[Diagnostic Approaches to Acute Knee Injury in Childhood and Adolescence. Yesterday and Today]

Overview

Journal Unfallchirurg

Date 2010 Apr 24

PMID 20414633

Authors

M Maier

E V Geiger

L Sellnow

D Schneidmuller

N Vennemann

M Mack

I Marzi

Affiliations

Soon will be listed here.

Abstract

Introduction: Clinical examination of acute knee injury in childhood is often difficult and therefore magnetic resonance imaging (MRI) serves as an additional diagnostic tool. The aim of the present study was to evaluate on the one hand the indications for diagnostic arthroscopy and on the other hand the indications for MRI.

Methods: Of the children treated between 1990 and 1999, 87 (group 1) underwent arthroscopy after clinical examination. Between 2000 and 2006 (group 2) 83 patients were examined using MRI after clinical examination and 53 were subsequently submitted to arthroscopy.

Results: In group 1 the clinical diagnosis was verified by arthroscopy in 79%. In group 2 the clinical and arthroscopic diagnoses were consistent in 60% of the patients. The MRI diagnosis was correctly recognized for patella dislocation in all cases, for ligament injuries in 83% and for meniscus injuries in 56%. Due to the application of MRI before arthroscopy the fraction of diagnostic arthroscopies could be reduced from 22% to 13%.

Conclusion: The number of diagnostic arthroscopies in childhood can be reduced by application of MRI.

References

Park G, Kim J, Lee S, Lee M . The value of ultrasonography in the detection of meniscal tears diagnosed by magnetic resonance imaging. Am J Phys Med Rehabil. 2007; 87(1):14-20. DOI: 10.1097/PHM.0b013e31815e643a. View

Feller J, Webster K . Clinical value of magnetic resonance imaging of the knee. ANZ J Surg. 2001; 71(9):534-7. DOI: 10.1046/j.1440-1622.2001.02183.x. View

Zaidi A, Babyn P, Astori I, White L, Doria A, Cole W . MRI of traumatic patellar dislocation in children. Pediatr Radiol. 2006; 36(11):1163-70. DOI: 10.1007/s00247-006-0293-0. View

Pennington J, Jones D, McIntyre S . Clinical pathways in total knee arthroplasty: a New Zealand experience. J Orthop Surg (Hong Kong). 2003; 11(2):166-73. DOI: 10.1177/230949900301100211. View

King S . Magnetic resonance imaging of knee injuries in children. Eur Radiol. 1997; 7(8):1245-51. DOI: 10.1007/s003300050284. View

Yoon Y, Kim S, Chung H, Choe B, Ahn J . Diagnostic efficacy in knee MRI comparing conventional technique and multiplanar reconstruction with one-millimeter FSE PDW images. Acta Radiol. 2007; 48(8):869-74. DOI: 10.1080/02841850701459791. View

Frobell R, Lohmander L, Roos H . Acute rotational trauma to the knee: poor agreement between clinical assessment and magnetic resonance imaging findings. Scand J Med Sci Sports. 2007; 17(2):109-14. DOI: 10.1111/j.1600-0838.2006.00559.x. View

Schneidmueller D, Maier M, Mack M, Straub R, Marzi I . [Therapeutic relevance of magnetic resonance imaging in joint injuries in children]. Unfallchirurg. 2005; 108(7):537-43. DOI: 10.1007/s00113-005-0936-x. View

Friemert B, Oberlander Y, Danz B, Haberle H, Bahren W, Gerngross H . [MRI vs. arthroscopy in the diagnosis of cartilage lesions in the knee. Can MRI take place of arthroscopy?]. Zentralbl Chir. 2002; 127(10):822-7. DOI: 10.1055/s-2002-35125. View

10.

Yoon Y, Rah J, Park H . A prospective study of the accuracy of clinical examination evaluated by arthroscopy of the knee. Int Orthop. 1997; 21(4):223-7. PMC: 3617692. DOI: 10.1007/s002640050155. View

11.

Runkel M, Kreitner K, Regentrop H, Kersjes W . [Sensitivity of magnetic resonance tomography in detecting meniscus tears]. Unfallchirurg. 2001; 103(12):1079-85. DOI: 10.1007/s001130050672. View

12.

AICHROTH P, Patel D, Zorrilla P . The natural history and treatment of rupture of the anterior cruciate ligament in children and adolescents. A prospective review. J Bone Joint Surg Br. 2002; 84(1):38-41. DOI: 10.1302/0301-620x.84b1.11773. View

13.

Kocher M, DiCanzio J, Zurakowski D, Micheli L . Diagnostic performance of clinical examination and selective magnetic resonance imaging in the evaluation of intraarticular knee disorders in children and adolescents. Am J Sports Med. 2001; 29(3):292-6. DOI: 10.1177/03635465010290030601. View

14.

Wittenberg R, Lutke A, Longwitz D, Greskotter K, Willburger R, Schmidt K . The correlation between magnetic resonance imaging and the operative and clinical findings after lumbar microdiscectomy. Int Orthop. 1998; 22(4):241-4. PMC: 3619616. DOI: 10.1007/s002640050250. View

15.

Fischer S, Fox J, Del Pizzo W, Friedman M, Snyder S, Ferkel R . Accuracy of diagnoses from magnetic resonance imaging of the knee. A multi-center analysis of one thousand and fourteen patients. J Bone Joint Surg Am. 1991; 73(1):2-10. View

16.

Abdon P, Bauer M . Incidence of meniscal lesions in children. Increase associated with diagnostic arthroscopy. Acta Orthop Scand. 1989; 60(6):710-1. DOI: 10.3109/17453678909149610. View

17.

Agneskirchner J, Lobenhoffer P . [Arthroscopic meniscus surgery: technical-operative methods]. Unfallchirurg. 2004; 107(9):795-801. DOI: 10.1007/s00113-004-0841-8. View

18.

Bryan S, Bungay H, Weatherburn G, Field S . Magnetic resonance imaging for investigation of the knee joint: a clinical and economic evaluation. Int J Technol Assess Health Care. 2004; 20(2):222-9. DOI: 10.1017/s026646230400100x. View

19.

Luhmann S, Schootman M, Gordon J, Wright R . Magnetic resonance imaging of the knee in children and adolescents. Its role in clinical decision-making. J Bone Joint Surg Am. 2005; 87(3):497-502. DOI: 10.2106/JBJS.C.01630. View

20.

Glynn N, Morrison W, Parker L, Schweitzer M, Carrino J . Trends in utilization: has extremity MR imaging replaced diagnostic arthroscopy?. Skeletal Radiol. 2004; 33(5):272-6. DOI: 10.1007/s00256-004-0750-5. View