title: Diagnosis and classification of chondral knee injuries: comparison between magnetic resonance imaging and arthroscopy.
abstract: OBJECTIVE
  To compare the magnetic resonance imaging (MRI) findings of patients undergoing knee arthroscopy for chondral lesions. The hypothesis was that MRI displays low sensitivity in the diagnosis and classification of chondral injuries.
  
  
  METHODS
  A total of 83 knees were evaluated. The MRIs were performed using the same machine (GE SIGNA HDX 1.45 T). The MRI results were compared with the arthroscopy findings, and an agreement analysis was performed. Thirty-eight of the 83 MRI exams were evaluated by another radiologist for inter-observer agreement analysis. These analyses were performed using the kappa (κ) coefficient.
  
  
  RESULTS
  The highest incidence of chondral injury was in the patella (14.4 %). The κ coefficient was 0.31 for the patellar surface; 0.38 for the trochlea; 0.46 for the medial femoral condyle; 0.51 for the lateral femoral condyle; and 0.19 for the lateral plateau. After dividing the injuries into two groups (ICRS Grades 0-II and Grades III and IV), the following κ coefficients were obtained as follows: 0.49 (patella); 0.53 (trochlea); 0.46 (medial femoral condyle); 0.43 (medial plateau); 0.67 (lateral femoral condyle); and 0.51 (lateral plateau). The MRI sensitivity was 76.4 % (patella), 88.2 % (trochlea), 69.7 % (medial femoral condyle), 85.7 % (medial plateau), 81.8 % (lateral femoral condyle) and 75 % (lateral plateau). Comparing the radiologists' evaluations, the following κ coefficients were obtained as follows: 0.73 (patella); 0.63 (trochlea); 0.84 (medial femoral condyle); 0.72 (medial plateau); 0.77 (lateral femoral condyle); and 0.91 (lateral plateau).
  
  
  CONCLUSIONS
  Compared with arthroscopy, MRI displays moderate sensitivity for detecting and classifying chondral knee injuries. It is an important image method, but we must be careful in the assessment of patients with suspected chondral lesions.
  
  
  METHODS
  III.
authors.affiliation: Uniorte - Hospital de Ortopedia, Antonio Pisicchio, 155, apto 1402, Londrina, PR, CEP 86040-482, Brazil. mvdanieli@hotmail.com.|Faculdade de Medicina de Botucatu - UNESP, Botucatu, SP, Brazil. mvdanieli@hotmail.com.
authors.forename: Marcus Vinicius
authors.initials: MV
authors.lastname: Danieli
authors.affiliation: Uniorte - Hospital de Ortopedia, Antonio Pisicchio, 155, apto 1402, Londrina, PR, CEP 86040-482, Brazil.
authors.forename: João Paulo Fernandes
authors.initials: JP
authors.lastname: Guerreiro
authors.affiliation: Uniorte - Hospital de Ortopedia, Antonio Pisicchio, 155, apto 1402, Londrina, PR, CEP 86040-482, Brazil.
authors.forename: Alexandre deOliveira
authors.initials: Ad
authors.lastname: Queiroz
authors.affiliation: Faculdade de Medicina de Botucatu - UNESP, Botucatu, SP, Brazil.
authors.forename: Hamilton daRosa
authors.initials: Hd
authors.lastname: Pereira
authors.affiliation: Ultramed, Londrina, PR, Brazil.
authors.forename: Susi
authors.initials: S
authors.lastname: Tagima
authors.affiliation: Ultramed, Londrina, PR, Brazil.
authors.forename: Marcelo Garcia
authors.initials: MG
authors.lastname: Marini
authors.affiliation: Faculdade de Medicina de Botucatu - UNESP, Botucatu, SP, Brazil.
authors.forename: Daniele Cristina
authors.initials: DC
authors.lastname: Cataneo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001182:Arthroscopy; D002357:Cartilage Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging; D002358:Cartilage, Articular / Q000293:injuries*; D002648:Child; D005260:Female; D006801:Humans; D007718:Knee Injuries / Q000145:classification / Q000175:diagnosis*; D007719:Knee Joint / Q000473:pathology / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D055815:Young Adult
keywords: Arthroscopy; Articular cartilage; Injury; Knee; Magnetic resonance imaging