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The Validation of Clinical Examination and MRI as a Diagnostic Tool for Cruciate Ligaments and Meniscus Injuries of the Knee Against Diagnostic Arthroscopy.膝关节十字韧带和半月板损伤的临床检查及磁共振成像作为诊断工具相对于诊断性关节镜检查的有效性验证
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Use of MRI by radiologists and orthopaedic surgeons to detect intra-articular injuries of the knee.放射科医生和骨科医生使用磁共振成像(MRI)检测膝关节的关节内损伤。
Rev Bras Ortop. 2017 Jan 17;53(1):28-32. doi: 10.1016/j.rboe.2016.12.013. eCollection 2018 Jan-Feb.
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The diagnostic accuracy of magnetic resonance imaging for anterior cruciate ligament injury in comparison to arthroscopy: a meta-analysis.磁共振成像与关节镜检查对前交叉韧带损伤的诊断准确性比较:一项荟萃分析。
Sci Rep. 2017 Aug 8;7(1):7583. doi: 10.1038/s41598-017-08133-4.

本文引用的文献

1
Diagnostic accuracy of a new clinical test (the Thessaly test) for early detection of meniscal tears.一种用于早期检测半月板撕裂的新临床测试(塞萨利测试)的诊断准确性。
J Bone Joint Surg Am. 2005 May;87(5):955-62. doi: 10.2106/JBJS.D.02338.
2
The causes and mechanisms of meniscal injuries in the sporting and non-sporting environment in an unselected population.在未经过筛选的人群中,运动和非运动环境下半月板损伤的原因及机制。
Knee. 2004 Apr;11(2):143-9. doi: 10.1016/S0968-0160(03)00105-4.
3
Valgus knee injuries: evaluation and documentation using a simple technique of stress radiography.
Knee. 2004 Feb;11(1):25-8. doi: 10.1016/S0968-0160(03)00009-7.
4
The rational clinical examination. Does this patient have a torn meniscus or ligament of the knee? Value of the physical examination.合理的临床检查。该患者是否存在膝关节半月板或韧带撕裂?体格检查的价值。
JAMA. 2001 Oct 3;286(13):1610-20. doi: 10.1001/jama.286.13.1610.
5
Acute knee injuries in the immature athlete.未成熟运动员的急性膝关节损伤。
Instr Course Lect. 1993;42:473-81.
6
A practical guide to the initial evaluation and treatment of knee ligament injuries.膝关节韧带损伤的初始评估与治疗实用指南
J Trauma. 1980 Jun;20(6):498-506. doi: 10.1097/00005373-198006000-00012.
7
Early diagnosis and treatment of acute ruptures of the anterior cruciate ligament; a clinical and arthrographic study of forty-eight cases.前交叉韧带急性断裂的早期诊断与治疗;48例临床与关节造影研究
J Bone Joint Surg Am. 1965 Dec;47(8):1503-13.
8
Epidemiology of meniscal lesions in the knee. 1,215 open operations in Copenhagen 1982-84.膝关节半月板损伤的流行病学。1982 - 1984年在哥本哈根进行的1215例开放性手术。
Acta Orthop Scand. 1990 Oct;61(5):435-7. doi: 10.3109/17453679008993557.
9
Incidence of lateral meniscus injury in professional basketball players.职业篮球运动员外侧半月板损伤的发生率。
Am J Sports Med. 1992 Jan-Feb;20(1):17-9. doi: 10.1177/036354659202000105.

磁共振成像在膝关节损伤中的有效性。

Validity of magnetic resonance imaging in knee injuries.

作者信息

Grubor Predrag, Asotic Amina, Grubor Milan, Asotic Mithat

机构信息

Clinic of Traumatology, Clinical Centre, University of Banja Luka, Bosnia and Herzegovina.

出版信息

Acta Inform Med. 2013;21(3):200-4. doi: 10.5455/aim.2013.21.200-204.

DOI:10.5455/aim.2013.21.200-204
PMID:24167392
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3804521/
Abstract

INTRODUCTION

Knee injuries are common in athletes, recreationists, and other people in their everyday activities.

OBJECTIVE

The study is aimed at establishing the validity of clinical findings, MRI and diagnostic arthroscopy of the knee in ACL, PCL, medial or lateral ligament lesions.

METHODS

The prospective research involved 63 inpatients at the Traumatology Clinic in Banja Luka- Niš between 1 January 2011 and 1 June 2012.

RESULTS

When clinically examining the ACL and based on the calculated post-test probability amounting to (LR+) = 0.8017, we conclude that there is a considerable probability (80.17%) that a patient with an arthroscopically diagnosed ACL lesion will have the same lesion diagnosed by MRI. The post-test probability following the clinical examination of the medial meniscus and amounting to (LR+) = 0.6943 suggests that there is a considerable probability (69.43%) that an arthroscopically diagnosed lesion of the medial meniscus will also be diagnosed by MRI. On the basis of the clinical examination of the lateral meniscus in the examined sample and calculated post-test probability amounting to (LR+) = 0.6346, we conclude that there is a considerable difference (63.46%) between the diagnostic arthroscopy and MRI of lateral meniscus lesions.

CONCLUSION

Arthroscopic examination of the knee is a more valuable method than diagnosis by MRI and clinical examination for detecting lesions of the ACL, PCL, medial and lateral meniscus.

摘要

引言

膝关节损伤在运动员、休闲运动者及其他从事日常活动的人群中很常见。

目的

本研究旨在确定膝关节前交叉韧带(ACL)、后交叉韧带(PCL)、内侧或外侧韧带损伤时,临床检查、磁共振成像(MRI)及诊断性关节镜检查结果的有效性。

方法

这项前瞻性研究纳入了2011年1月1日至2012年6月1日期间在巴尼亚卢卡 - 尼什创伤诊所的63名住院患者。

结果

在对ACL进行临床检查时,根据计算得出的检验后概率(LR+)= 0.8017,我们得出结论,关节镜诊断为ACL损伤的患者经MRI诊断为相同损伤的概率相当高(80.17%)。对内侧半月板进行临床检查后的检验后概率(LR+)= 0.6943,这表明关节镜诊断为内侧半月板损伤的患者经MRI诊断为相同损伤的概率相当高(69.43%)。根据对所检查样本中外侧半月板的临床检查及计算得出的检验后概率(LR+)= 0.6346,我们得出结论,外侧半月板损伤的诊断性关节镜检查与MRI之间存在相当大的差异(63.46%)。

结论

对于检测ACL、PCL、内侧和外侧半月板损伤,膝关节镜检查比MRI诊断和临床检查更有价值。