knee (p=0.22) between MRI vs arthroscopy.
CONCLUSION: MRI has high sensitivity and NPV for ACLI & PCLI, low sensitivity for LMI, low specificity for MMI and low PPV for PCLI, MMI and LMI. In cases of clinical suspicion of meniscal or ligamental injury, clinicians should not rely on MRI findings alone but should follow it up with diagnostic arthroscopy.
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