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Acute knee trauma: value of a short dedicated extremity MR imaging examination for prediction of subsequent treatment.

Abstract：

PURPOSE:To assess the predictive value of a short magnetic resonance (MR) imaging examination, in addition to or instead of radiography, performed in patients with acute knee trauma to identify those who require additional treatment versus those who do not and can be discharged without further follow-up. MATERIALS AND METHODS:The randomized controlled trial and use of collected data for prediction modeling were approved by the institutional review board; informed consent was obtained. Patients with recent knee injury were included in the trial if radiography was ordered. They were randomized into a group undergoing only radiography and a group undergoing radiography plus immediate MR imaging. A 0.2-T dedicated extremity MR imager and four short pulse sequences were used. Univariable and multivariable logistic regression analysis was used to evaluate patient characteristics, trauma mechanism, and findings at radiography and MR imaging for their value in prediction of need for subsequent treatment within the 6-month follow-up. RESULTS:Data in 189 patients (123 male patients, 66 female patients; mean age, 33.4 years), 109 of whom underwent treatment after their initial visit, were analyzed. Age of 30 years or older, indirect trauma mechanism, radiographic results, and MR imaging results were significant predictors of need for treatment in univariable and multivariable analyses (P < .05). In the multivariable analysis, only abnormal MR imaging results were significantly predictive of need for treatment, and only when MR imaging replaced radiography (odds ratio, 2.61; 95% confidence interval: 1.12, 6.06). CONCLUSION:Implementation of a dedicated extremity MR imaging examination, in addition to or instead of radiography, performed in patients with traumatic knee injury improves prediction of the need for additional treatment but does not significantly aid in identification of patients who can be discharged without further follow-up. Value of a short MR imaging examination in the initial stage after knee trauma is limited.

journal_name

Radiology

journal_title

Radiology

authors

Oei EH,Nikken JJ,Ginai AZ,Krestin GP,Verhaar JA,van Vugt AB,Hunink MG

doi

10.1148/radiol.2341031062

subject

Has Abstract

pub_date

2005-01-01 00:00:00

pages

125-33

issue

eissn

0033-8419

issn

1527-1315

pii

234/1/125

journal_volume

234

pub_type

临床试验,杂志文章,随机对照试验

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Acute knee trauma: value of a short dedicated extremity MR imaging examination for prediction of subsequent treatment.