[Evaluation of cartilage defects in the knee: validity of clinical, magnetic-resonance-imaging and radiological findings compared with arthroscopy].
BACKGROUND
The study was aimed to evaluate the validity of clinical, radiological and MRI examination for cartilage defects of the knee compared with arthroscopic finding.


METHODS
Seven-hundred seventy-two patients who were suffering from knee pain over more than 3 months were evaluated clinical (grinding-sign) and with radiography and magnetic resonance imaging (MRI) and subsequent arthroscopy.


RESULTS
The grinding sign had a sensitivity of 0.39. The association of a positive grinding test with high grade cartilage defects was significant (p<0.000). In 97.4% an intact chondral surface correlated with a normal radiological finding. Subchondral sclerosis, exophytes and a joint space narrowing was significantly associated with high grade cartilage defects (p<0.000). The accuracy of MRI was 59.5%. The MRI resulted in an overestimation in 36.6% and an underestimation in 3.9%. False-positive results were significant more often assessed in low-grade cartilage defects (p<0.000).


CONCLUSIONS
Clinical signs, x-ray imaging and MRI correlate with arthroscopic findings in cases of deep cartilage lesions. In intact or low-grade degenerated cartilage often results an overestimating of these findings.
Spahn
G
G
Praxisklinik für Unfallchirurgie und Orthopädie, Sophienstrasse 16, 99817, Eisenach, Germany. spahn@pk-eisenach.de
Wittig
R
R
Kahl
E
E
Klinger
H M
HM
Mückley
T
T
Hofmann
G O
GO
D000293:Adolescent; D000328:Adult; D000368:Aged; D001175:Arthrography / Q000379:methods*; D001182:Arthroscopy / Q000379:methods*; D002357:Cartilage Diseases / Q000175:diagnosis*; D005260:Female; D050724:Fractures, Cartilage / Q000175:diagnosis*; D006801:Humans; D007718:Knee Injuries / Q000175:diagnosis; D007719:Knee Joint / Q000000981:diagnostic imaging* / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity