Clinical judgement versus arthrography for diagnosing knee lesions

The authors carried out a retrospective, randomized study of 200 patients with a preoperative diagnosis of meniscal tear of the knee. Of 208 knees operated on, more than one lesion was found in 84 knees (40.4%). Arthrographic diagnosis was incomplete or incorrect in 103 (51.5%) of 200 knees. Chondromalacia of the patella was present in 55 knees (26.4%) and tears of the anterio cruciate ligament were present in 15 (20.8%) of the 72 athletes who formed part of the study population. With regard to the medial meniscus, arthrographic errors occurred in only 9%. For the lateral meniscus, the rate of accuracy of the radiologists' reports was 67% compared with 97% accuracy for clinical assessment. This study points out that clinical evaluation still remains the best means of diagnosing knee lesions.