Diagnostic Accuracy Of Ultrasonography In The Evaluation Of The Knee Joint Injuries Compared To MRI And Arthroscopy.

Abstract

BACKGROUND: High-resolution ultrasonography is becoming a leading imaging modality in the evaluation of musculoskeletal systems. It is economical, readily available, allows dynamic assessment of the knee joint, and findings can be compared with the contralateral side.
OBJECTIVES: To calculate sensitivity, specificity, and diagnostic accuracy of Ultrasonography in the evaluation of Menisco-Ligamentous injuries of knee joint keeping MRI and Arthroscopy (wherever applicable) as the gold standard for comparison.
PARTICIPANTS: Clinically suspected patients having knee ligamentous or meniscal injuries.
METHODS: In this Prospective study, 60 patients with clinically suspected Menisco-Ligamentous injuries were recruited. These patients underwent Ultrasonography of the injured knee as well as normal knee and MRI of the injured knee on the same day. MRI diagnosis was considered as final. Arthroscopy was done in 24 patients only having high-grade meniscal tears and cruciate ligament injuries requiring intervention. The absolute agreement was found between MRI and Arthroscopy in these 24 patients.USG findings were correlated with MRI to calculate its sensitivity, specificity, and diagnostic accuracy.
RESULTS: A total of 60 patients (50 males, 10 females) were diagnosed of having meniscal/ligamentous tears on USG and MRI. The majority of the patients (50%) belonged to the age group of 21-40 years. The most common injury seen in our study was medial meniscal tear followed by medial collateral ligament injury. The strength of agreement between USG and MRI was good with the Diagnostic accuracy of USG ranging from 83.3% to 95% for different meniscal/ ligamentous injuries.
CONCLUSION: Based on our results, it was concluded that USG is an effective imaging modality that has a positive effect on the management of many patients presenting with knee injuries. Knee USG has high accuracy in diagnosing menisco-ligamentous injuries. A wide availability, lower cost, and fair reliability make it a modality of the first choice for the evaluation of knee injuries. MRI can be reserved for patients with suspicious USG results.
KEYWORDS: HRUS High-Resolution Ultrasonography, PD Proton Density, ACL Anterior Cruciate Ligament, MM Medial Meniscus, MCL Medial Collateral Ligament.