scholarly journals Clinical, MRI and Arthroscopic Correlation in Internal Derangement of Knee

2012 ◽  
Vol 9 (3) ◽  
pp. 174-178 ◽  
Author(s):  
U K Sharma ◽  
B K Shrestha ◽  
S Rijal ◽  
B Bijukachhe ◽  
R Barakoti ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Cruciate Ligament ◽  
Meniscal Tear ◽  
Internal Derangement ◽  
Ligament Injury ◽  
Low Field ◽  
Diagnostic Arthroscopy ◽  
Medial Meniscal Tear ◽  
Low Field Mri ◽  
Sensitivity Specificity

Background The traumatic or degenerative internal derangement of the knee requires certain investigations for the establishment of diagnosis, in addition to clinical history and a thorough physical examination. The use of arthrography and arthroscopy improves the accuracy of the diagnosis. MRI scanning of the knee joint has often been regarded as the noninvasive alternative to diagnostic arthroscopy. Objective The purpose of the study was to correlate clinical and low field MRI findings with arthroscopy in internal derangement of the knee. Methods Forty one patients with suspected internal derangement of the knee were subjected to MR examination followed by arthroscopy. Clinical criteria used were history, mode of injury, Mc Murray’s, Apley’s grinding, Thessaly’s test for meniscal injury. Drawer test was considered to be essential for clinical diagnosis of cruciate ligament injury. MRI of the knee was performed in low field open magnet (0.35T, Magnetom C, Seimens). Arthroscopy was done within two months of MR examination and was considered gold standard for the internal derangement of the knee. Results The sensitivity, specificity, diagnostic accuracy of clinical examination were 96.1%, 33.3% and 73.1% respectively for medial meniscal tear; 38.4%, 96.4% and 78.1% respectively for lateral meniscal tear. The sensitivity, specificity, diagnostic accuracy of MRI were 92.3%,100% and 95.1% for medial meniscal tear; 84.6%96.4% and 92.6% respectively for lateral meniscal tear. ConclusionClinical examination showed higher sensitivity for medial meniscal tear compared to MRI, however with low specificity and diagnostic accuracy. Low field MRI showed high sensitivity, specificity, diagnostic accuracy for meniscal and cruciate ligament injury, in addition to associated derangement like articular cartilage damage, synovial thickening.DOI: http://dx.doi.org/10.3126/kumj.v9i3.6300 Kathmandu Univ Med J 2011;9(3):174-8 

scholarly journals Menisco-ligamentous injuries of knee joint: Can ultrasonography serve as an effective screening modality?

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Farooq Mir ◽  
Zahoor Raina ◽  
Omair Shah ◽  
Tariq Gojwari ◽  
Irfan Robbani ◽  
...  
Keyword(s):  
Knee Joint ◽  
Diagnostic Accuracy ◽  
Imaging Modality ◽  
Meniscal Tear ◽  
Clinical Findings ◽  
Ligament Injury ◽  
Effective Screening ◽  
Medial Collateral Ligament Injury ◽  
Magnetic Resonance Imaging Mri ◽  
Sensitivity Specificity

The aim is to calculate sensitivity, specificity and diagnostic accuracy of Ultrasonography (USG) as a screening modality in evaluation of Menisco- Ligamentous injuries of knee joint with Magnetic Resonance Imaging (MRI)as gold standard for comparison.Patients with clinically suspected Menisco-Ligamentous injurieswere evaluated by USG initially followed by MRI on the same day. A total of 60 patients (50 males, 10 females) underwent USG and MRI. USG was done using high frequency probe (9-14 Hz) and all the injuries noted. USG of the normal knee was done for comparison. MRI with trauma protocol sequences was done on the same day. The accuracy of USG and MRI in diagnosis of menisco-ligamentous injuries was compared. Majority of the patients (50%) belonged to age group of 21-40 years. Most common injuries seen were medial meniscal tear followed by medial collateral ligament injury. The strength of agreement between USG and MRI was good with Diagnostic accuracy of USG ranging from 83.3% to 95% for different meniscal/ligamentous injuries.USG is an effective imaging modality with high accuracy in diagnosing menisco-ligamentous injuries. USG can act as an effective screening modality in closed knee trauma for evaluation of menisco- ligamentous injuries especially in resource constrained regions owing to its easy availability, portability and lower cost. MRI can be reserved for patients with suspicious USG and clinical findings.

scholarly journals Arthroscopic Articular Cartilage Scores of the Canine Stifle Joint with Naturally Occurring Cranial Cruciate Ligament Disease

2020 ◽  
Author(s):  
Kimberly A. Agnello ◽  
Kei Hayashi ◽  
Dorothy Cimino Brown
Keyword(s):  
Articular Cartilage ◽  
Cruciate Ligament ◽  
Cartilage Damage ◽  
Meniscal Tear ◽  
Trochlear Groove ◽  
Cranial Cruciate Ligament ◽  
Stifle Joint ◽  
Naturally Occurring ◽  
Medial Meniscal Tear ◽  
Severity Scores

Abstract Objective This study aimed to evaluate frequency, location and severity of cartilage pathology in dogs with naturally occurring cranial cruciate ligament (CCL) disease. Study Design Stifle arthroscopic video recordings (n = 120) were reviewed. A modified Outerbridge classification system (MOCS) (0–4) was used to score cartilage at 10 locations in the femorotibial (medial and lateral femoral condyles and tibial plateaus) and patellofemoral compartments (proximal, middle and distal locations of the patella and femoral trochlear groove) of the stifle joint. Synovial pathology was scored and the presence of a medial meniscal tear was recorded. A Kruskal–Wallis test was used to evaluate association of location and synovitis with cartilage score; and presence of meniscal tear with cartilage and synovitis scores. Bonferroni correction was utilized and p < 0.05 was considered significant. Results Cartilage pathology and synovitis were identified in all joints. Overall cartilage severity scores were low (median MOCS 1). The median MOCS of the proximal trochlear groove (2) was significantly higher than all other locations evaluated. Higher synovitis scores were significantly associated with higher cartilage severity scores and a medial meniscal tear had no association with cartilage severity scores or synovitis. Conclusion Arthroscopic articular cartilage lesions are common in dogs with CCL disease at the time of surgical intervention, although the severity of cartilage damage is mild. The proximal trochlear groove of the femur had the most severe cartilage score in the stifle joint.

The effect of unloader knee braces on medial meniscal strain

2018 ◽  
Vol 43 (2) ◽  
pp. 132-139 ◽  
Author(s):  
Mayank Kalra ◽  
Ryan Bakker ◽  
Sebastian S Tomescu ◽  
Anna M Polak ◽  
Micah Nicholls ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Injury Risk ◽  
Medial Meniscus ◽  
Cruciate Ligament ◽  
Meniscal Tear ◽  
Compressive Force ◽  
Ligament Injury ◽  
Knee Braces ◽  
Anterior Cruciate

Background: A medial meniscal tear is a common knee injury, especially following an anterior cruciate ligament injury. Decreasing the compressive force on the medial meniscus during dynamic activities using an unloader knee brace could reduce meniscal strain, effectively reducing injury risk and/or severity. Objectives: To investigate the efficacy of two unloader knee braces on medial meniscus strain during dynamic activities in intact & deficient anterior cruciate ligament states. Study design: Combined in vivo/in vitro study. Methods: In vivo knee kinematics and muscle force profiles from a healthy individual performing single/doubleleg squats and walking motions were simulated on 10 cadaveric specimens using a dynamic knee simulator system. Simulations were performed on knees in unbraced and braced scenarios, with and without the anterior cruciate ligament. Anterior and posterior medial meniscal strains were measured. Results: Two different braces each showed a significant reduction in the posteromedial meniscal strain ( p ⩽ 0.01) in an intact anterior cruciate ligament state. Neither brace mirrored this result for the anteromedial strain ( p > 0.05). In the deficient anterior cruciate ligament state, the braces had no significant effect on strain ( p > 0.05). Conclusion: Two unloader knee braces effectively reduced strain in the medial meniscus with an intact anterior cruciate ligament during dynamic activities. Neither brace made a significant reduction in strain for anterior cruciate ligament-deficient knees. Clinical relevance Unloader knee braces could be used to reduce the medial meniscus strain following meniscal surgery and during rehabilitation in patients with an isolated medial meniscus injury. However, these braces cannot be recommended for this purpose in patients with an anterior cruciate ligament deficiency.

Extremity-dedicated low-field MRI shows good diagnostic accuracy and interobserver agreement for the diagnosis of the acutely injured knee

2015 ◽  
Vol 39 (5) ◽  
pp. 871-875
Author(s):  
Jonas Bürk ◽  
Marco Vicari ◽  
Philippe Dovi-Akué ◽  
Matthias Benndorf ◽  
Benjamin Fritz ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Interobserver Agreement ◽  
Low Field ◽  
Low Field Mri ◽  
Good Diagnostic Accuracy ◽  
Injured Knee

scholarly journals Arthroscopic and Low-Field MRI (0.25 T) Evaluation of Meniscus and Ligaments of Painful Knee

2012 ◽  
Vol 2 ◽  
pp. 24 ◽  
Author(s):  
Harish S Lokannavar ◽  
Xiaochun Yang ◽  
Harsha Guduru
Keyword(s):  
Negative Predictive Value ◽  
Predictive Value ◽  
Imaging Study ◽  
Cost Effective ◽  
Non Invasive ◽  
Low Field ◽  
Cost Effective Technique ◽  
Low Field Mri ◽  
Magnetic Resonance Imaging Mri ◽  
Sensitivity Specificity

Objective: Magnetic resonance imaging (MRI) is an accurate, non-invasive, cost-effective technique for examination of the soft tissue and osseous structures of the knee. The purpose of this study was to evaluate the accuracy of low-field MRI by comparing the results with subsequent arthroscopy. Materials and Methods: MR imaging study of 146 patients was done using 0.25 T ESTOATE G-SCAN and the sequence used were SE, FSE and GRE in all the three planes. The comparison was based on five parameters: accuracy, sensitivity, specificity, positive predictive value, and negative predictive value. Result: Our study showed high accuracy (98.08%) and negative predictive value (98.62%) for MRI in comparison with arthroscopy. Conclusion: Low-field MRI alleviates the need of arthroscopy for detection of meniscus tears and ligament tears.

scholarly journals Risk Factors for Lateral Meniscus Posterior Root Tears in the Anterior Cruciate Ligament–Injured Knee: An Epidemiological Analysis of 3956 Patients From the SANTI Study Group

2019 ◽  
Vol 47 (3) ◽  
pp. 598-605 ◽  
Author(s):  
Cesar Praz ◽  
Thais Dutra Vieira ◽  
Adnan Saithna ◽  
Nikolaus Rosentiel ◽  
Vikram Kandhari ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acl Reconstruction ◽  
Odds Ratio ◽  
Cruciate Ligament ◽  
Meniscal Tear ◽  
Lateral Meniscus ◽  
Significant Risk ◽  
Posterior Root ◽  
Medial Meniscal Tear ◽  
Anterior Cruciate

Background: Lateral meniscus posterior root tears (LMPRTs) result in loss of hoop forces and significant increases in tibiofemoral contact pressures. Preoperative imaging lacks reliability; therefore, holding an appropriate index of suspicion, based on the epidemiology of and risk factors for LMPRT, may reduce the rate of missed diagnoses. Purpose: The primary objectives of this study were to evaluate the incidence of and risk factors for lateral meniscus root lesions in a large series of patients undergoing anterior cruciate ligament (ACL) reconstruction. Study Design: Case-control study; Level of evidence, 3. Methods: All patients who underwent primary or revision ACL reconstruction by a single surgeon between January 2011 and April 2018 were considered for study eligibility. From this overall population, all patients who underwent repair of an LMPRT were identified. The epidemiology of LMPRT was defined by the incidence within the study population, stratified by key demographic parameters. Potentially important risk factors for the presence of LMPRT were evaluated in multivariate logistic regression analysis. Results: A total of 3956 patients undergoing ACL reconstruction were included in the study. An LMPRT was identified and repaired in 262 patients (6.6%). Multivariate analyses demonstrated that significant risk factors for LMPRT included a contact sports injury mechanism (7.8% incidence with contact sport mechanism vs 4.5% with noncontact mechanism; odds ratio, 1.69; 95% CI, 1.266-2.285; P < .001) and the presence of a medial meniscal tear (7.9% incidence with medial meniscal tear vs 5.8% without; odds ratio, 1.532; 95% CI, 1.185-1.979; P < .001). Although the incidence of LMPRT in male patients (7.3%) was higher than in females (4.8%), this was not significant in multivariate analysis ( P = .270). Patient age, revision ACL reconstruction, and a preoperative side-to-side laxity difference ≥6 mm were not significant risk factors for LMPRT. Conclusion: The incidence of LMPRT was 6.6% in a large series of patients undergoing ACL reconstruction. Participation in contact sports and the presence of a concomitant medial meniscal tear were demonstrated to be important independent risk factors. Their presence should raise the index of suspicion for this injury pattern.

scholarly journals A New Modified MR Dual Precision Positioning of Thin-Slice Oblique Sagittal Fat Suppression Proton Density Weighted Imaging: Its Diagnostic Accuracy in Anterior Cruciate Ligament Injury and its Grades

2021 ◽  
Author(s):  
Kun Li ◽  
Felix Young Jhonatan ◽  
Zhaohui Yu ◽  
Jinhua Chen ◽  
Lixin Huang ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Cruciate Ligament ◽  
False Negative ◽  
Acl Injury ◽  
Fat Suppression ◽  
Ligament Injury ◽  
Proton Density ◽  
Precision Positioning ◽  
Thin Slice

Abstract Purpose To evaluate the diagnostic accuracy of a new modified MR dual precision positioning of thin-slice oblique sagittal fat suppression proton density-weighted imaging (DPP-TSO-Sag-FS-PDWI) sequence in detecting ACL injuries and its grades compared to standard sequences using arthroscopy as the standard reference.Materials and Methods 42 patients enrolled in this retrospective study received the 1.5-T MRI with standard sequences and the new modified DPP-TSO-Sag-FS-PDWI sequence, and their arthroscopy results was recorded. The Mc Nemer-Bowker and weighted Kappa was performed to compare the consistency of MRI diagnosis with arthroscopic results. Finally, the diagnostic accuracy was calculated based on the true positive, true negative, false negative and false positive values.Results The diagnostic consistency of the DPP-TSO-Sag-FS-PDWI were higher than standard sequences for both reader 1 (K = 0.876 vs. 0.620) and reader 2 (K = 0.833 vs. 0.683) with good diagnostic repeatability (K = 0.794 vs. 0.598). Furthermore, the DPP-TSO-Sag-FS-PDWI can classify and diagnose three grades of ACL injury [the sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value were more than 84%], especially for grade II injury as the PPV was superior for reader 1 (92.3% vs. 53.9%) and reader 2 (84.6% vs. 69.2%).Conclusion The new modified DPP-TSO-Sag-FS-PDWI sequence can display the ACL injury on one or continuous levels by maximizing the acquisition of complete ligament shape and true anatomical images, and excluding the influence of anatomical differences between individuals. It can improve the diagnostic accuracy with good repeatability and classify three grades of the ACL injury.

scholarly journals Diagnostic values of clinical tests for the meniscals tear in patients with anterior cruciate ligament injury

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Đình Toàn Dương ◽  
Tiến Thành Vũ
Keyword(s):  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Clinical Signs ◽  
Meniscus Tear ◽  
Ligament Injury ◽  
Meniscal Injury ◽  
Clinical Tests ◽  
Arthroscopic Reconstruction ◽  
Anterior Cruciate ◽  
Sensitivity Specificity

Tóm tắt Đặt vấn đề: Từ tháng 4/2017 - 6/2018 chúng tôi đã tiến hành nghiên cứu trên 50 người bệnh tổn thương dây chằng chéo trước (DCCT) và rách sụn chêm (SC) khớp gối, được phẫu thuật nội soi tại Bệnh viện Hữu nghị Việt Đức với mục tiêu: Đánh giá độ nhạy, độ đặc hiệu và độ chính xác của các nghiệm pháp lâm sàng trong chẩn đoán tổn thương SC khớp gối. Phương pháp nghiên cứu: 50 người bệnh tổn thương DCCT và rách SC khớp gối, được phẫu thuật nội soi. Tổn thương SC (hình thái, phân loại) được quan sát trong mổ, được đối chiếu với triệu chứng lâm sàng, từ đó xác định độ nhạy, độ đặc hiệu và độ chính xác của các nghiệm pháp lâm sàng. Kết quả: Độ nhạy, độ đặc hiệu và độ chính xác của các dấu hiệu và nghiệm pháp lâm sàng lần lượt của rách sụn chêm trong: đau khe khớp (70%; 53%; 60%); McMuray (80%; 73,3%: 76%); Apley (65%; 70%; 68%); Thessaly (70%; 76,7%;74%); rách sụn chêm ngoài: đau khe khớp (73%; 66,7%; 70%); McMurray (69,2%; 75%: 72%); Apley (69,2%; 70,8%; 70%); Thessaly (73,1%; 75%; 74%). Kết luận: Khi thăm khám đánh giá tổn thương SC, nếu phát hiện có ít nhất 2 nghiệm pháp dương tính thì giá trị của chẩn đoán lâm sàng được nâng cao. Abstract Introduction: From 4 / 2017-6 / 2018, we conducted a study on 50 patients with anterior cruciate ligament (ACL) injury and meniscal injury, which had ACL arthroscopic reconstruction at Viet Duc University Hospital. Objectives: To evaluate the sensitivity, specificity and accuracy of clinical tests for meniscal injury. Materials and Methods: 50 patients with ACL injury and meniscal torn, had ACL arthroscopic reconstruction. Meniscal injury (morphology, classification) observed during surgery, collated with clinical tests, determining sensitivity, specificity and accuracy of clinical signs and clinical tests. Results: The sensitivity, specificity and accuracy of the clinical signs and clinical tests of medial meniscus tear: joint pain (70%; 53%; 60%); McMurraytest (80%; 73.3%: 76%); Apleytest (65%; 70%; 68%); Thessalytest (70%; 76.7%; 74%); for lateral meniscus tear: joint pain (73%; 66.7%; 70%); McMurraytest (69.2%; 75%: 72%); Apleytest (69.2%; 70.8%; 70%); Thessalytest (73.1%; 75%; 74%). Conclusion: When examining and assessing meniscus lesions, if the examination finds at least two positive results, the value of the clinical diagnosis is greatly improved. Keywords: Meniscal injury, knee injury, anterior cruciate ligament injury, arthroscopy.

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