title: Arthroscopic verification of objectivity of the orthopaedic examination and magnetic resonance imaging in intra-articular knee injury. Retrospective study.
abstract: BACKGROUND
  Arthroscopy of the knee joint is regarded as the most objective diagnostic method in intra-articular knee joint lesions.
  
  
  OBJECTIVE
  The purpose of this study was to assess the objectivity and diagnostic value of orthopaedic examination (OE) and magnetic resonance imaging (MRI) in reference to the arthroscopic result.
  
  
  METHODS
  In a group of 113 patients treated by arthroscopic surgery for post-traumatic knee pathology between 2008 and 2010 in our department, accuracy of clinical and MRI findings that preceded surgery were studied retrospectively using a statistical method. Sensitivity, specificity, accuracy and predictive negative and positive values were the subject of analysis.
  
  
  RESULTS
  In the presented trial, sensitivity values of the orthopaedic examination for injuries of the anterior cruciate ligament (ACL), meniscus medialis (MM), meniscus lateralis (ML) and chondral injuries (ChI) were 86%, 65%, 38% and 51%, respectively. Specificity values were 90%, 65%, 100% and 100%, respectively. The MR sensitivity and specificity values were 80%, 88%, 44% and 32%, and 86%, 64%, 93% and 97%, respectively.
  
  
  CONCLUSIONS
  Assessment of intra-articular knee joint lesions is a difficult diagnostic problem. In making a decision about arthroscopy of the knee joint, an appropriate sequence of examinations should be carried out: OE, MRI and arthroscopy. The improvement in the effectiveness of the orthopaedic examination and MRI can limit the too high frequency of diagnostic arthroscopies, which generates the risk of operation treatment and costs.
authors.affiliation: Department of Orthopedic and Traumatologic Surgery, Zeromski Hospital, Cracow, Poland.
authors.forename: Julian
authors.initials: J
authors.lastname: Dutka
authors.forename: Michał
authors.initials: M
authors.lastname: Skowronek
authors.forename: Paweł
authors.initials: P
authors.lastname: Skowronek
authors.forename: Lukasz
authors.initials: L
authors.lastname: Dutka