The correlation between MRI and Arthroscopy in knee injuries Author: Miler Georgiana Coauthor:...
-
Upload
georgia-emerald-shields -
Category
Documents
-
view
217 -
download
0
Transcript of The correlation between MRI and Arthroscopy in knee injuries Author: Miler Georgiana Coauthor:...
![Page 1: The correlation between MRI and Arthroscopy in knee injuries Author: Miler Georgiana Coauthor: Vitalis Lorand Coordinator: Lecturer Russu Octav, MD, PhD.](https://reader036.fdocuments.net/reader036/viewer/2022062518/56649f395503460f94c567cb/html5/thumbnails/1.jpg)
The correlation between
MRI and Arthroscopy in knee injuries
Author: Miler GeorgianaCoauthor: Vitalis LorandCoordinator: Lecturer Russu Octav, MD, PhD
![Page 2: The correlation between MRI and Arthroscopy in knee injuries Author: Miler Georgiana Coauthor: Vitalis Lorand Coordinator: Lecturer Russu Octav, MD, PhD.](https://reader036.fdocuments.net/reader036/viewer/2022062518/56649f395503460f94c567cb/html5/thumbnails/2.jpg)
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;
![Page 3: The correlation between MRI and Arthroscopy in knee injuries Author: Miler Georgiana Coauthor: Vitalis Lorand Coordinator: Lecturer Russu Octav, MD, PhD.](https://reader036.fdocuments.net/reader036/viewer/2022062518/56649f395503460f94c567cb/html5/thumbnails/3.jpg)
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.
![Page 4: The correlation between MRI and Arthroscopy in knee injuries Author: Miler Georgiana Coauthor: Vitalis Lorand Coordinator: Lecturer Russu Octav, MD, PhD.](https://reader036.fdocuments.net/reader036/viewer/2022062518/56649f395503460f94c567cb/html5/thumbnails/4.jpg)
Aim of study
To highlight the correlation between MRI and Arthroscopic knee injuries
![Page 5: The correlation between MRI and Arthroscopy in knee injuries Author: Miler Georgiana Coauthor: Vitalis Lorand Coordinator: Lecturer Russu Octav, MD, PhD.](https://reader036.fdocuments.net/reader036/viewer/2022062518/56649f395503460f94c567cb/html5/thumbnails/5.jpg)
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;
![Page 6: The correlation between MRI and Arthroscopy in knee injuries Author: Miler Georgiana Coauthor: Vitalis Lorand Coordinator: Lecturer Russu Octav, MD, PhD.](https://reader036.fdocuments.net/reader036/viewer/2022062518/56649f395503460f94c567cb/html5/thumbnails/6.jpg)
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
![Page 7: The correlation between MRI and Arthroscopy in knee injuries Author: Miler Georgiana Coauthor: Vitalis Lorand Coordinator: Lecturer Russu Octav, MD, PhD.](https://reader036.fdocuments.net/reader036/viewer/2022062518/56649f395503460f94c567cb/html5/thumbnails/7.jpg)
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
![Page 8: The correlation between MRI and Arthroscopy in knee injuries Author: Miler Georgiana Coauthor: Vitalis Lorand Coordinator: Lecturer Russu Octav, MD, PhD.](https://reader036.fdocuments.net/reader036/viewer/2022062518/56649f395503460f94c567cb/html5/thumbnails/8.jpg)
Age distribution
![Page 9: The correlation between MRI and Arthroscopy in knee injuries Author: Miler Georgiana Coauthor: Vitalis Lorand Coordinator: Lecturer Russu Octav, MD, PhD.](https://reader036.fdocuments.net/reader036/viewer/2022062518/56649f395503460f94c567cb/html5/thumbnails/9.jpg)
Gender distribution
![Page 10: The correlation between MRI and Arthroscopy in knee injuries Author: Miler Georgiana Coauthor: Vitalis Lorand Coordinator: Lecturer Russu Octav, MD, PhD.](https://reader036.fdocuments.net/reader036/viewer/2022062518/56649f395503460f94c567cb/html5/thumbnails/10.jpg)
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 ;
![Page 11: The correlation between MRI and Arthroscopy in knee injuries Author: Miler Georgiana Coauthor: Vitalis Lorand Coordinator: Lecturer Russu Octav, MD, PhD.](https://reader036.fdocuments.net/reader036/viewer/2022062518/56649f395503460f94c567cb/html5/thumbnails/11.jpg)
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;
![Page 12: The correlation between MRI and Arthroscopy in knee injuries Author: Miler Georgiana Coauthor: Vitalis Lorand Coordinator: Lecturer Russu Octav, MD, PhD.](https://reader036.fdocuments.net/reader036/viewer/2022062518/56649f395503460f94c567cb/html5/thumbnails/12.jpg)
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%
![Page 13: The correlation between MRI and Arthroscopy in knee injuries Author: Miler Georgiana Coauthor: Vitalis Lorand Coordinator: Lecturer Russu Octav, MD, PhD.](https://reader036.fdocuments.net/reader036/viewer/2022062518/56649f395503460f94c567cb/html5/thumbnails/13.jpg)
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 ;
![Page 14: The correlation between MRI and Arthroscopy in knee injuries Author: Miler Georgiana Coauthor: Vitalis Lorand Coordinator: Lecturer Russu Octav, MD, PhD.](https://reader036.fdocuments.net/reader036/viewer/2022062518/56649f395503460f94c567cb/html5/thumbnails/14.jpg)
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;
![Page 15: The correlation between MRI and Arthroscopy in knee injuries Author: Miler Georgiana Coauthor: Vitalis Lorand Coordinator: Lecturer Russu Octav, MD, PhD.](https://reader036.fdocuments.net/reader036/viewer/2022062518/56649f395503460f94c567cb/html5/thumbnails/15.jpg)
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 ;
![Page 16: The correlation between MRI and Arthroscopy in knee injuries Author: Miler Georgiana Coauthor: Vitalis Lorand Coordinator: Lecturer Russu Octav, MD, PhD.](https://reader036.fdocuments.net/reader036/viewer/2022062518/56649f395503460f94c567cb/html5/thumbnails/16.jpg)
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 ;
![Page 17: The correlation between MRI and Arthroscopy in knee injuries Author: Miler Georgiana Coauthor: Vitalis Lorand Coordinator: Lecturer Russu Octav, MD, PhD.](https://reader036.fdocuments.net/reader036/viewer/2022062518/56649f395503460f94c567cb/html5/thumbnails/17.jpg)
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;
![Page 18: The correlation between MRI and Arthroscopy in knee injuries Author: Miler Georgiana Coauthor: Vitalis Lorand Coordinator: Lecturer Russu Octav, MD, PhD.](https://reader036.fdocuments.net/reader036/viewer/2022062518/56649f395503460f94c567cb/html5/thumbnails/18.jpg)
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;
![Page 19: The correlation between MRI and Arthroscopy in knee injuries Author: Miler Georgiana Coauthor: Vitalis Lorand Coordinator: Lecturer Russu Octav, MD, PhD.](https://reader036.fdocuments.net/reader036/viewer/2022062518/56649f395503460f94c567cb/html5/thumbnails/19.jpg)
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.
![Page 20: The correlation between MRI and Arthroscopy in knee injuries Author: Miler Georgiana Coauthor: Vitalis Lorand Coordinator: Lecturer Russu Octav, MD, PhD.](https://reader036.fdocuments.net/reader036/viewer/2022062518/56649f395503460f94c567cb/html5/thumbnails/20.jpg)
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.
![Page 21: The correlation between MRI and Arthroscopy in knee injuries Author: Miler Georgiana Coauthor: Vitalis Lorand Coordinator: Lecturer Russu Octav, MD, PhD.](https://reader036.fdocuments.net/reader036/viewer/2022062518/56649f395503460f94c567cb/html5/thumbnails/21.jpg)
Thank you!