Division of Arthroscopy and Sports Medicine, Department of Orthopaedics and Trauma, National Orthopaedic Hospital, Igbobi, Lagos State, Nigeria.
Radiology Department. Olabisi Onabanjo University Teaching Hospital, Sagamu, Ogun State, Nigeria.
West Afr J Med. 2021 Jan;38(1):15-18.
Anterior Cruciate Ligament (ACL) injuries may be accompanied by associated injuries such as meniscal injuries. Clinical evaluation alone may at times miss the diagnosis of ACL injury and one or more associated injuries. However, an adjuvant diagnostic tool such as an MRI of the knee may be unaffordable to some patients. The goal of this study was to compare the sensitivity, specificity and predictive value of clinical and magnetic resonance image (MRI) findings in the diagnosis of anterior cruciate ligament and meniscal injuries.
This was a prospective study. The cases of ACL injury recruited had a magnetic resonance imaging of the injured knee, and knee arthroscopy done. The clinical, magnetic resonance imaging and arthroscopic diagnostic findings were all noted. The sensitivity, specificity, positive predictive value and negative predictive values of clinical and MRI findings were compared, with arthroscopic findings as gold standard.
A total of seventy-seven patients were recruited for the study. There were fifty-four males and twenty three females. The results of the tests of the sensitivity, specificity, positive predictive value and negative predictive value of clinical diagnosis and MRI when compared with arthroscopy findings, in detecting meniscal and anterior cruciate ligament injuries were as follows: For Clinical evaluation; Anterior Cruciate ligament: 81%, 80%, 86% and 76%; Medial Meniscus: 84%, 77%, 84% and 93%; and Lateral Meniscus: 85%, 77%, 85% and 82% respectively. For MRI: Anterior Cruciate Ligament (ACL): 87%, 89%, 93% and 78% ; Medial Meniscus: 87% 79%, 70% and 82%; and the Lateral Meniscus: 70%, 76% 73% and 72%.
The specificity, sensitivity and predictive value of clinical and MRI findings were comparable in relation to the diagnosis of ACL and Medial Meniscus tears. However, the values of these parameters were better with clinical examination than with MRI in relation to the diagnosis of lateral meniscus tears.
前交叉韧带（ACL）损伤可能伴有半月板损伤等相关损伤。仅凭临床评估有时可能会漏诊 ACL 损伤和一种或多种相关损伤。然而，对于一些患者来说，磁共振成像（MRI）等辅助诊断工具可能负担不起。本研究的目的是比较临床和磁共振成像（MRI）检查结果在诊断前交叉韧带和半月板损伤中的敏感性、特异性和预测值。
这是一项前瞻性研究。招募的 ACL 损伤病例均对受伤的膝关节进行了 MRI 检查和膝关节镜检查。记录了临床、磁共振成像和关节镜诊断发现。以关节镜检查结果为金标准，比较了临床和 MRI 检查结果的敏感性、特异性、阳性预测值和阴性预测值。
共有 77 例患者入组本研究。其中男性 54 例，女性 23 例。与关节镜检查结果相比，临床诊断和 MRI 检查在检测半月板和前交叉韧带损伤时的测试敏感性、特异性、阳性预测值和阴性预测值结果如下：对于临床评估；前交叉韧带：81%、80%、86%和 76%；内侧半月板：84%、77%、84%和 93%；外侧半月板：85%、77%、85%和 82%。对于 MRI：前交叉韧带（ACL）：87%、89%、93%和 78%；内侧半月板：87%、79%、70%和 82%；外侧半月板：70%、76%、73%和 72%。
临床和 MRI 检查结果在诊断 ACL 和内侧半月板撕裂方面的特异性、敏感性和预测值相当。然而，在诊断外侧半月板撕裂方面，临床检查的这些参数值要好于 MRI。
