Abstract
Background: Imaging modalities like ultrasonography (USG), magnetic resonance imaging (MRI) and magnetic resonance arthrography (MRAr) provide different form of information about the joint space and tendons related to the knee joint. Knee is the most frequently examined joint by MRI / MRAr as it is relatively non-invasive and highly accurate in assessing joint structures, saving majority of patients from non-therapeutic arthroscopy procedures. The main objective of this study is to understand the comparative role of routine MRI and MRAr in our hospital settings. Subjects and Methods: Twenty-five patients included in the study underwent both MRI and MRAr on the same day. Results were interpreted by radiologists and data was tabulated with the final diagnosis established on MRAr. Results: Efficacy of MRI was inferior in evaluation of Anterior Cruciate ligament, meniscal and capsular tears. In patients, where MRI was normal, MR Arthrography revealed significant findings. Conclusion: Routine MRI misses significant outcome information when compared to MRAr in evaluation of knee joint. Hence, MR Arthrography should be done for optimal evaluation of knee joints in all patients especially those with clinicoradiological discordance.
Highlights
Imaging modalities like ultrasonography (USG), magnetic resonance imaging (MRI) and magnetic resonance arthrography (MRAr) provide information about the joint space and tendons around the joint which is useful to the clinician. [1]
[4] Even though MRAr is an invasive procedure it is relatively less cumbersome when compared to conventional contrast-arthrography and it enables the evaluation of extra-articular anatomy helping in a satisfactory preoperative analysis of the joint space increasing the confidence of both the radiologist and treating orthopedician
Our study showed almost 100% specificity for the evaluated tears, sensitivity values were 70% for MM, 60% for Lateral Meniscus (LM), 80% for Medial Collateral Ligament (MCL), 65% for Anterior Cruciate Ligament (ACL) & 75% for Posterior Cruciate Ligament (PCL) with moderate correlation of MRI with MRAr (k= 0.65) with excellent correlation (k= 0.82) only in the case of Lateral collateral ligament, which is similar to the study by Mathieu L et al Crawford R et al found that MRAr is a highly precise tool in establishing ACL and Meniscal tears, it was found to be most sensitive for screening purposes and can be preferred over diagnostic-arthroscopy in majority of the patient groups as it is quicker, minimally-invasive and has significantly lesser complications
Summary
Imaging modalities like ultrasonography (USG), magnetic resonance imaging (MRI) and magnetic resonance arthrography (MRAr) provide information about the joint space and tendons around the joint which is useful to the clinician. [1]. [4] Even though MRAr is an invasive procedure it is relatively less cumbersome when compared to conventional contrast-arthrography and it enables the evaluation of extra-articular anatomy helping in a satisfactory preoperative analysis of the joint space increasing the confidence of both the radiologist and treating orthopedician. [2] Knee is the most frequently examined joint by MRI and MRAr as they are accurate and relatively non-invasive method for its evaluation and saves the patient from non-therapeutic arthroscopy procedures. It helps in reducing nontherapeutic arthroscopic procedures. It helps in reducing nontherapeutic arthroscopic procedures. [5] MRAr is minimally invasive when compared to arthroscopy and provides nearly the same detection accuracy as arthroscopy. [6]
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