Comparison of preoperative magnetic resonance imaging reports, examination and intraoperative arthroscopy findings in knee joint pathologies

Background: The knee joint is one of the most frequently injured joints due to the lack of muscle support,a load bearing joint,and increased sports activities. The diagnosis of knee joint pathologies is diagnosed by anamnesis,physical examination and imaging methods. MRI is one of the most common imaging methods in the knee joint because of its success in showing soft tissues. In our country, the density of outpatient applications decreases the physical examination evaluation periods of patients. Due to increased imaging studies, the time allocated for MRI reporting is reduced by radiologists. We believe that the diagnostic success of examination and MRI reports in the pathology of the knee joint due to the intensity of the Daily Polyclinic functioning conditions has decreased. Matherials and methods: In this study,we retrospectively performed physical examination in our outpatient clinic, performed MRI for pathology detected, and 1.5 tesla MRI was performed in various centers and 172 patients operated in our clinic were included. Mcmurray,applley,lachman and pivot shift examinations,meniscus lesions reported in MRI,ACL,PCL,cartilage lesion,medial patellar plica were recorded. The achievements of physical examination and MRI reporting were compared with the gold standard arthroscopy findings.Kappa analysis was performed for the evaluation of the adaptation between.P<0.05 was considered statistically significant. Results: The Mcmurray and Apley test had 76%- 73% sensitivity, 73%-82% specificity, 76%- The Mcmurray and Apley test had 76%- 73% sensitivity, 73%-82% specificity, 76%-75% consistency ,and the level of compliance was Kappa-065, -068(weak), respectively.75% consistency ,and the level of compliance was Kappa-065, -068(weak), respectively. The sensitivity of MRG was 70%, 73% specificity, 70% consistency level and compliance level was 242(low) for meniscus tears. For medial and lateral meniscus tears, 75%-30% sensitivity, 76%-98% specificity, 75%-85% consistency level and Kappa compliance level was 421-381(medium-low). It was found to have 78% sensitivity, 97% specificity, 93% consistency in detecting ACL lesions of MRG and that kappa compliance level was 780(significant). It was determined that MRG had 72% sensitivity, 93% specificity, 81% consistency level for advanced cartilage lesions and that kappa compliance was 632(significant). Conclusions: We found that the success rate of the examinations performed without leaving enough time in the Polyclinic conditions remained low compared to the literature.We concluded that the diagnostic success for medial meniscus was better than lateral meniscus,that the diagnostic success for anterior cross ligament lesions was significant,and that it was important to determine advanced cartilage lesions..However, in Polyclinic conditions for anterior ligament and advanced stage cartilage lesions we found that the reporting could change the diagnosis and treatment protocol.We believe that experience and adequate time allocation in examination and MRI reporting will improve clinical success and that it is not right to decide on the operation alone with physical examination or MRI reports,and that Anamnesis examination and MRI reports should be combined so that unnecessary arthroscopic interventions can be avoided.