HOME HELP CONTACT US SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:
Sign In to gain access to subscriptions and/or personal tools.

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Request Permissions Request Reprints Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Mandelbaum, B. R. Articles by Dorey, F. Search for Related Content PubMed Articles by Mandelbaum, B. R. Articles by Dorey, F.

Magnetic resonance imaging as a tool for evaluation of traumatic knee injuries

Anatomical and pathoanatomical correlations

Division of Orthopaedic Surgery

Gerald A.M. Finerman, MD

Division of Orthopaedic Surgery

Murray A. Reicher, MD

Department of Radiological Sciences, UCLA School of Medicine, Los Angeles, California

Steven Hartzman, MD

Department of Radiological Sciences, UCLA School of Medicine, Los Angeles, California

Larry W. Bassett, MD

Department of Radiological Sciences, UCLA School of Medicine, Los Angeles, California

Richard H. Gold, MD

Department of Radiological Sciences, UCLA School of Medicine, Los Angeles, California

Wolfgang Rauschning, MD

Department of Radiological Sciences, UCLA School of Medicine, Los Angeles, California

Fred Dorey, PhD

Division of Orthopaedic Surgery

Traumatic injury to the knee remains a diagnostic and therapeutic challenge. Magnetic resonance imaging (MRI) has been applied to musculoskeletal pathoa natomy and has been shown to be an effective tool for definition and characterization of knee pathology. A systematic approach is taken to establish anatomical and pathoanatomical correlations, as well as the role of MRI in the management of knee injuries.

Imaging was performed at the UCLA Medical Center using a permanent magnet system and a combination of solenoidal surface coils and thin-section, high-reso lution scanning techniques. Images depict structural anatomical and spatial details of the knee that correlate well with corresponding cadaveric cryosections. To determine pathoanatomical correlations and the effi cacy of MRI, 105 patients with preoperative diagnoses of meniscal tears, anterior and posterior cruciate liga ment tears, tibial plateau fracture, and patella and quad riceps injuries were imaged.

Results indicated that for the medial meniscus MRI demonstrated a 95.7% sensitivity, 81.8% specificity, 90% accuracy, 88.2% positive predictive value (PPV), and 93.1 % negative predictive value (NPV). Imaging of the lateral meniscus demonstrated a 75% sensitivity, 95% specificity, 91 % accuracy, 80% PPV, and 94% NPV. MRI of the ACL revealed 100% sensitivity, spec ificity, accuracy, positive and negative predictive values. MRI is a noninvasive tool which uses no ionizing radiation and can accurately define and characterize anatomy and pathoanatomy. This study indicates that MRI in conjunction with clinical evaluation can contrib ute to treatment decision-making processes and assist in preoperative planning. An algorithm demonstrating the potential clinical use of MRI is presented.

This article has been cited by other articles:

				S. Gohil, P. O. Annear, and W. Breidahl Anterior cruciate ligament reconstruction using autologous double hamstrings: a comparison of standard versus minimal debridement techniques using MRI to assess revascularisation: A RANDOMISED PROSPECTIVE STUDY WITH A ONE-YEAR FOLLOW-UP J Bone Joint Surg Br, September 1, 2007; 89-B(9): 1165 - 1171. [Abstract] [Full Text] [PDF]

				S. J. Luhmann, M. Schootman, J. E. Gordon, and R. W. Wright Magnetic Resonance Imaging of the Knee in Children and Adolescents. Its Role in Clinical Decision-Making J. Bone Joint Surg. Am., March 1, 2005; 87(3): 497 - 502. [Abstract] [Full Text] [PDF]

				J. L. Jackson, P. G. O'Malley, and K. Kroenke Evaluation of Acute Knee Pain in Primary Care Ann Intern Med, October 7, 2003; 139(7): 575 - 588. [Abstract] [Full Text] [PDF]

				A. Weiler, G. Peters, J. Maurer, F. N. Unterhauser, and N. P. Sudkamp Biomechanical Properties and Vascularity of an Anterior Cruciate Ligament Graft Can Be Predicted by Contrast-Enhanced Magnetic Resonance Imaging: A Two-Year Study in Sheep Am. J. Sports Med., November 1, 2001; 29(6): 751 - 761. [Abstract] [Full Text] [PDF]

				R. L. Cothran Jr., N. M. Major, C. A. Helms, and L. D. Higgins MR Imaging of Meniscal Contusion in the Knee Am. J. Roentgenol., November 1, 2001; 177(5): 1189 - 1192. [Abstract] [Full Text] [PDF]

				M. S. Kocher, J. DiCanzio, D. Zurakowski, and L. J. Micheli Dignostic Performance of Clinical Examination and Selective Magnetic Resonance Imaging in the Evaluation of Intraarticular Knee Disorders in Children and Adolescents Am. J. Sports Med., May 1, 2001; 29(3): 292 - 296. [Abstract] [Full Text] [PDF]

				M. J. Matava, K. Eck, W. Totty, R. W. Wright, and R. A. Shively Magnetic Resonance Imaging as a Tool to Predict Meniscal Reparability Am. J. Sports Med., July 1, 1999; 27(4): 436 - 443. [Abstract] [Full Text] [PDF]

				Accuracy of Imaging the Menisci on an In-Office, Dedicated, Magnetic Resonance Imaging Extremity System*: Peter D. Franklin,{dagger} MD, Richard A. Lemon,{ddagger}{section} MD, and Howard S. Barden,||a PhD Am. J. Sports Med., June 1, 1997; 25(3): 382 - 388. [Abstract] [PDF]

				H. J. Gelb, S. G. Glasgow, A. A. Sapega, and J. S. Torg Magnetic Resonance Imaging of Knee Disorders: Clinical Value and Cost-Effectiveness in a Sports Medicine Practice Am. J. Sports Med., January 1, 1996; 24(1): 99 - 103. [Abstract] [PDF]

				R. F. LaPrade, Q. M. Burnett II, M. A. Veenstra, and C. G. Hodgman The Prevalence of Abnormal Magnetic Resonance Imaging Findings in Asymptomatic Knees: With Correlation of Magnetic Resonance Imaging to Arthroscopic Findings in Symptomatic Knees Am. J. Sports Med., December 1, 1994; 22(6): 739 - 745. [Abstract] [PDF]

				R. M. Maywood, B. J. Murphy, J. W. Uribe, and K. S. Hechtman Evaluation of arthroscopic anterior cruciate ligament reconstruction using magnetic resonance imaging Am. J. Sports Med., July 1, 1993; 21(4): 523 - 527. [Abstract] [PDF]

				J. J. Bonamo, K. J. Kessler, and J. Noah Arthroscopic meniscectomy in patients over the age of 40 Am. J. Sports Med., July 1, 1992; 20(4): 422 - 429. [Abstract] [PDF]

				S. M. Howell, J. A. Clark, and R. D. Blasier Serial magnetic resonance imaging of hamstring anterior cruciate ligament autografts during the first year of implantation: A preliminary study Am. J. Sports Med., January 1, 1991; 19(1): 42 - 47. [Abstract] [PDF]

				M. L. Gross, L. L. Seeger, J. B. Smith, B. R. Mandelbaum, and G. A.M. Finerman Magnetic resonance imaging of the glenoid labrum Am. J. Sports Med., June 1, 1990; 18(3): 229 - 234. [Abstract] [PDF]

				D.W. Jackson, L.D. Jennings, R.M. Maywood, and P.E. Berger Magnetic resonance imaging of the knee Am. J. Sports Med., January 1, 1988; 16(1): 29 - 38. [Abstract] [PDF]