Abstract
Routine use of Magnetic Resonance Imaging (MRI) as screening test after clinical diagnosis for meniscal and/or anterior cruciate ligament (ACL) has a detrimental effect on patients in limited resourced countries. This study was done to compare accuracy of clinical examination and that of (MRI) on diagnosing meniscal and or (ACL) tears. Methodology: A cross-sectional-descriptive study was done on 57 knees of patients. Clinical examination, MRI and then diagnostic arthroscopy, as the gold standard, were done to all the cases. Results were recorded; the accuracies of MRI and clinical examination were evaluated and their results were compared. Results: Median age of patients was 40 years. Clinical examination had sensitivity of 93.62% and specificity of 40% for diagnosing meniscal tears; and sensitivity of 100%; and specificity of 97.67% for diagnosing ACL tear. MRI had sensitivity of 85.11%, and specificity of 40% for meniscal tear diagnosis and 71% and 100% respectively for ACL tear diagnosis. Diagnostic accuracy was 84.21% for meniscal and 98.24% for ACL tears by clinical examination and by MRI was 77.19% and 92.98% respectively. Conclusion: Clinical examination has higher accuracy than MRI on diagnosing both ACL and meniscal tear. Thus patients may be scheduled for diagnostic and interventional arthroscopy if clinical examination reveals meniscal and or ACL injuries. MRI use should be reserved when clinical evaluation is inconclusive or cannot be done.
Highlights
Menisci and cruciate ligaments are among the frequently injured structures of the knee one of commonest causes of knee pain
Magnetic Resonance Imaging (MRI) and diagnostic arthroscopy were done to all the candidates at Muhimbili Orthopedic Institute (MOI) between May 2018 to December 2018
Similar phenomenon was seen in the study done by Cerabona and colleagues where they observed that greater number of their participants could not recall well the mechanism of injury nor they could not correlate their injury mechanisms with specific pattern of meniscal tears they sustained
Summary
Menisci and cruciate ligaments are among the frequently injured structures of the knee one of commonest causes of knee pain. These structures have various functions including stabilising the joint, acting as axis for knee rotational movement and neutralization of sudden blows or forces to the knee [1] [2]. Other risk factors associated with meniscal and ACL tears include obesity, and female sex [3]-[8]. When these structures are injured, there are detrimental effects to the knee cartilage. Numerous studies have shown that tears of the meniscus lead to development and progression of osteoarthritis of the knee, early detection and proper management are of paramount importance [9] [10] [11] [12]
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