A STUDY IN INDIAN POPULATION CORRELATING THE DIAGNOSTIC ACCURACY OF CLINICAL EXAMINATION AND MRI IN ACL AND MENISCUS INJURIES

Abstract

In the modern era of medicine, magnetic resonance imaging (MRI) has become an indispensable part in diagnosing knee injuries.Due to an increased dependence and reliance on MRI,clinical findings are often ignored and this leads to a neglect in diagnosing ligament injury. Considering a highly variable result in clinical findings & less studies being performed in Indian population we did an agreement study comparing the role of clinical examination,MRI findings and diagnostic arthroscopy in the diagnosis of traumatic chronic anterior cruciate ligament & meniscal injuries in our tertiary care hospital. In our prospective study we included 267 patients with anterior cruciate ligament, medial meniscus and lateral meniscus injuries.First these patients were examined clinically,then subjected to an MRI scan and arthroscopic surgery.Here we report a superior sensitivity and specificity of clinical examination in comparison to MRI scan for diagnosis of medial meniscal tears. For the diagnosis of anterior cruciate ligament (ACL) and lateral meniscus injury the results were found to be aequivocal.We recommend that when suspected clinically, a normal MRI should not be considered as a sufficient evidence to defer an arthroscopy in knee injury patient.