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ARTHROSCOPY AND MAGNETIC RESONANCE IMAGING ARTHROGRAPHY IN THE DIAGNOSIS OF RECURRENT MENISCAL TEARS: A DOUBLE BLIND STUDY.



Abstract

Aim: Assessment of the effect of arthrography on the accuracy of MRI studies in the diagnosis of recurrent meniscal tears.

Materials and Methods: A prospective, double blind study was undertaken of 21 patients with a history and clinical examination suggestive of a recurrent meniscal tear. Patients deemed symptomatic enough to justify repeat arthroscopy were also assessed with conventional and contrast enhanced MR imaging. An arthroscopy was performed in order to identify, and where appropriate surgically manage, recurrent meniscal tears. The radiologist performing and reporting the investigations and the surgeons undertaking the arthroscopies were blinded to the results.

Results: 14 patients underwent both the MR scans and the arthroscopies during the period of investigation. An accurate diagnosis of a recurrent meniscal tear was diagnosed in 8 patients on the basis of the conventional MRI, and 7 using MR arthrography. The sensitivity of MRI and MR arthrography in the diagnosis of recurrent meniscal tears was 33%; the specificity of MRI and MR arthrography was 75% and 63% respectively.

Conclusion: Arthrography does not improve the diagnostic accuracy of MRI in assessment for recurrent meniscal tears.

Honorary Secretary – Mr Roger Smith. Correspondence should be addressed to BASK at the Royal College of Surgeons, 35 - 43 Lincoln’s Inn Fields, London WC2A 3PN