Alshoabi Sultan Abdulwadoud, Atassi Mohammed G, Alhamadi Mohammed A, Tashkandi A A, Alatowi Kamal M, Alnehmi Fawwaz S, Binmodied Abdul-Rub A, Gameraddin Moawia B, Daqqaq Tareef S
Department of Diagnostic Radiology Technology, College of Applied Medical Sciences, Taibah University, Almadinah Almunawwarah, Kingdom of Saudi Arabia.
Department of Radiology and Medical Imaging, Prince Mohamad bin Abdulaziz Hospital, National Guard, Almadinah Almunawwarah, Kingdom of Saudi Arabia.
J Family Med Prim Care. 2020 Feb 28;9(2):1154-1159. doi: 10.4103/jfmpc.jfmpc_949_19. eCollection 2020 Feb.
This study aimed to assess the meniscus and cruciate ligament lesions of the knee using magnetic resonance imaging (MRI) and to investigate the correlation between clinical and MRI diagnoses.
Herein, we reviewed the electronic medical records of 240 patients who underwent knee MRI. The images were evaluated and then the clinical and MRI diagnoses were compared.
Of the 240 patients, 66% were male and the mean age was 40.6 ± 15.5 years (range, 2-79 years). Knee pain alone was the most common presenting symptom (50.64%) followed by pain after trauma (47.92%). Majority of the knee lesions were medial meniscus (MM) lesions (63%) followed by osteoarthritis (48%) and ACL lesions (35%). The majority of the MM and ACL lesions were tears (54.6% and 69.41%, respectively) followed by degeneration (33.55% and 17.65%, respectively). However, the MM lesions were predominantly observed in the posterior horn (Odds ratio [OR], 152; 95% confidence interval (CI), 21.550-1072.113; < 0.001). The ACL lesions were significantly more common in men than in women (OR, 0.355; 95% CI, 0.191-0.661; = 0.001), and altered signal intensity on T2- and proton density-weighted images was the most common sign ( < 0.001). A strong compatibility was observed between the clinical and MRI diagnoses (Kappa = 0.141; < 0.001).
MM and ACL lesions are the most common injuries of the knee, which can be diagnosed by physical examination in most cases. Further confirmation by MRI should be reserved for doubtful cases only.
本研究旨在利用磁共振成像（MRI）评估膝关节半月板和交叉韧带损伤，并研究临床诊断与MRI诊断之间的相关性。
在此，我们回顾了240例行膝关节MRI检查患者的电子病历。对图像进行评估，然后比较临床诊断与MRI诊断。
240例患者中，66%为男性，平均年龄为40.6±15.5岁（范围2至79岁）。单纯膝关节疼痛是最常见的首发症状（50.64%），其次是外伤后疼痛（47.92%）。大多数膝关节损伤为内侧半月板（MM）损伤（63%），其次是骨关节炎（48%）和前交叉韧带（ACL）损伤（35%）。大多数MM和ACL损伤为撕裂（分别为54.6%和69.41%），其次是退变（分别为33.55%和17.65%）。然而，MM损伤主要见于后角（优势比[OR]，152；95%置信区间[CI]，21.550至1072.113；P<0.001）。ACL损伤在男性中显著多于女性（OR，0.355；95%CI，0.191至0.661；P=0.001），T2加权像和质子密度加权像上信号强度改变是最常见的征象（P<0.001）。临床诊断与MRI诊断之间观察到高度一致性（Kappa=0.141；P<0.001）。
MM和ACL损伤是膝关节最常见的损伤，大多数情况下可通过体格检查诊断。仅在可疑病例中才应通过MRI进一步确诊。
