Acute rotational trauma to the knee: poor agreement between clinical assessment and magnetic resonance imaging findings.

Abstract:

OBJECTIVES:To determine the incidence of anterior cruciate ligament (ACL) injuries in the general population; the pathology associated with a knee sprain verified by magnetic resonance imaging (MRI); and the agreement between clinical findings and MRI. MATERIAL AND METHODS:Inclusion criterion was an acute rotational trauma to the knee associated with effusion. One hundred and fifty-nine consecutive patients, mean age 27 years and 36% women, were included after clinical assessment at the orthopedic emergency unit. Patients were referred to an MRI examination (1.0 or 1.5 T) performed within a median of 8 days of the initial visit. RESULTS:The annual incidence of MRI verified ACL injuries was 0.81/1000 inhabitants aged 10-64 years. Fifty-six percent (n=89) of those included had sustained an ACL injury of whom 38% had an associated medial meniscus tear. There was a poor agreement between initial clinical antero-posterior laxity and MRI verified presence of an ACL tear (kappa 0.281). Every second patellar dislocation was diagnosed as a ligament injury. CONCLUSION:Our findings indicate that the incidence of ACL injuries is higher than previously described. We also show that the first clinical examination after an acute knee trauma has a low diagnostic value. Further assessment with MRI improves the chances of a correct diagnosis of intraarticular pathology and is recommended in the early phase after a rotational knee trauma.

journal_name

Scand J Med Sci Sports

authors

Frobell RB,Lohmander LS,Roos HP

doi

10.1111/j.1600-0838.2006.00559.x

subject

Has Abstract

pub_date

2007-04-01 00:00:00

pages

109-14

issue

2

eissn

0905-7188

issn

1600-0838

pii

SMS559

journal_volume

17

pub_type

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