Abstract
Introduction: The knee joint has a unique anatomical structure in the human body. The localization between the two longest bones in the human body – femur, and tibia – makes it prone to injuries, trauma, and other pathologies. Clinical examination of the joint is still the primary method in evaluating the condition of the patient's knee. The study aims to determine the diagnostic accuracy of clinical examination and magnetic resonance (MR) in assessing chondral lesions of knee joint using arthroscopy as a reference standard.Patients and methods: The examination was conducted on 94 patients (58 males and 36 females) with knee injuries. Clinical examination indicated a primary chondral lesion of knee cartilage in eight patients (five men and three women), with an average age of 45.75. Besides the clinical examination, the diagnostics were performed using MR imaging by Siemens of 0.5 Tesla, and arthroscopy was performed using Storz arthroscope.Results: Our research has generated the following values of clinical and MR results for chondral lesions: Sensitivity (Se) = 12.5%, Specificity (Sp): could not be calculated, Positive Predictive Value (PPV) = 100%, Negative Predictive Value (NPV) = 0% and Accuracy (ACC) = 12.5%. The accuracy of clinical and intraoperative results for chondral lesion was: Se =100%, Sp: could not be calculated, PPV = 100%, NPV: could not be calculated, and ACC = 100%. MR imaging and arthroscopy findings of chondral lesion showed: Se = 100%, Sp = 0%, PPV = 12.5%, NPV: could not be calculated and ACC = 12.5%. In comparing the clinical sign and MRand intraoperative result, Positive Predictive Value for patients with chondral lesion was maximal (100%), while comparing MR with the intraoperative result, Positive Predictive Value was 12.5%. In comparison between clinical sign and intraoperative results, the accuracy for patients with chondral lesion was 100%, while comparing the clinical sign with MR result and MR with the intraoperative result, the accuracy was 12.5%.Conclusion: Our examinations have shown that MR examination is not currently as valid for diagnosing injury of chondral cartilage of knee as the medical community or patients have anticipated it.
Highlights
The knee joint has a unique anatomical structure in the human body
MultiDetector Computed Tomography, with higher spatial resolution, may have a more significant role in diagnosing chondral damages. [2,3,4] The aim of the study is to determine the diagnostic accuracy of clinical examination and magnetic resonance (MR) in assessing chondral lesions of the knee joint using arthroscopy as a reference standard
For patients with a chondral proportion of healthy patients in relation to the total lesion, Negative Predictive Value was calculable only number of patients with negative test results using while comparing clinical signs with MR results, and the following formula: it was 0%
Summary
The knee joint has a unique anatomical structure in the human body that, together with localization between the two longest bones in the human body – femur and tibia – makes it prone to injuries, trauma, and other pathologies. [1]. The cartilage is exceptionally smooth on articulated surfaces, elastic, capable of sustaining high pressure generated even during regular movements within the joint. It is primarily composed of chondrocytes and proteoglycans. [1,2,3] The following method in the diagnostic protocol is most frequently the standard radiography of the knee joint in two directions Suppose both clinical and radiography signs indicate the lesion of cartilage. [2,3,4] The aim of the study is to determine the diagnostic accuracy of clinical examination and MR in assessing chondral lesions of the knee joint using arthroscopy as a reference standard MultiDetector Computed Tomography, with higher spatial resolution, may have a more significant role in diagnosing chondral damages. [2,3,4] The aim of the study is to determine the diagnostic accuracy of clinical examination and MR in assessing chondral lesions of the knee joint using arthroscopy as a reference standard
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