Diagnostic Accuracy of Magnetic Resonance Imaging in the Diagnosis of Anterior Cruciate Ligament Injury taking Arthroscopy as Gold Standard

Abstract

Objective: To determine the diagnostic accuracy of magnetic resonance imaging (MRI) in the diagnosis of anterior cruciate ligament injury, using arthroscopy as the gold standard. Methodology: It was a descriptive, cross-sectional study that included 154 patients with suspected anterior cruciate ligament injury from the Department of Orthopaedics, Imran Idrees Teaching Hospital, Sialkot. All patients underwent arthroscopy and the presence or absence of ACL (anterior cruciate ligament) injury was noted. MRI findings were compared with arthroscopy findings. Results: Among the 94 MRI-positive patients, 88 (True Positive) had ACL injury while 06 (False Positive) had no ACLinjury on arthroscopy. Out of 60 MRI-negative patients, 08 (False Negative) had ACL injury on arthroscopy while 52 (True Negative) had no ACL injury. Overall sensitivity, specificity, PPV (positive predictive value), NPV (negative predictive value) and DA (diagnostic accuracy) of MRI in the diagnosis of ACLinjury, taking arthroscopy as the gold standard was 91.67%, 89.66%, 83.62%, 86.67% and 90.91% respectively. Conclusion: The study concluded that MRI is a very sensitive and precise diagnostic modality. It has significantly improved the ability to diagnose ACL injuries, allowing for more accurate and reliable assessments. Additionally, the use of MRI has been instrumental in reducing the number of purely diagnostic arthroscopies, thereby minimizing the need for invasive procedures and enhancing patient care. Keywords: Knee injury, Magnetic Resonance Imaging, Arthroscopy, Anterior cruciate ligament.