The diagnosis of knee injuries in casualty--a prospective study

A prospective study of all knee injuries seen at a Casualty Department was organized. A clinical diagnosis was made in each case, based on standardized criteria, and the subsequent progress followed. Meniscal tears tended to be over-diagnosed clinically. Many injuries thus classified settled in three to four weeks without further sequelae. Conversely, complete ligament tears were under-diagnosed and in particular these tended to be missed in the presence of a haemarthrosis. Examination under anaesthesia is recommended if there is any doubt concerning ligamentous stability and all unexplained haemarthrosis should have early examination under anaesthesia and arthroscopy. Among those injuries initially regarded as less serious e.g. traumatic synovitis, no serious pathology subsequently emerged.