A COMPARISON OF ACCURACY BETWEEN CLINICAL EXAMINATION AND MAGNETIC-RESONANCE-IMAGING IN THE DIAGNOSIS OF MENISCAL AND ANTERIOR CRUCIATE LIGAMENT TEARS

A prospective and retrospective study was undertaken to compare the ac curacy of magnetic resonance imaging (MRI) with clinical examination i n diagnosing meniscal and anterior cruciate ligament (ACL) tears. Path ological findings were then confirmed during arthroscopy, One hundred fifty-four patients clinically diagnosed with a meniscal or ACL tear w ho ultimately had arthroscopic knee surgery were evaluated; 100 patien ts underwent clinical examination followed by MRI, and 54 underwent cl inical examination alone. The presence or absence of meniscal and ACL tears was confirmed during arthroscopy, The accuracies of clinical exa mination and MRI were compared for the 100 patients who underwent both clinical examination and MRI. The accuracy of MRI was 75% for medial meniscal tears, 69% for lateral meniscal tears and 98% for ACL tears. The accuracy of clinical examination was 82% for medial meniscal tears , 76% for lateral meniscal tears and 99% for complete tears of the ACL . Furthermore, the accuracy of clinical examination for the 54 patient s who underwent clinical examination alone was not significantly diffe rent from the accuracy of clinical examination in the 100 patients who also underwent MRI. There was no significant difference between the a ccuracy of clinical examination and MRI in the diagnosis of meniscal a nd ACL tears and, overall, MRI contributed to treatment in only 16 of 100 cases. Based on these findings, we feel that MRI, except in certai n circumstances, is an expensive and unnecessary diagnostic test in pa tients with suspected meniscal and ACL pathology.