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 re sults are compared to arthroscopy considered as reference. Clinical ex amination of acute traumatic knee is essential. Nevertheless, 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 but not mo rphologic damage. It is the only method able to evidence osteochondral injuries and soft-tissues associated lesions in traumatic knees. Emer gency NMR scans show results no differences in results compared with r outine examinations. However, one should keep in mind that negative NM R cannot exclude small cartilaginous lesions and partial tears of ante rior cruciate ligament. According to these results and the known quali ties of NMR (non invasive), we propose that this type of investigation should be more largely included in diagnostic attitude for acute inju red knee. Emergency diagnostic arthroscopy could be efficiently replac ed by NMR knee examination.