ARTHROSCOPIES

REVIEW IN CLINICALLY SUSPECTED KNEE INJURIES BUT NORMAL MRI (42 CASES)

Abstract

Knee pain due to injury is a common presentation in orthopedic outpatient
department. X-rays, MRI and arthroscopy are the basic investigation tools when meniscoligametous
injury is suspected. If MRI is normal usually arthroscopy is withheld. In this study
we analyzed the arthroscopic findings of such cases in which X rays and MRI were normal
or near normal. Objectives: 1- To find out knee injuries in patients with painful knees. 2- To
find out any other pathology of knee joint. Design: It’s a retrospective study in which 42 such
cases were analyzed who underwent arthroscopy with a normal or near normal MRI. Setting:
This study includes cases done at CMH Rawalpindi, Muzaffarabad, Kharian and Malir. Period
includes May 2005 to August 2014. A total number of 209 arthroscopies were done by the
same orthopedic surgeon. Results: Out of 42 cases 31 were males while 11 were females.
Mean age was 31.4 years (range 18-54 years).In all cases arthroscopy was done by the same
orthopedic surgeon within 6 weeks of MRI. MRI films were reported by a qualified radiologist. In
all cases there was a strong clinical suspicion of menisco-ligamentous injury while X-rays and
MRI were near normal or normal. Out of 42 cases in 36 (85.7%) cases, one or more findings
were detected on arthroscopy which were not picked by MRI. Conclusions: It is concluded
that if a menisco-ligamentous injury is strongly suspected in a knee on clinical examination,
arthroscopic evaluation should not be denied to a patient even if X-rays and MRI are normal.