Comparison of clinical examination and magnetic resonance imaging in the diagnosis of internal derangements of the knee

Internal derangements of the knee are the most frequent cause of referation to the knee surgery clinic and operation. In this respect, it is important to evaluate these pathologies correctly and to make a proper diagnosis. The diagnostic tools that we have are history, physical examination, x/rays (clinical evaluation; CE), magnetic resonance imaging (MRI) and arthroscopy. The purpose of this study is to make a comparison between CE and MRI when arthroscopy is accepted as gold standard.Between 1998-2008, 918 patients (968 knees) with mean age of 43.9 were evaluated arthroscopically. %52 of these patients were male and %48 were female. For the patients treated arthroscopically, the findings and final diagnosis of CE and MRI (if available) and the data of the findings after arthroscopic examination were recorded to the arthroscopy form. Arthroscopic findings were referred as gold standard, sensitivity, specifity and accuracy rates of CE and MRI were determined and statistical analysis was made in the internal derangements of the knee.For medial meniscal lesions, sensitivity of CE was %84.5, specifity %60.8, for MRI these values were %92.0 and %55.1 respectively, for lateral meniscal lesions, sensitivity of CE was %50.5, specifity %96.1, for MRI these values were %58.5 and %95.6 respectively, for anterior cruciate lesions, sensitivity of CE was %84.9, specifity %94.8, for MRI these values were %92.9 and %98.1 respectively, for cartilage lesions, sensitivity of CE was %64.7, specifity %90.6, for MRI these values were %36.3 and %96.5 respectively. Between CE and MRI there was no difference between values of sensitivity, specivity for all groups.As a result, internal derangements of the knee can be diagnosed by CE as current as MRI.