Accuracy of standard magnetic resonance imaging sequences for meniscal and chondral lesions versus knee arthroscopy. A prospective case‐controlled study of 719 cases. Issue 6 (27th April 2021)

• Record Type: Journal Article
• Authors: Porter, Mark; Shadbolt, Bruce
• Is Part Of: ANZ journal of surgery. Volume 91:Issue 6(2021)
• Page Start: 1284
• Page End: 1289
• Publication Date: 2021-04-27
• Subjects: accuracy -- arthroscopy -- knee -- magnetic resonance imaging -- orthopaedic surgery; Surgery -- Periodicals; 617.005
• DOI: 10.1111/ans.16890
• Languages: English
• ISSNs: 1445-1433

Abstract

Abstract: Background: Magnetic resonance imaging (MRI) is commonly used for diagnosis and as a research tool, but its accuracy is questionable. The goal of this study was to compare the accuracy of knee MRI with clinical assessment for diagnosing meniscal tears, and to determine the accuracy of MRI for grading chondral lesions, relative to arthroscopy. Methods: Physically active patients presenting with mechanical symptoms warranting a knee arthroscopy and satisfying the inclusion criteria, had both a knee arthroscopy and MRI performed. Arthroscopic findings were compared with those of MRI, using the International Chondral Research Society grading for chondral damage, and the presence or absence of a meniscal tear. Results: A total of 719 patients were recruited over a period of 6.5 years, average age 52 years (standard deviation, SD 5.2), male:female = 493:226. Kappa scores with standard errors (SE) for agreement between MRI and knee arthroscopy were 0.41 (SE 0.1) for medial meniscal tears, and 0.44 (SE 0.1) for lateral meniscal tears. For the grade of chondral damage, the Kappa scores with SE values were 0.09 (0.1), 0.17 (0.1), and 0.22 (0.07) for anterior, medial and lateral compartments, respectively. Using areas under the receiver operating characteristic curves, we found clinical assessment was more accurate than MRI for diagnosis of lateral meniscal tears ( P < 0.001), and of similar accuracy for the diagnosis of medial meniscal tears ( P = 0.12). Conclusions: MRI has relatively poor correlation with arthroscopic findings for grading the chondral damage and was less accurate than clinical assessment for the diagnosis of lateral meniscal tears. Abstract : A total of 719 patients took part in a prospective study to determine the relative accuracy of clinical assessment and magnetic resonance imaging (MRI), relative to knee arthroscopy. Clinical diagnosis was more accurate than MRI for the diagnosis of lateral meniscal tears, and of similar accuracy for medial meniscal tears. MRI had poor to fair correlation with arthroscopy for the grade of chondral damage within each compartment of the knee.