Sensitivity and Specificity of Clinical Examination, Magnetic Resonance Imaging and Arthroscopy in the Diagnosis of Chronic Knee Joint Injury

Original article


Elfadli M, Boshalla H, Makhlouf S, Khalil M, Hassan Noh H

Department of Orthopaedic and Trauma , Al-Jala Hospital Benghazi, Libya

JMJ 2009;9(4):294-296


Objective: To compare the accuracy of clinical examination and magnetic resonance imaging (MRI) findings versus arthroscopy findings in chronic knee injuries. Methods: During the years 2003 to 2007, we evaluated 60 patients (58 male,2 female) with an average age of 28.5 years ( range 17 to 52 years ) with chronic knee injuries. All patients were admitted to Al-Jala Hospital, Benghazi, Libya. After clinical examination, MRI reports reviewed and arthroscopy performed, .Statistical analysis including specificity, sensitivity, accuracy, positive and negative predictive values were calculated. Results: By comparing the positive results, for medial meniscal tears, lateral meniscal tears, and anterior cruciate ligament in clinical findings, MRI, and arthroscopic findings we found no significant difference between the three type (x2=2.16 p > 0.05). This study revelled that there was a significant difference between the accuracy of clinical examination and MRI in the diagnosis of medial and lateral meniscal tears ( McNemar’s test x2 =0.022, p<0.05), were it was higher in clinical examination (93.3%) and (71.7% ) in MRI for medial meniscus tears. Conclusion: Although MRI is an accurate, non-invasive method of evaluating knee pathologies, it was, no more accurate than clinical examination in this study. The experienced surgeon can safely rely on clinical skills. Routine ordering of an MRI is not needed. MRI can be useful adjunct to clinical examination in selected cases, but the surgeon must be aware of its limitations. Keywords: Arthroscopic surgery, Magnetic resonance imaging, Clinical examination, knee Link/DOI: