Clinical, Magnetic Resonance Imaging, and Arthroscopic Correlation in Anterior Cruciate Ligament and Meniscal Injuries of the Knee

Abstract

Background: The aim of this study is to compare and correlate the clinical, magnetic resonance imaging (MRI), and arthroscopy findings in anterior cruciate ligament (ACL) and meniscal injuries of the knee. Methods: This was a prospective study of 30 cases of ACL and meniscal injuries of the knee admitted between September 2014 and May 2016, who underwent clinical examination, MRI, and arthroscopy of the knee. Results: In our study of 30 cases, there were 26 male and four female patients with age ranging from 18 years to 60 years, with most patients in between 21 years and 30 years. Clinical examination had sensitivity of 90.91%, specificity of 100%, and accuracy of 93.33% for ACL, sensitivity of 83.33%, specificity of 77.78%, and accuracy of 80% for medial meniscus, and sensitivity of 75%, specificity of 77.27%, and accuracy of 76.67% for lateral meniscus. MRI had sensitivity of 95.45%, specificity of 87.5%, and accuracy of 93.33% for ACL, sensitivity of 91.67%, specificity of 55.56%, and accuracy of 70% for medial meniscus, and sensitivity of 62.5%, specificity of 72.73%, and accuracy of 70% for lateral meniscus. Conclusion: In conclusion, the present study supports that clinical diagnosis is of primary necessity, as the positive predictive value is high for all the lesions. MRI is an additional diagnosing tool for ligament and meniscal injuries of the knee. Routine use of MRI to confirm the diagnosis is not indicated, as the positive predictive value is low, but can be used to exclude pathology, as the negative predictive value is high for all the lesions. 中 文 摘 要: 背景: 研究的目的是比較和相關膝關節前交叉韌帶和半月板損傷的臨床、磁共振成像和關節鏡檢查結果。 方法: 從2014年9月至2016年5月入院，對30例膝關節前交叉韌帶和半月板損傷患者接受臨床檢查、膝關節MRI和關節鏡檢查，進行前瞻性研究。 結果: 本研究中30例，26例男性，4例女性，年齡18至60歲，絕大多數患者為21至30歲。臨床檢查對前交叉韌帶的靈敏性為90.91%，特異性為100%，準確率為93.33% ; 內側半月板的靈敏度為83.33%，特異性為77.78%，準確率為80% ; 外側半月板的靈敏性為75%，特異性為77.27%，準確率為76.67%。而磁共振成像對前交叉韌帶的靈敏性為95.45%，特異性為87.5%，準確率為93.33% ; 內側半月板的靈敏性為91.67%，特異性為55.56%，準確率為70% ;外側半月板的靈敏性為62.5%，特異性為72.73%，準確率為70％。 結論: 本研究支持臨床診斷是首要必需的，因為所有病變的陽性預測值都很高。磁共振成像是膝蓋韌帶和半月板損傷的附加診斷工具。因為陽性預測值低，常規使用磁共振成像來確認診斷沒有必要。但因為所有病變的陰性預測值都很高，可以用於排除病變。 Keywords: ACL, arthroscopy, ligament injury, meniscus, MRI