Comparing MRI Diagnostic Accuracy for ACL and PCL Knee Injuries: Evidence from Arthroscopy-Confirmed Cases
Keywords:
arthroscopy-confirmed cases, mri diagnosticAbstract
Background: Injuries of knee joints are commonly occurred for different causes. Knee joint is one of the most important. Anterior (ACL) and posterior (PCL) crucial ligaments are prone to tear or sparing. MRI represents a golden imaging modality for assessment both chronic and acute pain causing disorders in the knee.
Objective: To evaluate the accuracy of MRI in diagnosis of injuries in anterior and posterior crucial ligaments compared to arthroscopy.
Patients and Methods: This was a cross-sectional study conducted in Afak hospital in period from March 2022 to April 2023, included 40 patients who were visited the orthopedic clinic suffering from knee trauma and referred for knee MRI and then got arthroscopic examination.
Result: Patients’ age ranged 25-55 years with a mean of 31.3±5.9 years. Overall ACL injury reported in 69.6% of patients and PCL injuries in 4% posterior cruciate ligaments. Compared to arthroscopy, MRI was 91.4% sensitive and 81.3% specific with accuracy of 89.2% in diagnosis of overall ACL injuries. For PCL injuries , MRI was 18% sensitive and 100% specific with 27.4% accuracy.
Conclusion: MRI had a good benefit in assessment of knee derangement. MRI had different efficacy according to types of knee problems
References
Abulhasan JF, Grey MJ. Anatomy and physiology of knee stability. Journal of Functional Morphology and kinesiology. 2017 Sep 24;2(4):34-9
Hirtler L, Lübbers A, Rath C. Vascular coverage of the anterior knee region– an anatomical study. Journal of Anatomy. 2019 Aug;235(2):289-98.
Flaxman TE, Speirs AD, Benoit DL. Joint stabilisers or moment actuators: the role of knee joint muscles while weight-bearing. Journal of Biomechanics. 2012 Oct 11;45(15):2570-6.
Juneja P, Hubbard JB. Anatomy, bony pelvis and lower limb, knee medial collateral ligament.
Rong GW, Wang YC. The role of cruciate ligaments in maintaining knee joint stability. Clin Orthop Relat Res. 1987 Feb;(215):65-71.
Veltri DM, Deng XH, Torzilli PA, Warren RF, Maynard MJ. The role of the cruciate and posterolateral ligaments in stability of the knee. A biomechanical study. Am J Sports Med. 1995 JulAug;23(4):436-43.
Smillie IS. Injuries of the knee joint. Annexe Thesis Digitisation Project 2019 Block 22. 1946.
Majewski M, Susanne H, Klaus S. Epidemiology of athletic knee injuries: A 10-year study. The knee. 2006 Jun 1;13(3):184-8.
Rohman EM, Macalena JA . "Anterior cruciate ligament assessment using arthrometry and stress imaging". Current Reviews in Musculoskeletal Medicine.2016: 9 (2): 130–8
Muthuri SG, McWilliams DF, Doherty M, Zhang W. History of knee injuries and knee osteoarthritis: a meta-analysis of observational studies. Osteoarthritis and cartilage. 2011 Nov 1;19(11):1286-93.
Messier SP, Legault C, Schoenlank CR, Newman JJ, Martin DF, DeVita P. Risk factors and mechanisms of knee injury in runners. Med Sci Sports Exerc. 2008 Nov 1;40(11):1873-9.
Rossi R, Dettoni F, Bruzzone M, Cottino U, D'Elicio DG, Bonasia DE. Clinical examination of the knee: know your tools for diagnosis of knee injuries. Sports Medicine, Arthroscopy, Rehabilitation, Therapy & Technology. 2011 Dec;3(1):1-0.
Dickens V, Ali F, Gent H, Rees A. Assessment and diagnosis of knee injuries: the value of an experienced physiotherapist. Physiotherapy. 2003 Jul 1;89(7):417-22.
Geraets SEW, Meuffels DE, van Meer BL, Breedveldt Boer HP, BiermaZeinstra SMA, Reijman M. Diagnostic value of medical history and physical examination of anterior cruciate ligament injury: comparison between primary care physician and orthopaedic surgeon. Knee Surgery, Sport Traumatol Arthrosc 2015;23(4):968-
van Eck CF, van den Bekerom MPJ, Fu FH, Poolman RW, Kerkhoff GMMJ. Methods to diagnose acute anterior cruciate ligament rupture: a meta-analysis of physical examinations with and without anaesthesai. Knee Surg Sports Traumatol Arthrosc. 2013;21:1895–1903
Siddiqui MA, Ahmad I, Bin Sabir A, Ullah E, Rizvi SAA, Rizvi SWA. Clinical examination vs MRI: evaluation of diagnostic accuracy in detecting ACL and meniscal injuries in comparison to arthroscopy. Pol Orthop Traumatol. 2013; 78:59–63.
Navali AM, Bazavar M, Mohseni MA, Safari B, Tabrizi A. Arthroscopic evaluation of the accuracy of clinical examination versus MRI in diagnosing meniscus tears and cruciate ligament ruptures. Arch Iran Med. 2013;16(4):229–232.
Kostov H, Arsovski O, Kostova E, Nikilov V. Diagnostic assessment in anterior cruciate ligament (ACL) tears. Prilozi. 2014;35(1):209–218.
Nasir A. the role of magnetic resonance image in knee joint injury. Int Res J Med Science: 2013: 1(5). 1-7.
Rahman A, Nafees M, Akram MH, Andrabi AH, Zahid M. Diagnostic accuracy of magnetic resonance imaging in meniscal injuries of knee joint and its role in selection of patients for arthroscopy. Journal of Ayub Medical College Abbottabad. 2010 Dec 1;22(4):10-4.
Ayman F. Ahmed, Ahmed Abdel Azeem, Amr Eladawy. Mohamed Abdeen. MRI as an accurate tool for the diagnosis and characterization of different knee joint meniscal injuries. the Egyptian Journal of Radiology and Nuclear Medicine 48 (2017) 953–960.
Khandelwal K, Chaturvedi VC, Mishra V, Khandelwal G. Diagnostic accuracy of MRI knee in reference to arthroscopy in meniscal and anterior cruciate ligament injuries. The Egyptian Journal of Radiology and Nuclear Medicine. 2018 Mar 1;49(1):138-45.
Mir BA, Sultan A, Bashir A. Internal derangement of the knee-sensitivity and specificity of an MRI in correlation with a diagnostic arthroscopy. Journal of Evolution of Medical and Dental Sciences. 2015 Dec 17;4(101):16635-8.
Gimhavanekar S, Suryavanshi K, Kaginalkar J, Rote-Kaginalkar V. Magnetic resonance imaging of knee joint: diagnosis and pitfalls using arthroscopy as gold standard. Int J Sci Stud. 2016 Apr 1;4(1):110-6.
Amin MF, Abd El Kareem H, Sadek AF, Saleh AN. MRI evaluation of the knee post double bundle ACL reconstruction: Association of graft findings and comparison with arthroscopy. The egyptian journal of radiology and nuclear medicine. 2016 Jun 1;47(2):521-9.
