Document Detail

Reliability of the clinical assessment in predicting the cause of internal derangements of the knee.
MedLine Citation:
PMID:  8534299     Owner:  NLM     Status:  MEDLINE    
The reliability of the clinical assessment, which comprised history, physical examination, and plain radiographs, was determined by comparing the initial preoperative diagnosis with the postoperative diagnosis as determined arthroscopically, and by comparing the results of the clinical evaluation with published reports of arthrography, computed tomography (CT), and magnetic resonance imaging (MRI). The study group included 206 patients (216 knees) scheduled for arthroscopic surgery for suspected internal derangements. The primary preoperative clinical diagnosis was correct in 175 knees (81%), with an overall accuracy of 93%, sensitivity of 89%, and specificity of 94%. The most common preoperative diagnoses were medial and lateral meniscal tears. Results of the clinical assessment were comparable or superior to published reports of arthrography, CT, and MRI. Thus, it may be unnecessary to routinely use these costly special studies to determine the need for arthroscopic surgery. We conclude that a thorough clinical assessment can provide sufficient information for the surgeon to make a definitive primary preoperative diagnosis, and that arthroscopy should not be performed without first completing a complete preoperative examination.
G C Terry; B E Tagert; M J Young
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association     Volume:  11     ISSN:  0749-8063     ISO Abbreviation:  Arthroscopy     Publication Date:  1995 Oct 
Date Detail:
Created Date:  1996-02-07     Completed Date:  1996-02-07     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8506498     Medline TA:  Arthroscopy     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  568-76     Citation Subset:  IM    
Hughston Clinic, P.C., Columbus, Georgia 31908, USA.
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MeSH Terms
Aged, 80 and over
Diagnosis, Differential
Diagnostic Errors
Joint Diseases / diagnosis,  radiography,  surgery
Knee Injuries / diagnosis*,  radiography,  surgery
Knee Joint* / radiography,  surgery
Middle Aged
Physical Examination
Predictive Value of Tests
Sensitivity and Specificity

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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