title: Early magnetic resonance imaging in acute knee injury: a cost analysis.
abstract: OBJECTIVE
  Acute knee injury is common, and MRI is often only used when non-operative management fails because of limited availability. We investigated whether early MRI in acute knee injury is more clinically and cost-effective compared to conventional physiotherapy and reassessment.
  
  
  METHODS
  All patients with acute indirect soft tissue knee injury referred to fracture clinic were approached. Recruited patients were randomised to either the MRI group: early MRI within 2 weeks or the control group: conventional management with physiotherapy. Patients were assessed in clinic initially, at 2 weeks and 3 months post-injury. Management costs were calculated for all patients until surgical treatment or discharge.
  
  
  RESULTS
  Forty-six patients were recruited: 23 in the MRI and 23 in the control group. Male sex and mean age were similar in the two groups. The total management cost of the MRI group was £16,127 and control group was £16,170, with a similar mean cost per patient (NS). The MRI group had less mean physiotherapy (2.5 ± 1.9 vs. 5.1 ± 3.5, p < 0.01) and outpatient appointments (NS). Median time to surgery and time off work was less in the MRI group (NS). The MRI group had less pain (p < 0.05), less activity limitation (p = 0.04) and better satisfaction (p = 0.04).
  
  
  CONCLUSIONS
  Early MRI in acute knee injury facilitates faster diagnosis and management of internal derangement at a cost comparable to conventional treatment. Moreover, patients had significantly less time off work with improved pain, activity limitation and satisfaction scores.
  
  
  METHODS
  II.
authors.affiliation: Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex HA7 4LP, UK.
authors.forename: Nirav K
authors.initials: NK
authors.lastname: Patel
authors.forename: Andrew
authors.initials: A
authors.lastname: Bucknill
authors.forename: David
authors.initials: D
authors.lastname: Ahearne
authors.forename: Janet
authors.initials: J
authors.lastname: Denning
authors.forename: Kailash
authors.initials: K
authors.lastname: Desai
authors.forename: Martin
authors.initials: M
authors.lastname: Watson
mesh_terms: D000293:Adolescent; D000328:Adult; D003362:Cost-Benefit Analysis; D005260:Female; D005500:Follow-Up Studies; D017048:Health Care Costs / Q000706:statistics & numerical data; D006801:Humans; D007718:Knee Injuries / Q000175:diagnosis* / Q000191:economics / Q000628:therapy; D008131:London; D008279:Magnetic Resonance Imaging / Q000191:economics*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D017060:Patient Satisfaction; D026741:Physical Therapy Modalities / Q000191:economics / Q000706:statistics & numerical data; D016896:Treatment Outcome; D055815:Young Adult