What is the best way to evaluate an acute traumatic knee injury?
The Journal of Family Practice. 2008 February;57(2):116-118
February 1, 2008|The Journal of Family Practice
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TABLE 2
MRI compares well with operative Dx in identifying knee lesions in adolescents
| INJURY | LR+ (95% CI) | LR– (95% CI) |
|---|---|---|
| Medial meniscus | 7.18 (3.34–15.46) | 0.10 (0.01–0.63) |
| Lateral meniscus | 20.53 (5.27–80.07) | 0.07 (0.01–0.46) |
| Anterior cruciate ligament | 100 | 0 |
| *Adapted from Major et al, 2003.7 | ||
| MRI, magnetic resonance imaging; LR, likelihood ratio; CI, confidence interval. | ||
Recommendations from others
University of Michigan Health System8 guidelines indicate the following:
- Most knee pain is caused by patellofemoral syndrome and osteoarthritis.
- MRI of the knee has not been proven to be superior to the clinical exam by an experienced examiner in the evaluation of acute knee injuries.
- MRI may be useful to assess bone pathology underlying chronic knee pain.
- Differentiating between knee pain without constitutional symptoms, knee pain with constitutional symptoms, and traumatic knee pain is helpful in determining a diagnosis.
- Patients with knee pain and swelling who have non-bloody aspirates may also have serious knee pathology.
