scholarly journals The accuracy of magnetic resonance imaging diagnosis of non-osseous knee injury at Steve Biko Academic Hospital

2019 ◽  
Vol 23 (1) ◽  
Author(s):  
Nashil Singh ◽  
Heleen Hanekom ◽  
Farhana E. Suleman
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Predictive Value ◽  
Knee Injury ◽  
Cruciate Ligament ◽  
Resonance Imaging ◽  
Academic Hospital ◽  
Knee Ligament ◽  
Predictive Values ◽  
Negative Results

Background: Preoperative magnetic resonance imaging (MRI) has internationally been proven to reduce unnecessary knee arthroscopies and assist with surgical planning. This has the advantage of avoiding unnecessary surgery and the associated anaesthetic risk, as well as reducing costs. No data were found in the recently published literature assessing the accuracy of MRI interpretation of knee ligament injury in the public sector locally.Objectives: This pilot study aimed to determine the accuracy of MRI in detecting non-osseous knee injury in a resource-limited tertiary-level academic hospital in Pretoria, South Africa, compared to the gold standard arthroscopy findings.Method: This was an exploratory retrospective analysis of 39 patients who had MRI and arthroscopy at Steve Biko Academic Hospital (SBAH). True positive, true negative, false positive and false negative results were extrapolated from findings in both modalities and translated into sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for each structure.Results: Negative predictive values were recorded as 97%, 81%, 90% and 100% (anterior cruciate ligament [ACL], medial meniscus [MM], lateral meniscus [LM] and posterior cruciate ligament [PCL], respectively), which were comparative to recently published international literature. The PPV results were lower than those previously evaluated at 55%, 58%, 55% and not applicable. The sensitivities and specificities of the ligaments were 83%, 58%, 83% and not applicable; and 87%, 81%, 70% and not applicable, respectively.Conclusion: Magnetic resonance imaging was found to be sensitive and specific, with a high NPV noted in all structures evaluated. Negative results can therefore be used to avoid unnecessary surgery to the benefit of the patient and state. The study reiterates that high accuracy can be obtained from MRI on a 1.5-tesla non-dedicated scanner, with interpretation by generalist radiologists.

scholarly journals General practitioner access to magnetic resonance imaging for suspected knee ligament and meniscal injuries

2014 ◽  
Vol 96 (4) ◽  
pp. 126-128
Author(s):  
ASC Bidwai ◽  
HJ Butterworth ◽  
PG Sherry
Keyword(s):  
Magnetic Resonance Imaging ◽  
General Practitioner ◽  
Magnetic Resonance ◽  
Cruciate Ligament ◽  
Resonance Imaging ◽  
Ligament Injuries ◽  
Knee Ligament ◽  
Meniscal Lesions ◽  
Magnetic Resonance Imaging Mri ◽  
Knee Magnetic Resonance Imaging

Knee magnetic resonance imaging (MRI) has been shown to be sensitive and specific for the detection of knee meniscal lesions and cruciate ligament injuries, and it is more reliable than clinical examination itself. 1 This has led to the suggestion that general practitioners (GPs) could use knee MRI in the assessment of these pathologies, making appropriate and informed decisions. 2

scholarly journals The Role of Magnetic Resonance Imaging in Traumatic Knee Injury

2020 ◽  
Vol 5 (1) ◽  
pp. 53-61
Author(s):  
Madan Thapa ◽  
Subash Thapa ◽  
Pramod Kumar Chhetri
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Knee Injury ◽  
Wide Spectrum ◽  
Cruciate Ligament ◽  
Lateral Meniscus ◽  
Lateral Collateral Ligament ◽  
Bone Bruise ◽  
Resonance Imaging ◽  
Collateral Ligament

Introduction: Magnetic Resonance Imaging (MRI) as a non-invasive modality plays a vital role in assessment of a wide spectrum of internal knee derangements. This study focuses on the commonest anatomical derangement and reveals the importance of MRI to characterize the pattern of derangement in the assessment of the patient with knee injury. Methods: This is the hospital based prospective study conducted among 65 patients referred to department of radiology with first presentation of knee injury during two years period from August, 2013 to August, 2015. Patient fulfilling the inclusion criteria underwent Magnetic Resonance Imaging knee in SIEMENS MAGNETOM C 0.35 Tesla MRI machine, after taking written informed consent. Descriptive analysis of data was analyzed using SPSS 20.0 program Result: Of the total 65 patients with knee injury, Sport injuries were the most common mode of knee injury. 63 cases with trauma had findings on MRI. Most of the cases presented with joint effusion (59 cases). Anterior Cruciate Ligament (ACL) tear is the commonest injury (37 cases) during knee trauma followed by Medial Collateral Ligament (MCL), Medial Meniscus, Posterior Cruciate Ligament (PCL), Lateral Meniscus and Lateral Collateral Ligament(LCL) injuries. Conclusion: MRI as a high-contrast soft-tissue imaging technique can be used as a noninvasive modality to assess a wide spectrum of internal knee derangements in a patient with knee injury. Specific pattern of bone bruise can guide us to narrow our diagnosis.

Diffusion-Weighted Magnetic Resonance Imaging of Cholesteatoma Using PROPELLER at 1.5T: A Single-Centre Retrospective Study

2017 ◽  
Vol 68 (2) ◽  
pp. 116-121 ◽  
Author(s):  
Sharon E. Clarke ◽  
Dipan Mistry ◽  
Talal AlThubaiti ◽  
M. Naeem Khan ◽  
David Morris ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Retrospective Study ◽  
Magnetic Resonance ◽  
Predictive Value ◽  
Resonance Imaging ◽  
Predictive Values ◽  
Second Look ◽  
Diffusion Weighted ◽  
Magnetic Resonance Imaging Mri ◽  
Sensitivity Specificity

Purpose The purpose of this study was to evaluate the sensitivity, specificity, and positive and negative predictive values of the diffusion-weighted periodically rotated overlapping parallel lines with enhanced reconstruction (PROPELLER) technique in the detection of cholesteatoma at our institution with surgical confirmation in all cases. Methods A retrospective review of 21 consecutive patients who underwent diffusion-weighted PROPELLER magnetic resonance imaging (MRI) on a 1.5T MRI scanner prior to primary or revision/second-look surgery for suspected cholesteatoma from 2009-2012 was performed. Results Diffusion-weighted PROPELLER had a sensitivity of 75%, specificity of 60%, positive predictive value of 86%, and negative predictive value of 43%. In the 15 patients for whom the presence or absence of cholesteatoma was correctly predicted, there were 2 cases where the reported locations of diffusion restriction did not correspond to the location of the cholesteatoma observed at surgery. Conclusion On the basis of our retrospective study, we conclude that diffusion-weighted PROPELLER MRI is not sufficiently accurate to replace second look surgery at our institution.

The Role of Diffusion-weighted Magnetic Resonance Imaging in the Evaluation of Anterior Cruciate and Posterior Cruciate Ligament Tears

2019 ◽  
Vol 1 ◽  
pp. 97-100
Author(s):  
Vijinder Arora ◽  
Sonali Malik ◽  
Kunwarpal Singh
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Predictive Value ◽  
Cruciate Ligament ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Conventional Mri ◽  
Anterior Cruciate

Objective: The objective of our study was to determine the role of diffusion-weighted (DW) magnetic resonance imaging (MRI) in diagnosing and differentiating between complete and partial anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) tears and to compare it with conventional MRI sequences. Materials and Methods: We conducted a prospective study for a period of 2 years from October 2017 to October 2019 on 30 patients with clinically suspected ACL/PCL injuries of the knee. MRI of the knee joint was performed using conventional, and DW sequences and the findings on both the sequences were assessed independently and compared with the intraoperative or follow-up MRI findings. Results: As per operative and follow-up MRI findings, the sensitivity and specificity of conventional MRI were 60% and 33.33% with a positive and negative predictive value of 47.37% and 45.45%, respectively. On the other hand, the sensitivity and specificity of DW MRI were 70.00% and 33.33% with a positive and negative predictive value of 51.22% and 52.13%, respectively. P = 0.417 was statistically not significant. Conclusion: According to our study, adding DW sequence to conventional MR sequences yielded comparable results in diagnosis and differentiation between complete and partial ACL and PCL tears.

scholarly journals Diagnostic accuracy of magnetic resonance imaging in detecting anterior cruciate ligament injuries

2017 ◽  
Vol 26 (3) ◽  
pp. 218-23
Author(s):  
Ashfaq Ahmed ◽  
Muhammad A. Razzaque ◽  
Muhammad Kaleem ◽  
Atiq U. Zaman ◽  
Rizwan Akram ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Anterior Cruciate Ligament ◽  
Magnetic Resonance ◽  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Ligament Injury ◽  
Resonance Imaging ◽  
Anterior Cruciate

Background: The anterior cruciate ligament (ACL) stabilizes the joint during hyperextension and prevents anterior translation over femur. The objective of this study was to determine the diagnostic accuracy of magnetic resonance imaging (MRI) in detecting ACL injury by taking arthroscopy as gold standard in patients with traumatic knee injury.Methods: Patients fulfilling the study criteria were treated with clinical examination, MRI and then arthroscopy at the Department of Orthopedics and Spine in the Ghurki Trust Teaching Hospital, Lahore. The accuracy, sensitivity and specificity of MRI in diagnosing  the anterior cruciate ligament injury were calculated based on arthroscopic findings. All the data were analyzed using SPSS 17.0 version.Results: A total 185 patients were included. 91.1% were males and 8.9% were females with Mean age of 28.25±0.433. The accuracy of MRI in diagnosing the anterior cruciate ligament was 91.89%, with sensitivity of 93.33%, specificity of 85.71%, positive predictive value of 96.55% and the negative predictive value  of 75%.Conclusion: MRI is accurate and non-invasive modality for the assessment of ligamentous injuries. It can be used as a first line investigation to patients with suspicion of ACL injury.

Using magnetic resonance imaging to accurately assess injury to the posterior ligamentous complex of the spine: a prospective comparison of the surgeon and radiologist

2010 ◽  
Vol 12 (4) ◽  
pp. 391-396 ◽  
Author(s):  
Jeffrey A. Rihn ◽  
Nuo Yang ◽  
Charles Fisher ◽  
Davor Saravanja ◽  
Harvey Smith ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Mr Imaging ◽  
Predictive Value ◽  
Spinal Trauma ◽  
Resonance Imaging ◽  
Predictive Values ◽  
Posterior Ligamentous Complex ◽  
Prospective Comparison ◽  
Musculoskeletal Radiologist

Object Magnetic resonance imaging has been proposed as a powerful technique for assessing the integrity of the posterior ligamentous complex (PLC) in spinal trauma. Because MR imaging is often used to determine appropriate treatment, it is important to determine the accuracy and reliability of MR imaging in diagnosing PLC disruption. The purpose of this study is to compare the ability of the radiologist and surgeon to assess disruption of the PLC in the setting of acute cervical and thoracolumbar trauma using MR imaging. Methods The components of the PLC in 89 consecutive patients with cervical or thoracolumbar fractures following acute spinal trauma were evaluated using MR imaging by both a musculoskeletal radiologist and an independent spine surgeon and assessed intraoperatively under direct visualization by the treating surgeon. The MR imaging interpretations of the musculoskeletal radiologist and surgeon were compared with the intraoperative report for accuracy, sensitivity, specificity, and positive and negative predictive values. A comparison between the radiologist's and spine surgeon's accuracy of MR imaging interpretation was performed. Results The agreement between both the spine surgeon's and radiologist's MR imaging interpretation and the actual intraoperative findings was moderate for most components of the PLC. Overall, the MR imaging interpretation of the surgeon was more accurate than that of the radiologist. The interpretation of MR imaging by the surgeon had negative predictive value and sensitivity of up to 100%. However, the specificity of MR imaging for both the surgeon and radiologist was lower, ranging from 51.5 to 80.5%. Conclusions Comparison of the MR imaging interpretations between surgeon and radiologist indicates that the surgeon was more accurate for some PLC components. The relatively low positive predictive value and specificity for MR imaging in assessing PLC integrity suggests that both the surgeon and radiologist tend to overdiagnose PLC injury using MR imaging. This can lead to unnecessary surgeries if only MR imaging is used for treatment decision making.

scholarly journals Magnetic Resonance Imaging Evaluation of Menisci and Cruciate Ligamentous Injuries of the Knee with Arthroscopic Correlation

2017 ◽  
Vol 13 (1) ◽  
pp. 95-98
Author(s):  
Mohammed Mominul Hoque Sarker ◽  
Md Taharul Alam ◽  
Syed Zoherul Alam ◽  
Mohammad Shafiqul Alam ◽  
AKM Sharifur Rahman ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Predictive Value ◽  
Spin Echo ◽  
Cruciate Ligament ◽  
Knee Injuries ◽  
Resonance Imaging ◽  
Non Invasive ◽  
Arthroscopic Examination ◽  
Sensitivity Specificity

Introduction: Now a days Magnetic Resonance Imaging (MRI) has become the primary investigation for the assessment of knee injuries. Non-invasive MRI has the ability of high resolution and accuracy to diagnose the knee injuries and it can be the alternative to diagnostic arthroscopy. Objective: To validate MRI evaluation in the assessment of cruciate ligamentous and meniscal injuries of the knee joint and compare with arthroscopic findings. Materials and Methods: This cross sectional study was conducted at Combined Military Hospital, Dhaka from 01 January 2013 to 30 June 2013 where sixty patients who had the history of twisting injuries to the knee were selected in this study. Along with injury history they were strongly suspected to have meniscal and/or cruciate ligamentous tears. Then they were examined by open MRI machine 0.4 tesla, Hitachi, made in Japan. A Quadrature (QD) extremity coil was used in this study. Spin echo T1, fast spin echo T2 and Short Tau Inversion Recovery (STIR) sequences were taken in direct coronal, sagittal and axial planes with 4mm slice thickness. Data were recorded and statistical analysis was done by SPSS version 20. Results: Total 60 patients underwent MRI and Arthroscopic examination. The final diagnosis was established by direct findings at Arthroscopic examination. The Sensitivity, Specificity and Accuracy of Magnetic Resonance Imaging in the diagnosis of cruciate ligamentous and meniscal injuries as compared to arthroscopy were Anterior Cruciate Ligament (ACL): 96.88% sensitivity, 96.43% specificity, 96.66% accuracy, 96.87% Positive predictive value (PPV) and 96.42% Negative predictive value (NPV); Medial Meniscus (MM): 96.43% sensitivity, 98.87% specificity,96.66% accuracy, 96.42% PPV and 98.88% NPV; for Lateral Meniscus (LM): 80.00% sensitivity, 97.77% specificity, 93.33% accuracy, 92.30% PPV and 93.62% NPV. Conclusion: As a non-invasive diagnostic modality Magnetic Resonance Imaging is very useful and having high sensitivity, specificity and accuracy in the detection of meniscal and cruciate ligament injuries. To prevent unwanted arthroscopies MRI should be done in every patient of suspected cruciate ligamentous and meniscal injury before doing arthroscopy. Journal of Armed Forces Medical College Bangladesh Vol.13(1) 2017: 95-98

scholarly journals Timing of magnetic resonance imaging affects the accuracy and interobserver agreement of anterolateral ligament tears detection in anterior cruciate ligament deficient knees

2020 ◽  
Vol 32 (1) ◽  
Author(s):  
Audrey Xinyun Han ◽  
Tien Jin Tan ◽  
Tiep Nguyen ◽  
Dave Yee Han Lee
Keyword(s):  
Magnetic Resonance Imaging ◽  
Anterior Cruciate Ligament ◽  
Magnetic Resonance ◽  
Predictive Value ◽  
Interobserver Agreement ◽  
Cruciate Ligament ◽  
Anterolateral Ligament ◽  
Resonance Imaging ◽  
Mri Scans ◽  
Anterior Cruciate

Abstract Purpose We aimed to identify the anterolateral ligament (ALL) tears in anterior cruciate ligament (ACL)-deficient knees using standard 1.5-Tesla magnetic resonance imaging (MRI). Methods We included all patients who underwent primary ACL reconstruction at our center between 2012 and 2015. Exclusion criteria included patients with multiple ligament injuries, lateral collateral ligament, posterolateral corner, and infections, and patients who underwent MRI more than 2 months after their injury. All patients (n = 148) had ACL tears that were subsequently arthroscopically reconstructed. The magnetic resonance (MR) images of the injured knees performed within 2 months of injury were reviewed by a musculoskeletal radiologist and an orthopedic surgeon. The patients were divided into two groups. The first group of patients had MRI performed within 1 month of injury. The second group of patients had MRI performed 1–2 months after the index injury. Both assessors were blinded and the MR mages were read separately to assess the presence of ALL, presence of a tear and the location of the tear. Based on their readings, interobserver agreement (kappa statistic (K)), sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were compared. Results The ALL was identified in 100% of the patients. However, there was a discrepancy of up to 15% in the identification of tear of the ALL. In the first group in which MRI scans were performed within 1 month of injury, the ALL tear was identified by the radiologist in 92% of patients and by the surgeon in 90% of patients (Κ = 0.86). In the second group in which MRI scans were performed within 1–2 months of the injury, the ALL tear was identified by the radiologist in 78% of patients and by the surgeon in 93% of patients (K = 0.62). Conclusion The ALL can be accurately identified on MRI, but the presence and location of ALL tear and its location cannot be reliably identified on MRI. The accuracy in identification and characterization of a tear was affected by the interval between the time of injury and the time when the MRI was performed. Level of evidence Diagnostic, level IIIb, retrospective.

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

2018 ◽  
Vol 24 (1) ◽  
pp. 52-56
Author(s):  
Patel Ishani ◽  
Chandru Vijay ◽  
Nekkanti Supreeth ◽  
Renukarya Ravishankar ◽  
Reddy Vishnu Vardhan ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Anterior Cruciate Ligament ◽  
Magnetic Resonance ◽  
Predictive Value ◽  
Medial Meniscus ◽  
Cruciate Ligament ◽  
Lateral Meniscus ◽  
Resonance Imaging ◽  
Clinical Magnetic Resonance Imaging ◽  
Anterior Cruciate

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.

Correlation of Arthroscopic and Clinical Examinations With Magnetic Resonance Imaging Findings of Injured Knees in Children and Adolescents

1998 ◽  
Vol 26 (1) ◽  
pp. 2-6 ◽  
Author(s):  
Carl L. Stanitski
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Predictive Value ◽  
Articular Surface ◽  
Cruciate Ligament ◽  
Knee Injuries ◽  
Imaging Findings ◽  
Resonance Imaging ◽  
Arthroscopic Findings ◽  
Anterior Cruciate

This study evaluated the correlation among clinical diagnosis, magnetic resonance imaging reports, and arthroscopic findings in 28 patients aged 8 to 17 years (average, 14.4) with knee injuries. Meniscal, anterior cruciate ligament, and articular surface injuries were evaluated. A highly positive correlation (78.5%) was found between clinical and arthroscopic findings. A highly negative correlation was found between arthroscopic and magnetic resonance imaging findings (78.5%) and between clinical and magnetic resonance imaging findings (75%). In this series, accuracy, positive predictive value, negative predictive value, sensitivity, and specificity data were much more favorable from clinical examination than from magnetic resonance imaging. Overall, magnetic resonance imaging diagnoses added little guidance to patient management and at times provided spurious information.

Sign in / Sign up

Export Citation Format

Share Document