Title: A Descriptive MRI Analysis of Pattern, Location and Grading of Meniscal Injuries of the Knee Joint with Arthroscopic Correlation
Authors: Dr Gopinath. G, Prof. Dr Adaikkapan. M, Prof. Dr Senthilnathan. A, Dr Rajadirajan. S, Dr Sankar. M
DOI: https://dx.doi.org/10.18535/jmscr/v4i11.16
Background: Within a decade of its clinical introduction, magnetic resonance imaging has revolutionized diagnostic imaging of the knee. It has become the imaging test of choice for meniscal pathologies in the knee. Purpose: The objective of this study is to correlate the MRI findings with the arthroscopic findings of meniscal injuries of the knee as well as to analyze the type and grade of meniscal tears. Materials and Methods: MR imaging studies of the knee were performed in 50 clinically suspected patients using a 1.5T MR machine. Various sequences in coronal, sagittal and axial planes were obtained to evaluate the ligaments, menisci, joint effusion and bony contusions. Results: Medial meniscal tear was seen in 46% of cases and lateral meniscal tear was found in 38% of cases. Medial meniscal tear were found in 61% of cases, who had complete ACL tear. Next common ligament to be torn was the medial collateral ligament, which was seen in 14 patients. 57% of these patients had grade 2 tear. Conclusion: MRI is an accurate, non-invasive technique in detecting the meniscal injuries of the knee. It has great capability in classifying them into patterns and grades and can also avoid unnecessary arthroscopic examination. Various sequences are used to identify the tears but certain specific sequences proved to be most useful and should be included as a part of the standard protocol. 1. Keith L Moore, Arthur F Dailey, Clinically Oriented Anatomy- 5th edition, Churchill Livingstone, Edinburgh; 1999 2. Agur AIVIR, Lee MJ. Grants’ Atlas of Anatomy, 9t11 edition. Baltimore: Williams and Wilkins; 1991. 3. DeMaeseneerM, Shahabpour M, Van Roy F,et al. MRimaging of the medial collateral ligament bursa : findings in patients and anatomic data derived from cadavers. AJR Am JRoentgenol200l;177:911-917. 4. Rothstein CP, Laorr A, Helms CA, et al. Sernimembranous — tibial collateral ligament bursitis: MR image findings. AJR Am Roentgenology 1995;155:875-877. 5. Kean DM, Worthingston BS, Preston BJ, et al. Nuclear magnetic resonance imaging of the knee: examples of normal anatomy and pathology. British J Radiol1 983;56(666):3 55-364. 6. Fu Fh, Hamer CD, Vince KG. Knee Surgery, Vol 1 Baltimore (BM): Williams and Wilkins; 1994. 7. Prickett, William D, Ward S, Mathew M. magnetic resonance imaging of the knee. Sports medicine vol 31(1 4),2001 ;997-1 019. 8. Crotty JI\4, Monu JUV, Pope TL Jr. I\4agnetic resonance Imaging of the musculoskeletal system: part 4. The knee. Clinical orthopedics and related research 330:288-303. 9. Hartzman S. Reicher MA, Basset LW, et al. MR imaging of the knee part 2. Chronic disorders. Radiology 1987; 162:553-557. 10. Turner AD, Prodromos C, Petasnick J, Clark JW. Acute injury of the ligaments of the knee: Magnetic Resonance Evaluation 1985;1 54:717-722. 11. Smith Douglas, May David, Philips Paul. MR Imaging of the anterior cruciate ligament: frequency of discordant findings and correlation with arthroscopic findings. Am J Roentgenol 1996;166:41 1-413. 12. Singh JP, Garg L, Shrimalli R, Setia V, Gupta V. MR imaging of the knee with arthroscopic correlation in twisting injuries. IJRI 2004;14(1):33-40. 13. Roberts C, Towers JD, Spangehl, Carrino J, Morisson M/. Advanced MR Imaging of the cruciate ligaments. Magnetic Resonance Imaging Clinics 2007;148:762-765. 14. Ruth Crawford, Gayle Walley, Stephen Bridgman, Nicola Maffulli.(2007). “Magnetic resonance imaging versus arthroscopy in the diagnosis of knee pathology, concentrating on meniscal lesions and ACL tears: a systematic review” Br Med Bull (2007) 84 (1): 5- 23. 15. Ali Akbar Esmaili Jah, Sohrav, Keyhani, Reza Zarei. (2005). “Accuracy of MRI in comparison with clinical and arthroscopic findings in ligamentous and meniscal injuries of the knee”. Acta Orthop. Belg.,2005, 71,189-196. 16. Munk B, Madsen F, Ludorf. (1998). “Clinical magnetic resonance imaging and arthroscopic findings in knees: A comparative prospective study of meniscus, ACL and Cartilage lesions”. March 1998, Vol14(2): 171-175Abstract
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