The correlation between MRI and Arthroscopy in knee injuries Author: Miler Georgiana Coauthor:...
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Transcript of The correlation between MRI and Arthroscopy in knee injuries Author: Miler Georgiana Coauthor:...
The correlation between
MRI and Arthroscopy in knee injuries
Author: Miler GeorgianaCoauthor: Vitalis LorandCoordinator: Lecturer Russu Octav, MD, PhD
Knee trauma
Injuries of the knee joint occur most often due to trauma at this level;
The most commonly affected part is the anterior cruciate ligament,as well as both the internal and external meniscus;
The anterior cruciate ligament and the two menisci are prone to injuries when the knee rotates during a sustained effort;
The severity of this type of injuries depends on its location, on the degree of stretching, as well as the physical shape and muscle strength.
Aim of study
To highlight the correlation between MRI and Arthroscopic knee injuries
Material and methods:
The retrospective study was performed on a group of 60 patients with knee injuries during one year( 2013 ) , which received medical care at the clinic of Orthopaedics and Traumatology 2 in Targu-Mures;
Anatomic elements studied : • Anterior cruciate ligament• Posterior cruciate ligament• Internal collateral ligament• Internal meniscus• External meniscus• Persistent vertical septum• Baker cyst • Reactive synovitis• Outerbridge chondropathy
Statistic study used: correlation coefficient Kappa ( which evaluates the agreement rate between the two techniques )
Value of K Strength of agreement
< 0.20 Poor
0.21 - 0.40 Fair
0.41 - 0.60 Moderate
0.61 - 0.80 Good
0.81 - 1.00 Very good
Age distribution
Gender distribution
ACL on MRI and Arthroscopy
Kappa coefficient=0.90Arthroscopic ACL lesion
Total
absent prezent
MRI ACL lesion
absent
Number 0 3 3
% row 0,00% 100,00% 100,00%
% column 0,00% 8,10% 7,00%
% total 0,00% 7,00% 7,00%
prezent
Number 6 34 40
% row 15,00% 85,00% 100,00%
% column 100,00% 91,90% 93,00%
% total 14,00% 79,10% 93,00%
Total
Number 6 37 43
% row 14,00% 86,00% 100,00%
% column 100,00% 100,00% 100,00%
% total 14,00% 86,00% 100,00%
43 patients with ACL injuries, 93% on MRI, 86% on Arthroscopy and both 79.1%; Kappa coefficient is 0.90, which indicates a very good strength of agreement between the
two techniques ;
PCL lesion on MRI and Arthroscopy
Not enough datas to calculate a Kappa coefficient
Arthroscopic PCL lesion
Total
absent
MRI PCL lesion prezent
Number 2 2
% row 100,00% 100,00%
% column 100,00% 100,00%
% total 100,00% 100,00%
Total
Number 2 2
% row 100,00% 100,00%
% column 100,00% 100,00%
% total 100,00% 100,00%
I have only 2 patients with PCL injuries and both stood out on MRI and Arthroscopy;
Internal collateral ligament lesion on MRI and Arthroscopy
Kappa coefficient
Arthroscopic Internal collateral ligament lesion
Total
prezent
MRI internal collateral ligament lesion
prezentă
Number 1 1
% row 100,00% 100,00%
% column 100,00% 100,00%
% total 100,00% 100,00%
Total
Number 1 1
% row 100,00% 100,00%
% column 100,00% 100,00%
% total 100,00% 100,00%
IM lesion on MRI and Arthroscopy
Coeficientul Kappa=0.96Arthroscopic IM lesion
Total
absent prezent
MRI IM lesion
absent
Number 0 1 1
% row 0,00% 100,00% 100,00%
% column 0,00% 2,40% 2,30%
% total 0,00% 2,30% 2,30%
prezent
Number 2 41 43
% row 4,70% 95,30% 100,00%
% column 100,00% 97,60% 97,70%
% total 4,50% 93,20% 97,70%
Total
Number 2 42 44
% row 4,50% 95,50% 100,00%
% column 100,00% 100,00% 100,00%
% total 4,50% 95,50% 100,00%
44 patients with IM injuries, 97.7% on MRI, 95.5% on Arthroscopy and both 93.2%;
Kappa coefficient is 0.96, , which indicates a very good strength of agreement between the two techniques ;
EM lesion on MRI and Arthroscopy
Kappa coefficient=0.74Arthroscopic EM lesion
Total
absent prezent
MRI EM lesion
absent
Number 0 5 5
% row 0,00% 100,00% 100,00%
% column 0,00% 23,80% 17,90%
% total 0,00% 17,90% 17,90%
prezent
Number 7 16 23
% row 30,40% 69,60% 100,00%
% column 100,00% 76,20% 82,10%
% total 25,00% 57,10% 82,10%
Total
Number 7 21 28
% row 25,00% 75,00% 100,00%
% column 100,00% 100,00% 100,00%
% total 25,00% 75,00% 100,00%
28 patients with EM injuries, 82.1% on MRI, 75% on Arthroscopy and both 57.1%;
Kappa coefficient is 0.74, which indicates a good strength of agreement between the two techniques;
Vertical septum persistence on MRI and Arthroscopy
Kappa coefficient
Arthroscopic vertical septum persistence
Total
prezent
MRI vertical septum persistence
absent
Number 4 4
% row 100,00% 100,00%
% column 30,80% 30,80%
% total 30,80% 30,80%
prezent
Number 9 9
% row 100,00% 100,00%
% column 69,20% 69,20%
% total 69,20% 69,20%
Total
Number 13 13
% row 100,00% 100,00%
% column 100,00% 100,00%
% total 100,00% 100,00%
Even though the Kappa coefficient couldn’t be assessed because of a small amount of dates, the injuries stood out at 4 patients on Arthroscopy and at 9 patients on MRI ;
Baker cyst on MRI and Arthroscopy
Kappa coefficient=0.54Arthroscopic Baker cyst
Total
absent prezent
MRI Baker cyst
absent
Number 1 0 1
% row 100,00% 0,00% 100,00%
% column 16,70% 0,00% 14,30%
% total 14,30% 0,00% 14,30%
prezent
Number 5 1 6
% row 83,30% 16,70% 100,00%
% column 83,30% 100,00% 85,70%
% total 71,40% 14,30% 85,70%
Total
Number 6 1 7
% row 85,70% 14,30% 100,00%
% column 100,00% 100,00% 100,00%
% total 85,70% 14,30% 100,00%
7 patients with Baker cyst, 85.7% on MRI, 14.3% on Arthroscopy and both 14.3%;
Kappa coefficient is 0.54, which indicates a moderate strength of agreement ;
Reactive synovitis on MRI and Arthroscopy
Kappa coefficient
Arthroscopic reactive synovitis
Total
prezentă
MRI reactive synovitis absent
Number 51 51
% row 100,00% 100,00%
% column 100,00% 100,00%
% total 100,00% 100,00%
Total
Number 51 51
% row 100,00% 100,00%
% column 100,00% 100,00%
% total 100,00% 100,00%
This kind of lesion stood out only on Arthroscopy at 51 of 60 patients;
Cartilage lesions on MRI and Arthroscopy
Kappa coefficient
Arthroscopic Cartilage lesions
Total
prezentă
MRI Cartilage lesions
absent
Number 26 26
% row 100,00% 100,00%
% column 70,30% 70,30%
% total 70,30% 70,30%
prezent
Number 11 11
% row 100,00% 100,00%
% column 29,70% 29,70%
% total 29,70% 29,70%
Total
Number 37 37
% row 100,00% 100,00%
% cplumn 100,00% 100,00%
% total 100,00% 100,00%
From 37 patients with Cartilage lesions, it stood out on MRI on 11 patients and on Arthroscopy on 26 patients;
The Kappa coefficient couldn’t be assessed;
Conclusions :
The Kappa coefficient couldn’t be assessed in all types of lesions as it didn’t occur often enough; however, these lesions were highlighted both on MRI and Arthroscopy in a significant percentage;
The diagnostic accuracy of arthroscopy and MRI diagnosis of knee lesions is high. Their reliability in diagnosing knee lesions is obvious.
MRI and arthroscopy were compared by using the Kappa coefficient method. The value of the coefficient showed a high agreement between the two techniques.
In conclusion, my study proved to be related to the recent academic researches regarding my topic.
Thank you!