Document Detail

Role of magnetic resonance imaging in the clinical management of the acutely locked knee.
MedLine Citation:
PMID:  12324825     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To explore prospectively the hypothesis that MRI of the acutely locked knee can alter surgical decision-making. DESIGN AND PATIENTS: The study group comprised patients with a clinical diagnosis of knee locking requiring arthroscopy. The decision to carry out arthroscopy was made by an experienced consultant orthopaedic surgeon specialising in trauma and recorded in the patient's notes prior to MRI. Preoperative MRI was carried out using a 1.5 T system. The management was altered from surgical to conservative treatment in 20 (48%) patients on the basis of the MR findings. Arthroscopy was limited to patients with an MR diagnosis of a mechanical block, usually a displaced meniscal tear or loose body. Both patient groups were followed clinically until symptoms resolved. RESULTS: Forty-two patients were entered into the study. MRI identified a mechanical cause for locking in 22 patients (21 avulsion meniscal tears and 1 loose body). All were confirmed at arthroscopy. Twenty patients were changed from operative to non-operative treatment on the basis of the MRI findings. One patient in this group required a delayed arthroscopy for an impinging anterior cruciate ligament stump. The sensitivity/specificity/accuracy of MRI in identifying patients who require arthroscopy was therefore 96%/100%/98% respectively. CONCLUSION: MRI can successfully segregate patients with a clinical diagnosis of mechanical locking into those who have a true mechanical block and those who can be treated conservatively. MRI should precede arthroscopy in this clinical setting.
Eugene G McNally; Khalid N Nasser; Stewart Dawson; Leslie A Goh
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Publication Detail:
Type:  Journal Article     Date:  2002-08-21
Journal Detail:
Title:  Skeletal radiology     Volume:  31     ISSN:  0364-2348     ISO Abbreviation:  Skeletal Radiol.     Publication Date:  2002 Oct 
Date Detail:
Created Date:  2002-09-26     Completed Date:  2003-02-25     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7701953     Medline TA:  Skeletal Radiol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  570-3     Citation Subset:  IM    
Department of Musculoskeletal Radiology, Nuffield Orthopaedic Centre and Oxford Radcliffe Hospital, Oxford, OX3 7LD, UK.
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MeSH Terms
Knee Injuries / pathology*,  surgery
Knee Joint / pathology*
Magnetic Resonance Imaging*
Prospective Studies
Sensitivity and Specificity

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