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Effectiveness of MR Imaging in Selection of Patients for Arthroscopy of the Knee¹

¹ From the Departments of Radiology (P.W.J.V., B.P.M.t.B., A.R.v.E., J.L.B.) and Medical Statistics (W.P.), Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, the Netherlands; Department of Radiology, Westeinde Hospital, The Hague, the Netherlands (T.P.W.d.R.); and Department of Radiology, Leyenburg Hospital, The Hague, the Netherlands (W.M.C.M.). Received April 26, 2001; revision requested June 9; revision received September 6; accepted October 16. Address correspondence to P.W.J.V. (e-mail: p.w.j.vincken@lumc.nl).

View larger version (27K): [in a new window]   Figure 1. Schematic shows study design. MR+ = signs of major injury, arthroscopy indicated; MR- = normal MR images or signs of minor injury, arthroscopy not indicated.

View larger version (158K): [in a new window]   Figure 2. Sagittal intermediate-weighted MR image (2,350/20) reveals a tear in the posterior horn of the medial meniscus (arrow) that extends to both upper and lower articular surfaces. This tear was not recognized at arthroscopy performed 16 days after the MR imaging examination and therefore constitutes a false-positive diagnosis at MR.

View larger version (147K): [in a new window]   Figure 3. Sagittal intermediate-weighted MR image (2,350/20) reveals a tear in the posterior horn of the lateral meniscus (arrow) that extends to both upper and lower articular surfaces. This tear was not recognized at arthroscopy performed 14 days after the MR imaging examination and therefore constitutes a false-positive diagnosis at MR.

View larger version (184K): [in a new window]   Figure 4a. (a,b) Sagittal intermediate-weighted MR images (2,350/20) reveal what was thought to be a complete ACL rupture (arrow) that was not appreciated as a complete rupture at arthroscopy. The radiologist diagnosed a complete rupture extending toward the posterior cruciate ligament. According to the arthroscopist, however, it was a partial rupture that involved approximately 50% of the ligamentous body.

View larger version (186K): [in a new window]   Figure 4b. (a,b) Sagittal intermediate-weighted MR images (2,350/20) reveal what was thought to be a complete ACL rupture (arrow) that was not appreciated as a complete rupture at arthroscopy. The radiologist diagnosed a complete rupture extending toward the posterior cruciate ligament. According to the arthroscopist, however, it was a partial rupture that involved approximately 50% of the ligamentous body.