A Prospective study of Correlation between Clinical, MRI and Arthroscopic Findings in Internal Derangement of Knee

William Abraham, A (2020) A Prospective study of Correlation between Clinical, MRI and Arthroscopic Findings in Internal Derangement of Knee. Masters thesis, Madras Medical College, Chennai.

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Abstract

BACKGROUND AND OBJECTIVES: Internal derangements of the knee is a common presenting clinical condition in the orthopaedic OPD. It is important to deal these cases with accurate diagnosis and early treatment. MRI is a proved sensitive and accurate noninvasive tool in investigating internal derangements of knee but false and misleading results are equally reported in the literature. The clinical examination and standard tests to determine instability and internal derangements still stands as preliminary, more reliable and cost effective way of diagnosing such knee problems. Hence this study is intended to determine the benefits of arthroscopy directly and also to compare the sensitivity and specificity of clinical, MRI and arthroscopy in diagnosing internal derangements of the knee. METHODOLOGY: This is a prospective study of 35 cases of internal derangements of the knee admitted in the institute of Orthopaedics and Traumatology who underwent MRI and Arthroscopy of the knee. Cases were taken according to inclusion and exclusion criteria i.e., Patients suffering from knee problems like pain, instability and with recent symptoms of locking of knee or effusion, Patients who have undergone MRI due to any other indication which confirms Internal derangement of knee, Patients with chronic knee pain and doubtful knee injury, Patients aged between 17-60yrs. RESULTS: In our study of 35 cases, there were 23 male and 12 female patients with age ranging from 17 years to 60 years with most patients in between 21-30 years. 10 cases admitted were sport injuries, 16 had motor vehicle accidents and 9 due to domestic falls. Right side being more common side affected. Although MRI is found to be a sensitive noninvasive diagnostic tool, it still has a high rate of false and misleading results. Arthroscopy correlates better with clinical findings and also has an additional advantage of being therapeutic modality. CONCLUSION: In conclusion the present study supports that clinical diagnosis is of primary necessity and MRI is additional diagnosing tool for IDK. Arthroscopy combines more accurate diagnosing tool and therapeutic modality which is more convenient, economical and convincing technique to both surgeon and patients alike. However high expectations from patients’ knowing the diagnosis before undergoing interventional procedures like arthroscopy and insurance companies expecting evidence for undergoing such procedure makes MRI as the highly demanding and needed technique in diagnosing IDK. However MRI has false and misleading in specific knee pathologies as being reported in the standard literature which is confirmed in our study also. It is concluded that arthroscopy still remains the gold standard in diagnosing the internal derangements of the knee.

Item Type: Thesis (Masters)
Additional Information: 221712013
Uncontrolled Keywords: Clinical, MRI, Arthroscopic Findings, Internal Derangement of Knee, Prospective study.
Subjects: MEDICAL > Orthopaedics
Depositing User: Subramani R
Date Deposited: 13 Feb 2021 13:29
Last Modified: 13 Feb 2021 13:29
URI: http://repository-tnmgrmu.ac.in/id/eprint/14098

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