CORRELATION BETWEEN MRI AND ARTHROSCOPIC FINDINGS IN THE DIAGNOSIS OF KNEE PATHOLOGY IN YOUNG AND ADULT PATIENTS

BACKGROUND: MRI is increasingly used as a diagnostic tool for sports injuries involving the knees before referral to arthroscopy. OBJECTIVES: Since degenerative changes increase with age, we aimed to evaluate whether age affects the accuracy of MRI. METHODS: This is a retrospective study of patients with knee injury whose evaluation included both MRI and arthroscopy. Two age groups were defined: young adults (18-39 years) and adults (40 years and above). RESULTS: Of 966 patients undergoing knee arthroscopy, 132 had preoperative MRI: 48.5% young adults and 51.5% adults. Arthroscopy identified a meniscus tear in 85% and a ligament tear in 21%. Seventeen percent had combined tears and no injury was identified in 4%. The sensitivity and specificity of MRI for ligament tears was 59%, 95%, and for meniscus tears was 91%, and 40%. The sensitivity for bucket handle tears was 86%. The sensitivity of MRI for combined injury was low, 41%. In 8% of patients no pathology was identified by MRI, which was confirmed by arthroscopy in only 4%. One patient with normal MRI had a bucket handle menisceal tear and one other patient had a tear of the anterior cruciate ligament. MRI in adults and young adults revealed that sensitivities for the different types of lesions were similar for both age groups. CONCLUSIONS: Although degenerative changes increase with age, our hypothesis that MRI will be less sensitive in adults was proven wrong. In the presence of appropriate signs and symptoms, older age should not be considered a factor affecting decisions concerning preoperative imaging workup.