Radiology, Vol 204, 799-805, Copyright © 1997 by Radiological Society of North America

ARTICLES

Acutely injured knee: effect of MR imaging on diagnostic and therapeutic decisions

EJ Maurer, PA Kaplan, RG Dussault, DR Diduch, A Schuett, FC McCue, PP Hornsby and BJ Hillman
Department of Radiology, University of Virginia Health Sciences Center, Charlottesville 22908, USA.

PURPOSE: To assess the effect of knee magnetic resonance (MR) imaging on the diagnosis and management of acute knee injury. MATERIALS AND METHODS: Two orthopedic knee surgeons prospectively completed pre- and post-MR imaging questionnaires on 84 of 91 consecutive patients with acute knee injury. The pre- and post-MR imaging clinical diagnoses, certainty regarding these diagnoses, other diagnostic tests, and subjective impression of the usefulness of MR imaging were determined. RESULTS: Seven hundred thirty-one of 840 pre- and post-MR imaging diagnoses agreed. Agreement was lowest for medial meniscal injuries (54 of 84). Significantly fewer meniscal injuries were suspected after MR imaging (P < .05). In 60 patients, the orthopedist changed at least one of the 10 potential diagnoses after MR imaging. Clinical diagnostic certainty increased by a mean of 14% for all diagnoses. The increase in diagnostic certainty was greatest for medial meniscal injuries (30%), followed by lateral meniscal injuries (21%). The proposed management changed in 41 patients, resulting in significantly fewer arthroscopic procedures (P < .01). The post-MR imaging management plans included 37% (27 of 73) fewer arthroscopic procedures. CONCLUSION: MR imaging affects the diagnosis and management of acute knee injury by decreasing the number of arthroscopic procedures, improving clinician diagnostic certainty, and assisting in management decisions.

This article has been cited by other articles:

				L. Boxheimer, A. M. Lutz, M. Zanetti, K. Treiber, L. Labler, B. Marincek, and D. Weishaupt Characteristics of Displaceable and Nondisplaceable Meniscal Tears at Kinematic MR Imaging of the Knee Radiology, January 1, 2006; 238(1): 221 - 231. [Abstract] [Full Text] [PDF]

				M. E. A. P. M. Adriaensen, M. C. J. M. Kock, T. Stijnen, M. R. H. M. van Sambeek, H. van Urk, P. M. T. Pattynama, and M. G. Myriam Hunink Peripheral Arterial Disease: Therapeutic Confidence of CT versus Digital Subtraction Angiography and Effects on Additional Imaging Recommendations Radiology, November 1, 2004; 233(2): 385 - 391. [Abstract] [Full Text] [PDF]

				M. Zanetti, C. W. A. Pfirrmann, M. R. Schmid, J. Romero, B. Seifert, and J. Hodler Patients with Suspected Meniscal Tears: Prevalence of Abnormalities Seen on MRI of 100 Symptomatic and 100 Contralateral Asymptomatic Knees Am. J. Roentgenol., September 1, 2003; 181(3): 635 - 641. [Abstract] [Full Text] [PDF]

				M. Zanetti, J. K. Strehle, H.-P. Kundert, H. Zollinger, and J. Hodler Morton Neuroma: Effect of MR Imaging Findings on Diagnostic Thinking and Therapeutic Decisions Radiology, November 1, 1999; 213(2): 583 - 588. [Abstract] [Full Text]