A Comparison of Clinical Examination and Magnetic Resonance Imaging Results with Arthroscopy Results in Knee Intra-Articular Pathologies

Rıfat Şahin; Mehmet Sabri Balık

Makale detayları

A Comparison of Clinical Examination and Magnetic Resonance Imaging Results with Arthroscopy Results in Knee Intra-Articular Pathologies

Yazarlar:

Rıfat Şahin | Mehmet Sabri Balık

Yayıncı:

Sakarya University

Ana Başlıklar:

Ortopedi

Dergi:

Sakarya Tıp Dergisi Vol.14 Issue 4, pp.368-375

Belge Tipi:

Makale

Yayın Tarihi:

12/2024

Belge Dili:

İngilizce

Document ID (Org No.):

2001334115

pISSN:

2146-409X

Anahtar kelimeler:

Özet:

 Objective: We aimed to determine in which of the symptomatic intra-articular pathologies of the knee, clinical examination and magnetic resonance imaging MRI can be an alternative to diagnostic arthroscopy. Materials and Methods: Prospective analysis of 50 patients aged 18 to 50 years who underwent arthroscopy with the diagnosis of meniscus tear, cruciate ligament injury, cartilage damage, or plica between 2013 and 2015 was conducted. The results of the physical examination and MRI were compared with arthroscopy findings. Results: Patients with a mean age of 35 years. Sensitivity, specificity, and accuracy rates in the Mc-Murray test were 90, 11, 76; 76, 33, 68 in the Apley test; and 80, 33, 72 in the Eges test. Sensitivity, specificity, and accuracy rates in the MRI for the medial meniscus were 87, 68, 80; 92, 92, 92 for the lateral meniscus; 36, 95, 62 for chondral injury; 90, 95, 94 for the anterior cruciate ligament; and 21, 59, 34 in the plica. Conclusion: It should be noted that positive results can also be obtained in other knee intra-articular pathologies other than meniscus tear, as the sensitivity of these tests used to diagnose meniscus tear is high, but specificity is low. 1.5-tesla MRI has a high accuracy rate for detecting meniscus and anterior cruciate ligament injuries, while the diagnostic power of chondral surface evaluation remains limited, and high-resolution cartilagespecific images are required. As it is insufficient for evaluating plica on its own, it must be carefully incorporated during arthroscopy.

 Objective: We aimed to determine in which of the symptomatic intra-articular pathologies of the knee, clinical examination and magnetic resonance imaging MRI can be an alternative to diagnostic arthroscopy. Materials and Methods: Prospective analysis of 50 patients aged 18 to 50 years who underwent arthroscopy with the diagnosis of meniscus tear, cruciate ligament injury, cartilage damage, or plica between 2013 and 2015 was conducted. The results of the physical examination and MRI were compared with arthroscopy findings. Results: Patients with a mean age of 35 years. Sensitivity, specificity, and accuracy rates in the Mc-Murray test were 90, 11, 76; 76, 33, 68 in the Apley test; and 80, 33, 72 in the Eges test. Sensitivity, specificity, and accuracy rates in the MRI for the medial meniscus were 87, 68, 80; 92, 92, 92 for the lateral meniscus; 36, 95, 62 for chondral injury; 90, 95, 94 for the anterior cruciate ligament; and 21, 59, 34 in the plica. Conclusion: It should be noted that positive results can also be obtained in other knee intra-articular pathologies other than meniscus tear, as the sensitivity of these tests used to diagnose meniscus tear is high, but specificity is low. 1.5-tesla MRI has a high accuracy rate for detecting meniscus and anterior cruciate ligament injuries, while the diagnostic power of chondral surface evaluation remains limited, and high-resolution cartilagespecific images are required. As it is insufficient for evaluating plica on its own, it must be carefully incorporated during arthroscopy.

 Objective: We aimed to determine in which of the symptomatic intra-articular pathologies of the knee, clinical examination and magnetic resonance imaging MRI can be an alternative to diagnostic arthroscopy. Materials and Methods: Prospective analysis of 50 patients aged 18 to 50 years who underwent arthroscopy with the diagnosis of meniscus tear, cruciate ligament injury, cartilage damage, or plica between 2013 and 2015 was conducted. The results of the physical examination and MRI were compared with arthroscopy findings. Results: Patients with a mean age of 35 years. Sensitivity, specificity, and accuracy rates in the Mc-Murray test were 90, 11, 76; 76, 33, 68 in the Apley test; and 80, 33, 72 in the Eges test. Sensitivity, specificity, and accuracy rates in the MRI for the medial meniscus were 87, 68, 80; 92, 92, 92 for the lateral meniscus; 36, 95, 62 for chondral injury; 90, 95, 94 for the anterior cruciate ligament; and 21, 59, 34 in the plica. Conclusion: It should be noted that positive results can also be obtained in other knee intra-articular pathologies other than meniscus tear, as the sensitivity of these tests used to diagnose meniscus tear is high, but specificity is low. 1.5-tesla MRI has a high accuracy rate for detecting meniscus and anterior cruciate ligament injuries, while the diagnostic power of chondral surface evaluation remains limited, and high-resolution cartilagespecific images are required. As it is insufficient for evaluating plica on its own, it must be carefully incorporated during arthroscopy.

 Amaç: Çalışmamızda semptomatik diz eklem içi patolojilerin hangilerinde klinik muayene ve manyetik rezonans görüntülemenin tanısal artroskopiye alternatif olabileceğini saptamayı amaçladık. Gereç ve Yöntemler: 2013-2015 yılları arasında, 18-50 yaş aralığında menisküs yırtığı, çapraz bağ yaralanması, kıkırdak hasarı veya plika tanısıyla artroskopi yapılan 50 hastanın fizik muayene ve manyetik rezonans görüntüleme MRG sonuçları artroskopi bulguları ile prospektif olarak kıyaslandı. Bulgular: Hastaların yas ortalaması 35 tir. Sırasıyla duyarlılık, özgüllük ve doğruluk oranları Mc- Murray testinde: 90, 11, 76; Apley testinde: 76, 33, 68; Ege testinde: 80, 33, 72 saptandı. MRG de bu oranlar; medial menisküs için: 87, 68, 80; lateral menisküs için: 92, 92, 92; kondral hasarlanma için: 36, 95, 62; ön çapraz bağ için: 90, 95, 94; plikalarda: 21, 59, 34 saptandı. Sonuç: Meniskus yırtığı tanısı icin uygulanan bu testlerin duyarlılıkları yuksek ancak ozgullukleri dusuk kaldıgından menisküs dışı diğer diz eklem içi patolojilerde de pozitif sonuç alınabileceği unutulmamalıdır. 1,5 tesla MRG, menisküs ve ön çapraz bağ yaralanmalarını saptamada yüksek doğruluk oranına sahipken kondral yüzeyin değerlendirilmesinde tanı gücü kısıtlı kalmakta; yüksek çözünürlüklü kıkırdak spesifik çekimlere ihtiyaç duyulmaktadır. Plikaları değerlendirmede ise tek başına yeterli olmadığından artroskopi sırasında özenle varlığı aranmalıdır.

Makale detayları

A Comparison of Clinical Examination and Magnetic Resonance Imaging Results with Arthroscopy Results in Knee Intra-Articular Pathologies

Yazarlar:

Rıfat Şahin | Mehmet Sabri Balık

Yayıncı:

Sakarya University

Ana Başlıklar:

Ortopedi

Dergi:

Sakarya Tıp Dergisi Vol.14 Issue 4, pp.368-375

Belge Tipi:

Makale

Yayın Tarihi:

12/2024

Belge Dili:

İngilizce

Document ID (Org No.):

2001334115

pISSN:

2146-409X

Chondral lesion

Knee

Magnetic resonance imaging

Meniscus

PlicaDiz

Kondral lezyon

Manyetik rezonans görüntüleme

Menisküs

Plika

Sayı

Makale detayları

Yazarlar: Rıfat Şahin | Mehmet Sabri Balık

Yayıncı: Sakarya University

Ana Başlıklar: Ortopedi

Dergi: Sakarya Tıp Dergisi Vol.14 Issue 4, pp.368-375

Belge Tipi: Makale

Yayın Tarihi: 12/2024

Belge Dili: İngilizce

Document ID (Org No.): 2001334115

pISSN: 2146-409X

Sayı

Yazarlar:

Rıfat Şahin | Mehmet Sabri Balık

Yayıncı:

Sakarya University

Ana Başlıklar:

Ortopedi

Dergi:

Sakarya Tıp Dergisi Vol.14 Issue 4, pp.368-375

Belge Tipi:

Makale

Yayın Tarihi:

12/2024

Belge Dili:

İngilizce

Document ID (Org No.):

2001334115

pISSN:

2146-409X