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Indian Journal of Orthopaedics Surgery
Year : 2018, Volume : 4, Issue : 2
First page : ( 147) Last page : ( 154)
Print ISSN : 2395-1354. Online ISSN : 2395-1362.
Article DOI : 10.18231/2395-1362.2018.0031

A comparative study of magnetic resonance imaging and arthroscopy in internal derangement of knee

Sarath Vellanki1,*, Rao A. Srinivasa2, Vibhari K. Jyotsna3

1Associate Professor, Dept. of Orthodontics, Katuri Medical College & Hospitals, Chinakondrupadu, Guntur, Andhra Pradesh, India

2Professor and HOD, Dept. of Orthodontics, Katuri Medical College & Hospitals, Chinakondrupadu, Guntur, Andhra Pradesh, India

3Post Graduate, Dept. of Orthodontics, Katuri Medical College & Hospitals, Chinakondrupadu, Guntur, Andhra Pradesh, India

*Corresponding Author: Email: drsarathvellanki@rediffmail.com

Online published on 24 September, 2018.

Abstract

Thepurposeof this study is to compare the findings of magnetic resonance imaging with arthroscopy in internal derangements of knee and to assess the sensitivity, specificity and accuracy of magnetic resonance imaging in comparison to arthroscopy.

Methods and Materials

Fifty six patients with history of suspected internal derangement of knee were evaluated prospectively with MRI and compared with arthroscopy during a one and half a year period from January 2016 to June 2017 at Katuri Medical College & Hospitals, Chinakondrupadu, Guntur. 1.5 Tesla MRI machine using a closed extremity coil is used. Commonly used sequences in MRI of the knee include Turbo-spin echo (TSE), FFE (Gradient echo) and Short Tau Inversion Recovery (STIR) sequences in Axial, Sagittal and Coronal planes using a slice thickness of 3 mm with a 0.3 mm slice gap. Arthroscopy of the knee with standard anteromedial and anterolateral portals with the patient in supine position done in all the cases.

Observations

The diagnostic sensitivity, specificity and accuracy of MRI in detecting cruciate ligament and meniscal injuries as compared to arthroscopy is as follows: Anterior Cruciate Ligament (ACL): 97.29%, 89.47%, 94.64%; Posterior Cruciate Ligament (PCL): 100%, 100%, 100%; Medial Meniscus (MM): 100%, 93.33%, 98.21% and Lateral Meniscus (LM): 93.10, 92.59, 92.85. Most common lesions found were ACL and Medial Meniscal tears (posterior horn of MM being the most common site).

Summary and Conclusion

MRI is a useful non-invasive modality having high sensitivity, specificity and accuracy in diagnosing cruciate ligament and meniscal injuries. MRI should be considered as the first line of investigation in all patients with suspected internal derangements of knee. MRI being easily available and non-invasive is useful as a pre-operative screening modality, thus improves the quality of diagnostic and therapeutic arthroscopies and further reduces the morbidity. Arthroscopy is the gold standard in diagnosing cruciate ligament and meniscal injuries.

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Keywords

Arthroscopy, MRI.

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