TITLE:
Evaluation of Accuracy of Clinical Examination and MRI on Diagnosing Anterior Cruciate Ligament and Meniscal Tears in Comparison to Diagnostic Arthroscopy among Patients Attending at Muhimbili Orthopedic Institute
AUTHORS:
Hellen Machagge, Felix Mrita, Mohamed Muhamedhussen, Billy Haonga, Cuthbert N. Mcharo
KEYWORDS:
MRI, Clinical Examination, Diagnostic Accuracy, ACL, Meniscal
JOURNAL NAME:
Open Journal of Orthopedics,
Vol.11 No.12,
December
7,
2021
ABSTRACT: Routine use of Magnetic Resonance Imaging (MRI) as screening test after clinical diagnosis for meniscal and/or anterior
cruciate ligament (ACL) has a detrimental effect on patients in
limited resourced countries. This study was done to compare accuracy of
clinical examination and that of (MRI) on diagnosing meniscal and or (ACL) tears. Methodology: A
cross-sectional-descriptive study was
done on 57 knees of patients. Clinical examination, MRI and then diagnostic
arthroscopy, as the gold standard, were done to all the cases. Results were
recorded; the accuracies of MRI and clinical examination were evaluated and
their results were compared. Results: Median age of patients was 40 years. Clinical examination had sensitivity of
93.62% and specificity of 40% for diagnosing meniscal tears; and
sensitivity of 100%; and specificity of 97.67% for diagnosing ACL tear. MRI had
sensitivity of 85.11%, and specificity of 40% for meniscal tear diagnosis and
71% and 100% respectively for ACL tear diagnosis. Diagnostic accuracy was
84.21% for meniscal and 98.24% for ACL tears by clinical examination and by MRI
was 77.19% and 92.98% respectively. Conclusion: Clinical examination
has higher accuracy than MRI on diagnosing both ACL and meniscal tear. Thus
patients may be scheduled for diagnostic and interventional arthroscopy if
clinical examination reveals meniscal and or
ACL injuries. MRI use should be reserved when clinical evaluation is
inconclusive or cannot be done.