膝关节镜检查患者的临床诊断准确性。
Accuracy of clinical diagnosis in patients undergoing knee arthroscopy.
机构信息
Institute of Orthopaedics, Norfolk & Norwich University Hospital, Norwich, UK.
出版信息
Int Orthop. 2010 Feb;34(1):39-44. doi: 10.1007/s00264-009-0760-y. Epub 2009 Apr 1.
A retrospective analysis of patients who underwent knee arthroscopy was undertaken to determine the accuracy of clinical diagnosis when compared with arthroscopic findings, and to see whether any specific pathologies were difficult to diagnose. The preoperative diagnosis was compared with the operative findings and the accuracy, sensitivity and specificity of the clinical diagnosis calculated. Six hundred ninety-eight patients were included. The overall accuracy, sensitivity and specificity of clinical diagnosis was 99%, 70% and 99%, respectively. Ninety percent of patients underwent a beneficial procedure, while 10% had a normal knee diagnosed at operation. Medial meniscal tear was the hardest pathology to diagnose with accuracy, sensitivity and specificity rates of 82%, 92% and 79%, respectively. Clinical examination remains an accurate method of assessing whether patients would benefit from an arthroscopy, although the correct diagnosis may not be determined preoperatively, particularly if pain was located in the medial tibio-femoral joint.
对接受膝关节镜检查的患者进行回顾性分析，以确定临床诊断与关节镜检查结果的准确性，并观察是否存在任何难以诊断的特定病理情况。将术前诊断与手术结果进行比较，并计算临床诊断的准确性、敏感性和特异性。共纳入 698 例患者。临床诊断的总体准确性、敏感性和特异性分别为 99%、70%和 99%。90%的患者接受了有益的手术，而 10%的患者在手术中被诊断为正常膝关节。内侧半月板撕裂是最难准确诊断的病理情况，其准确性、敏感性和特异性分别为 82%、92%和 79%。临床检查仍然是评估患者是否受益于关节镜检查的准确方法，尽管术前可能无法确定正确的诊断，特别是如果疼痛位于内侧胫股关节。
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