Diagnostic assessment in anterior cruciate ligament (ACL) tears (original) (raw)
Related papers
2019
Introduction: MRI is a noninvasive, radiation free modality with a good ability to evaluate soft tissues. About 28% of populations among all population visits in hospital have complained with knee pain. There may be many causes such as infections, trauma, degenerative joint conditions, inflammatory conditions, and congenital lesions. Commonly injured ligament in knee is Anterior cruciate ligament (ACL) which is usually associated with Meniscal injures. In the body knee is important weight bearing joint of the body that provides mobility and stability during physical activity as well as balance while standing. Knee injuries like Traumatic injuries are frequently encountered both in general practice and in the hospital setting. Knee injury is offen caused by sports activities and may lead to severe pain and disability. Aim: The main aim of this study is to MRI evaluation in the knee injuries related to anterior cruciate ligament compared to arthroscopy. Material and methods: In this study 40 patients were included who were visiting to CCM hospital with suspected ACL injury. From all the patients detail history and clinical provisional diagnosis were taken. All the patients were taken for MRI examination followed by arthroscopy. Patients with injury of ACL and meniscal injuries were included in this study. MRI was analysis with the standard imaging planes of the knee were evaluated with each ACL bundle being classified as intact, partially torn, or completely torn. Result: In this study 40 patients were included with suspected ACL injuries, which are associated with pain, limitation of movement, and swelling of the knee joint. According to ACL tear seen in MRI 30 patients shows partial and 10 patients shows complete ACL tear whereas Arthroscopy shows 12 patients with partial and 28 patients shows complete tear. According to the associated injuries re-sampling the type of meniscal injuries,in comparing to MRI and Arthroscopy the incidence of medial meniscus tear was 26 and lateral meniscus tear was 14 in MRI and meniscus tear was 25 and lateral meniscus tear was 15 in Arthroscopy. Conclusion: MRI is commonly used diagnostic arthroscopy in most settings, and is considered an effective screening tool in most patients. MRI findings before arthroscopy help in the management of meniscal and ligament injuries. MRI has also been proved as cost effective.
The Journal of bone and joint surgery. British volume, 1995
We reviewed 38 patients with arthroscopically-proven complete ACL tears operated on less than three weeks after injury. Their average age was 26 years (16 to 43), with 27 males and 11 females. All patients had had MRI preoperatively. The same examiner performed the Lachman, anterior-drawer, and pivot-shift tests without anaesthesia, recording the differences between the injured and the normal knees. The patients then had KT-1000 arthrometry by the same examiner at 15 lb (6.8 kg) and 20 lb (9 kg), with active displacement, and with maximum manual displacement. All scored positive for differences greater than 3 mm. The results of physical examination, KT-1000 tests and MRI were analysed using McNemar's test for matched data with continuity correction and a 95% confidence interval for each test. The sensitivity of the KT-1000 manual maximum test was 97% for 3 mm and 100% for 2 mm; this was the most useful arthrometric result. The Lachman test gave 95% sensitivity, providing the bes...
Annals of PIMS-Shaheed Zulfiqar Ali Bhutto Medical University
Objective: To evaluate the correlation between Magnetic Resonance Imaging (MRI) findings and Arthroscopy in diagnosing anterior cruciate ligament (ACL) injuries, using Arthroscopy as the gold standard. Methodology: This prospective cross-sectional study was conducted at the Department of Orthopedic Surgery, Combined Military Hospital, Rawalpindi, from February to August 2019. Clinical evidence of ACL injury was present in 127 individuals. They had an MRI as well as an arthroscopy. The diagnostic efficacy of MRI for ACL tears was evaluated, and its sensitivity, specificity, PPV, NPV, and accuracy were all calculated. Comparisons between arthroscopic and magnetic resonance imaging (MRI) findings yielded three classifications: True Positive (MRI verified by Arthroscopy), True Negative (both MRI and Arthroscopy negative for ACL injury), and False Positive/False Negative (differences between MRI and Arthroscopy). The arthroscopic inspection and MRI findings were entered into SPSS 23 soft...
Reliability Assessment of Arthroscopic Findings Versus MRI in ACL Injuries of the Knee
This study was conducted to analyze the reliability of clinical diagnosis in ACL tear injuries. Material and methods: All patients attending our clinic with knee pain from 2009 to 2013 underwent systematic and thorough clinical assessment. From one hundred and three patients with knee problems in 73 were arhroscopicaly diagnosed ACL tears. All these patients underwent therapeutic arthroscopic knee surgery. The clinical diagnosis was confirmed during this procedure. The accuracy, sensitivity and specificity were calculated based on these arthroscopic findings. Results: The accuracy of clinical diagnosis in our study was 82.5% for ACL tears. Our study revealed high sensitivity and specificity and almost high accuracy for ACL injuries of knee joint in comparison to arthroscopy. MRI is an appropriate screening tool for therapeutic arthroscopy, making diagnostic arthroscopy unnecessary in most patients. Conclusion: Magnetic resonance imaging is accurate and non invasive modality for the assessment of ligamentous injuries. It can be used as a first line investigation in patients with soft tissue trauma to knee.
PloS one, 2018
To assess the diagnostic validity of clusters combining history elements and physical examination tests to diagnose partial or complete anterior cruciate ligament (ACL) tears. Prospective diagnostic study. Orthopaedic clinics (n = 2), family medicine clinics (n = 2) and community-dwelling. Consecutive patients with a knee complaint (n = 279) and consulting one of the participating orthopaedic surgeons (n = 3) or sport medicine physicians (n = 2). Not applicable. History elements and physical examination tests performed independently were compared to the reference standard: an expert physicians' composite diagnosis including history elements, physical tests and confirmatory magnetic resonance imaging. Penalized logistic regression (LASSO) was used to identify history elements and physical examination tests associated with the diagnosis of ACL tear and recursive partitioning was used to develop diagnostic clusters. Diagnostic accuracy measures including sensitivity (Se), specifici...
Role of MRI in detecting cruciate ligaments tears, confirmed subsequently with arthroscopy
IP Innovative Publication Pvt. Ltd., 2017
Introduction: Due to its anatomical structure, its exposure to external forces and the functional demands placed on it, Knee Joint is one of the most commonly injured joints. Objective: To observe the sensitivity and specificity of MRI in detecting cruciate ligaments tears, and confirmed with arthroscopy. Materials and Method: It was conducted at Ramkrishna Care Hospital, Raipur. 67 patients with complaints of knee pain with history of knee injury between the age group of 15-60 years were selected for study. Results: 61 had ACL tear on MRI out of which 58 showed similar results on arthroscopy. The sensitivity, specificity and accuracy for MRI for ACL came out to be 100%, 66.67% and 95.52% respectively. Similarly out of 2 patients diagnosed with PCL tear on MRI examination only 1 had positive result arthroscopically giving sensitivity of 50%, specificity of 90% and accuracy of 98.5%. Conclusion: Magnetic Resonance Imaging has highly accurate for pre-operative diagnosis of ligamentous injuries of knee joint and can be used as a screening tool before arthroscopic examination.
IOSR Journals , 2019
Background :The knee joint is a common site of injury due to trauma, repetitive activities, and sports activities.Clinical diagnosis, encompassing an accurate history, thorough examination and interpretation of investigations, is an art all doctors are expected to master during their career. A number of previous studies have examined the accuracy of clinical diagnosis in traumatic meniscal or ligamentous injuries of the knee. Multiple imaging modalities are currently used to evaluate pathologic conditions of the knee. Magnetic resonance imaging has a better soft tissue contrast and multi planar slice capability which has revolutionized and has become the ideal modality for imaging complex anatomy of the knee joint.Arthroscopy considered to be the 'gold standard' investigative method. Which can be used in its dual mode, either as diagnostic and/or as therapeutic tool.Aim of the study was to correlate clinical, radiological and arthroscopic findings of meniscal and anterior cruciate ligament injuries of knee. Materials and methods :This is a prospective study involving 30 patients with history of knee injuries who have admitted in Department of Orthopaedics, Narayana medical college was conducted for a period of two year and were scheduled to undergo arthroscopic surgery of the knee for either meniscal or ACL injury based on clinical and Magnetic Resonance Imaging (MRI) findings were included in the study. Results :: 30 patients were studied comparing clinical examination, MRI with arthroscopy and were analyzed. Clinical examination showed sensitivity, specificity, Positive Predictive value (PPV), Negative Predictive value (NPV), accuracy of 68.1%,62.5%,83.3%,41.6%,66.6%respectively for medial meniscus tear,75%,83.3%,75.0%,83.3%,80% respectively for lateral meniscus tear and 91.3%,85.7%,95.4%,75.0%,90.0%, respectively for Anterior Cruciate Ligament (ACL) tear. MRI findings showed sensitivity, specificity PPV, NPV, accuracy of 68.1%,75.0%,88.2%,46.1%,70.0% respectively for medial meniscus, 50.0%,83.3%,66.6%,71.4%,70.0% respectively for lateral meniscus tear, 78.2%,85.7%,94.7%,54.5%,80.0% respectively for ACL tear. Conclusion: Clinical tests to detect ACL and lateral meniscus injuries have a high degree of correlation when compared to arthroscopy and MRI. Clinical tests to detect medial meniscus injuries have a lower degree of correlation compared to MRI and arthroscopy.
IOSR Journals , 2019
Background: The knee joint is a common site of injury due to trauma, repetitive activities, and sports activities.Clinical diagnosis, encompassing an accurate history, thorough examination and interpretation of investigations, is an art all doctors are expected to master during their career. A number of previous studies have examined the accuracy of clinical diagnosis in traumatic meniscal or ligamentous injuries of the knee. Multiple imaging modalities are currently used to evaluate pathologic conditions of the knee. Magnetic resonance imaging has a better soft tissue contrast and multi planar slice capability which has revolutionized and has become the ideal modality for imaging complex anatomy of the knee joint.Arthroscopy considered to be the 'gold standard' investigative method. Which can be used in its dual mode, either as diagnostic and/or as therapeutic tool.Aim of the study was to correlate clinical, radiological and arthroscopic findings of meniscal and anterior cruciate ligament injuries of knee. Materials and methods:This is a prospective study involving 30 patients with history of knee injuries who have admitted in Department of Orthopedics, Narayana medical college was conducted for a period of two year and were scheduled to undergo arthroscopic surgery of the knee for either meniscal or ACL injury based on clinical and Magnetic Resonance Imaging (MRI) findings were included in the study. Results:30 patients were studied comparing clinical examination, MRI with arthroscopy and were analyzed. Clinical examination showed sensitivity, specificity, Positive Predictive value (PPV), Negative Predictive value (NPV), accuracy of 68.1%,62.5%,83.3%,41.6%,66.6%respectively for medial meniscustear,75%,83.3%,75.0%,83.3%,80% respectively for lateral meniscus tear and 91.3%,85.7%,95.4%,75.0%,90.0%, respectively for Anterior Cruciate Ligament (ACL) tear. MRI findings showed sensitivity, specificity PPV, NPV, accuracy of 68.1%, 75.0%, 88.2%,46.1%,70.0% respectively for medial meniscus, 50.0%,83.3%,66.6%,71.4%,70.0% respectively for lateral meniscus tear, 78.2%,85.7%,94.7%,54.5%,and 80.0% respectively for ACL tear. Conclusion: Clinical tests to detect ACL and lateral meniscus injuries have a high degree of correlation when compared to arthroscopy and MRI. Clinical tests to detect medial meniscus injuries have a lower degree of correlation compared to MRI and arthroscopy.
Journal of thee Medical Sciences (Berkala Ilmu Kedokteran), 2021
Anterior cruciate ligament (ACL) injury is the most common knee ligament injured. Anterior drawer and Lachman tests are the most common physical examinations for helping diagnose ACL injuries, while magnetic resonance imaging (MRI) is the first choice of supporting examination for evaluating any internal abnormality of the knee. However, studies concerning the accuracy of those examinations in the Indonesian population are limited. This study aimed to compare the accuracy between the anterior drawer test, Lachman test, and MRI in diagnosing ACL injury in Javanese patients. This retrospective study used medical records data of patients who underwent knee arthroscopy in the Department of Orthopaedics and Traumatology, Dr. Sardjito General Hospital, Yogyakarta in 2018. The MRI and the clinical examination results were compared to the arthroscopy results as the gold standard. The study showed the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy for the anterior drawer test were 86.67%
Journal of Nepal Medical Association
Introduction: Magnetic Resonance Imaging is the preferred imaging modality in patients having anterior cruciate ligament tears. The aim of this study was to find out the prevalence of anterior cruciate ligament tears using magnetic resonance imaging among patients undergoing arthroscopy in a tertiary care centre. Methods: A descriptive cross-sectional study was conducted in the Department of Orthopaedics and Traumatology of a tertiary care centre. Data from 17 November 2017 to 17 October 2022 were collected between 26 December 2022 and 30 December 2022 from the hospital records. Ethical approval was obtained from Institutinal Review Committee of the same institute (Reference number: 233/22). All patients with a knee injury who received arthroscopy were included in the study. Magnetic resonance imaging reports, arthroscopic findings and relevant data of each case were retrieved from the medical case records of patients. Convenience sampling method was used. Point estimate and 95% Con...