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Acute rotational trauma to the knee: poor agreement between clinical assessment and magnetic resonance imaging findings.

Frobell, Richard LU ; Lohmander, Stefan LU and Roos, Harald LU (2007) In Scandinavian Journal of Medicine & Science in Sports 17(2). p.109-114
Abstract
To determine the incidence of anterior cruciate ligament (ACL) injuries in the general population; the pathology associated with a knee sprain verified by magnetic resonance imaging (MRI); and the agreement between clinical findings and MRI.Materials and methods: Inclusion criterion was an acute rotational trauma to the knee associated with effusion. One hundred and fifty-nine consecutive patients, mean age 27 years and 36% women, were included after clinical assessment at the orthopedic emergency unit. Patients were referred to an MRI examination (1.0 or 1.5 T) performed within a median of 8 days of the initial visit.Results: The annual incidence of MRI verified ACL injuries was 0.81/1000 inhabitants aged 10-64 years. Fifty-six percent... (More)
To determine the incidence of anterior cruciate ligament (ACL) injuries in the general population; the pathology associated with a knee sprain verified by magnetic resonance imaging (MRI); and the agreement between clinical findings and MRI.Materials and methods: Inclusion criterion was an acute rotational trauma to the knee associated with effusion. One hundred and fifty-nine consecutive patients, mean age 27 years and 36% women, were included after clinical assessment at the orthopedic emergency unit. Patients were referred to an MRI examination (1.0 or 1.5 T) performed within a median of 8 days of the initial visit.Results: The annual incidence of MRI verified ACL injuries was 0.81/1000 inhabitants aged 10-64 years. Fifty-six percent (n=89) of those included had sustained an ACL injury of whom 38% had an associated medial meniscus tear. There was a poor agreement between initial clinical antero-posterior laxity and MRI verified presence of an ACL tear (kappa 0.281). Every second patellar dislocation was diagnosed as a ligament injury. Conclusions: Our findings indicate that the incidence of ACL injuries is higher than previously described. We also show that the first clinical examination after an acute knee trauma has a low diagnostic value. Further assessment with MRI improves the chances of a correct diagnosis of intraarticular pathology and is recommended in the early phase after a rotational knee trauma. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
knee joint, humans, adult, magnetic resonance imaging, prospective studies, clinical trial, anterior cruciate ligament, adolescent
in
Scandinavian Journal of Medicine & Science in Sports
volume
17
issue
2
pages
109 - 114
publisher
Wiley-Blackwell
external identifiers
  • wos:000244886700003
  • scopus:33947231682
ISSN
1600-0838
DOI
10.1111/j.1600-0838.2006.00559.x
language
English
LU publication?
yes
id
ae03f739-9d8f-4cdd-9089-a2c72d82aa45 (old id 166145)
alternative location
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=17394470&dopt=Abstract
date added to LUP
2007-07-12 11:29:59
date last changed
2017-10-22 04:32:27
@article{ae03f739-9d8f-4cdd-9089-a2c72d82aa45,
  abstract     = {To determine the incidence of anterior cruciate ligament (ACL) injuries in the general population; the pathology associated with a knee sprain verified by magnetic resonance imaging (MRI); and the agreement between clinical findings and MRI.Materials and methods: Inclusion criterion was an acute rotational trauma to the knee associated with effusion. One hundred and fifty-nine consecutive patients, mean age 27 years and 36% women, were included after clinical assessment at the orthopedic emergency unit. Patients were referred to an MRI examination (1.0 or 1.5 T) performed within a median of 8 days of the initial visit.Results: The annual incidence of MRI verified ACL injuries was 0.81/1000 inhabitants aged 10-64 years. Fifty-six percent (n=89) of those included had sustained an ACL injury of whom 38% had an associated medial meniscus tear. There was a poor agreement between initial clinical antero-posterior laxity and MRI verified presence of an ACL tear (kappa 0.281). Every second patellar dislocation was diagnosed as a ligament injury. Conclusions: Our findings indicate that the incidence of ACL injuries is higher than previously described. We also show that the first clinical examination after an acute knee trauma has a low diagnostic value. Further assessment with MRI improves the chances of a correct diagnosis of intraarticular pathology and is recommended in the early phase after a rotational knee trauma.},
  author       = {Frobell, Richard and Lohmander, Stefan and Roos, Harald},
  issn         = {1600-0838},
  keyword      = {knee joint,humans,adult,magnetic resonance imaging,prospective studies,clinical trial,anterior cruciate ligament,adolescent},
  language     = {eng},
  number       = {2},
  pages        = {109--114},
  publisher    = {Wiley-Blackwell},
  series       = {Scandinavian Journal of Medicine & Science in Sports},
  title        = {Acute rotational trauma to the knee: poor agreement between clinical assessment and magnetic resonance imaging findings.},
  url          = {http://dx.doi.org/10.1111/j.1600-0838.2006.00559.x},
  volume       = {17},
  year         = {2007},
}