Accuracy of standard MRI sequences for meniscal tears and grading of chondral lesions in the knee, relative to knee arthroscopy: A prospective study of 719 cases

Introduction: Musculoskeletal magnetic resonance imaging (MRI) is commonly used for diagnosis and research, but its accuracy remains unproven clinical usefulness questionable. The goal of this study was to compare the knee MRI with assessment diagnosing meniscal tears, determine grading chondral lesions, relative arthroscopy. Methods: Physically active patients presenting acute / sub-acute onset mechanical symptoms, in absence grade 2-3 ligament injury or true locking, that had been preventing them from taking part their usual physical activity at least 4 weeks, findings warranted a arthroscopy, both arthroscopy an performed. Patients were over age 18 years, fit general anaesthetic, no contraindications MRI, prepared undergo both. A standard performed intra-operative compared those using International Chondral Research Society (ICRS) damage, presence tear. All MRIs on either 1.5T 3.0T machine, sequences. Results: 719 recruited period 6.5 years. Their average 52 years (standard deviation, SD 5.2), male:female ratio 493:226. Kappa scores errors (SE) agreement between 0.41 (SE 0.1) medial 0.44 lateral tears. For SE values 0.09 (0.1), 0.17 0.22 (0.07) anterior, compartments respectively. Using areas under receiver operating characteristic curves, we found more accurate than tears (P<0.001), similar (P=0.12). Discussion: relatively poor correlation arthroscopic damage less Other research has suggested overused practice may increase number arthroscopies Up 40% diagnosed tear Insufficient will undermine validity any which modality primary role methodology. Conflict interest declaration: My co-authors I acknowledge have conflict relevance submission abstract.