Use of MRI by radiologists and orthopaedic surgeons to detect intra-articular injuries of the knee

Figueiredo, Sergio; Castelo, Luis Sa; Pereira, Ana Daniela; Machado, Luis; Silva, Joao Andre; Sa, Antonio

doi:10.1016/j.rboe.2016.12.013

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ORIGINAL ARTICLE • Rev. bras. ortop. 53 (01) • Jan-Feb 2018 • https://doi.org/10.1016/j.rboe.2016.12.013 copy

Use of MRI by radiologists and orthopaedic surgeons to detect intra-articular injuries of the knee^☆ ☆ Work performed at Departamento de Ortopedia II, Centro Hospitalar de Leiria, Leiria, Portugal.

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

Magnetic resonance imaging (MRI) is paramount in the assessment of knee pathology, particularly when planning for a surgical procedure. This study compared the diagnostic accuracy in MRI reading of pathological knees by radiologists and orthopaedic surgeons.

Materials and methods:

Cross-sectional study comprising 80 randomly selected patients previously submitted to arthroscopic surgery after clinical examination and MRI. A diagnosis by MRI interpretation was requested from the two teams, one of radiologists and another of orthopaedic surgeons. The conclusions of each team were later compared. Statistical significance was considered for p < 0.05.

Results:

The radiologists’ findings achieved statistical significance regarding osteochondral injuries, ACL, and medial meniscus (p < 0.05), and orthopaedic surgeons regarding ACL injuries and menisci (p < 0.05). ACL injuries demonstrated a statistically significant association between teams (p < 0.001).

Conclusions:

MRI appears to offer reliable readings of ACL injuries, regardless the specialty of the observer. The lateral compartment is scarcely well read.

Keywords:
Arthroscopy; Magnetic resonance imaging; Meniscus; Anterior cruciate ligament; Knee

Radiologists	p-value	PPV	NPV	Sensitivity	Specificity
Osteochondral lesions
Medial condyle	0.125	0.778	0.522	0.389	0.857
Medial Plateau	0.360	0.714	0.480	0.278	0.857
Lateral Condyle	0.001	0.727	0.754	0.333	0.942
Lateral Plateau	0.044	1.000	0.400	0.318	1.000
Patello femoral	–	–	1.000	–	0.727
Ligamentary lesions
ACL (yes/no)	<0.001	0.552	0.827	0.762	0.723
ACL (specified)	<0.001	–	–	–	–
Meniscal lesions
Medial (yes/no)	<0.001	0.857	0.688	0.894	0.611
Medial (specified)	0.150	–	–	–	–
Lateral (yes/no)	0.079	0.500	0.717	0.458	0.750
Lateral (specified)	0.002	–	–	–	–
Synovitis	0.673	0.667	0.500	0.333	0.800

Orthopaedic surgeons	p-value	PPV	NPV	Sensitivity	Specificity
Osteochondral lesions
Medial condyle	0.284	0.650	0.538	0.684	0.500
Medial plateau	0.383	0.562	0.000	0.947	0.000
Lateral condyle	0.946	0.318	0.690	0.333	0.942
Lateral plateau	0.299	0.654	0.143	0.739	0.100
Patello femoral	–	–	1.000	–	0.727
Ligamentary lesions
ACL (yes/no)	0.003	0.450	0.893	0.857	0.532
ACL (specified)	<0.001	–	–	–	–
Meniscal lesions
Medial (yes/no)	<0.001	0.854	0.647	0.872	0.611
Medial (specified)	0.003	–	–	–	–
Lateral (yes/no)	0.004	0.500	0.833	0.792	0.568
Lateral (specified)	0.014	–	–	–	–
Synovitis	0.673	0.333	0.500	–	0.909

Orthopaedic surgeons	Radiologists’ accuracy	Orthopaedic surgeons’ accuracy	CMH test (p-value)
Osteochondral lesions
Medial condyle	0.623	0.592	0.130
Medial plateau	0.568	0.474	0.620
Lateral condyle	0.638	0.638	0.276
Lateral plateau	0.659	0.420	0.681
Patello femoral	–	–	–
Ligamentary lesions
ACL (yes/no)	0.743	0.695	<0.001
Meniscal lesions
Medial (yes/no)	0.753	0.742	0.089
Lateral (yes/no)	0.604	0.680	0.084
Synovitis	0.567	–	–

Sociedade Brasileira de Ortopedia e Traumatologia Al. Lorena, 427 14º andar, 01424-000 São Paulo - SP - Brasil, Tel.: 55 11 2137-5400 - São Paulo - SP - Brazil
E-mail: rbo@sbot.org.br

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[1] * Corresponding author. E-mail: sergio.figueiredo@gmail.com(S. Figueiredo).

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Use of MRI by radiologists and orthopaedic surgeons to detect intra-articular injuries of the knee☆ ☆ Work performed at Departamento de Ortopedia II, Centro Hospitalar de Leiria, Leiria, Portugal.

ABSTRACT

Objective:

Materials and methods:

Results:

Conclusions:

Use of MRI by radiologists and orthopaedic surgeons to detect intra-articular injuries of the knee^☆ ☆ Work performed at Departamento de Ortopedia II, Centro Hospitalar de Leiria, Leiria, Portugal.