CORRELATIONS BETWEEN CLINICAL ASPECTS NMR ARTHROSCOPY IN ACUTE KNEE TRAUMA

Authors study retrospectively 81 cases of isolated recent (less than t hree months) knee traumas. These include clinical aspects, NMR, arthro scopy. Clinical examinations have been graded : 1. possible lesion; 2. likely lesions; 3. confirmed lesions. Clinical examinations and NMR r esults are compared to arthroscopy considered as reference. Clinical e xamination of acute traumatic knee is essential. Neverthelss, its valu e for detecting precise lesions is poor, except for knee locking well correlated with meniscal tears. Results show that NMR provide better r esults than clinical examination. NMR is reliable for detecting tears of posterior cruciate ligament, tears of posterior horn of menisci (se nsibility : 93 %; specificity : 80 %). Its results are less effective for appreciation of lesion of anterior cruciate ligament (sensibility : 88 %; specificity : 78 %) because of partial tears and functional bu t not morphologic damage. It is the only method able to evidence osteo chondral injuries and soft-tissues associated lesions in traumatic kne es. Emergency NMR scans show results no differences in results compare d with routine examinations. However, one should keep in mind that neg ative NMR cannot exclude small cartilaginous lesions and partial tears of anterior cruciate ligament. According to these results and the kno wn qualities of NMR (non invasive), we propose that this type of inves tigation should be more largely included in diagnostic attitude for ac ute injured knee. Emergency diagnostic arthroscopy could be efficientl y replaced by NMR knee examination.