title: Sensitivity of magnetic resonance imaging for detection of patellofemoral articular cartilage defects.
abstract: OBJECTIVE
  Chondral defects within the patellofemoral compartment are common and lack the ability to heal on their own. Early detection of these lesions with a noninvasive modality would be beneficial in delaying or preventing their possible progression to osteoarthritis. We hypothesized that magnetic resonance imaging (MRI) is a sensitive, specific, and accurate imaging modality for the detection of patellofemoral chondral defects with substantial interobserver reliability and that MRI has a higher sensitivity, specificity, and accuracy for detecting patellar defects than trochlear defects.
  
  
  METHODS
  A systematic review of multiple medical databases was performed by use of the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) protocol. Analysis of studies that reported diagnostic performance of MRI in the assessment of patellofemoral chondral defects (patella and trochlea), using arthroscopy as the reference gold standard, was performed. Sensitivity, specificity, accuracy, and interobserver reliability were reported. Significant heterogeneity across studies precluded meta-analysis.
  
  
  RESULTS
  MRI was more sensitive in detection of patellar (87%) versus trochlear (72%) defects. MRI was similarly specific for patellar (86%) and trochlear (89%) defects. MRI was similarly accurate for patellar (84%) and trochlear (83%) defects. Interobserver agreement was substantial to almost perfect for both patellar and trochlear defects.
  
  
  CONCLUSIONS
  MRI is a highly sensitive, specific, and accurate noninvasive diagnostic modality for the detection of chondral defects in the patellofemoral compartment of the knee, using arthroscopy as the reference gold standard. Although there was wide variability in the statistical parameters assessed, MRI was more sensitive for detection of patellar versus trochlear defects and similarly specific and accurate for patellar and trochlear defects. Interobserver reliability is substantial to near perfect in the assessment of these lesions, without a significant difference between patellar and trochlear defects.
  
  
  CONCLUSIONS
  Use of MRI may allow early detection of chondral defects within the patellofemoral compartment, enabling clinicians to adopt strategies to delay or prevent progression to osteoarthritis.
  
  
  METHODS
  Level III, systematic review of Level I, II, and III studies.
authors: Sports Medicine Center and Cartilage Restoration Program, The Ohio State University, Columbus, USA.
authors: Joshua D
authors: JD
authors: Harris
authors: Robert H
authors: RH
authors: Brophy
authors: Guang
authors: G
authors: Jia
authors: Brandon
authors: B
authors: Price
authors: Michael
authors: M
authors: Knopp
authors: Robert A
authors: RA
authors: Siston
authors: David C
authors: DC
authors: Flanigan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002358:Cartilage, Articular / Q000293:injuries* / Q000473:pathology*; D002648:Child; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D057071:Patellofemoral Joint / Q000473:pathology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity