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MR imaging before arthroscopy in knee joint disorders?
E D Rappeport1, S Mehta, S B Wieslander
1Stockport Acute Services NHS Trust, U.K.
Purpose:
To review the current literature examining the relative merits of arthroscopy and MR imaging of the knee.
Material And Methods:
All papers comparing MR imaging with arthroscopy published within the last 10 years according to Medline were collected and read.
Results:
Technology has improved considerably during recent years allowing detailed non-invasive visualization of the knee. In particular, the development of cheaper whole-body and dedicated low-field MR units has opened up for non-invasive inspection of the knee at reasonable cost. Meniscal tears can be detected with accuracy rates of around 90% and rupture of the anterior cruciate ligament with accuracy rates of around 93% compared to arthroscopy. However, arthroscopy is not the ideal gold standard, since it has weak points, e.g. peripheral meniscal tears or osteochondritis without apparent damage to the cartilage.
Conclusion:
Based on the overwhelming literature it seems safe to conclude that MR examinations of the knee should be performed before arthroscopy is undertaken.