Diagnosis of acute knee ligament injuries: the value of stress radiography compared with clinical examination, stability under anaesthesia and arthroscopic or operative findings.
A consecutive series of 85 stress radiographic examinations was performed in order to evaluate the clinical reliability and use of stress radiography in disclosing acute knee ligament injuries. Eighty-three examinations were performed within one week of the injury. Sagittal stress examination discovered 27% of the 37 anterior cruciate ligament (ACL) tears and all four posterior cruciate tears. Valgus stress detected 56% of the medial collateral tears. The specificity of stress radiography was even reduced by the number of false positive stress results (n = 25) in posterior drawer or valgus-varus examinations. An ACL tear was, however, an isolated or major ligament injury in twenty (80%) of the false positive results. Clinical examination revealed all the medial collateral tears whereas only 40% of the anterior cruciate tears. The most reliable method for diagnosing acute knee injuries where clinical examination has failed in disclosing instability is examination under anaesthesia supplemented by acute arthroscopy.
Harilainen
A
A
Myllynen
P
P
Rauste
J
J
Silvennoinen
E
E
D000293:Adolescent; D000328:Adult; D000368:Aged; D000758:Anesthesia; D001182:Arthroscopy; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000175:diagnosis*; D007718:Knee Injuries / Q000000981:diagnostic imaging* / Q000601:surgery; D008023:Ligaments, Articular / Q000293:injuries* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012399:Rotation; D013314:Stress, Mechanical