Agreement Between Clinical Examination and Magnetic Resonance Imaging in Acute Knee Trauma With Hemarthrosis
Brown, Jamie Sutherland LU
; Frobell, Richard B.
LU
; Isacsson, Anders
LU
; Englund, Martin
LU
and Olsson, Ola
LU
(2022)
In Clinical Journal of Sport Medicine
32(4).
p.401-406
- Abstract
Objective:Hemarthrosis after knee trauma often indicates serious joint injury. Few studies have evaluated agreement between clinical examination and findings from magnetic resonance imaging (MRI). We aimed to describe the agreement between acute clinical examination and subacute MRI findings after acute knee trauma with hemarthrosis and the importance of the subspecialty of the examiner.Design:Longitudinal cohort study. Agreement with MRI findings was evaluated by logistic regression.Setting:Helsingborg hospital.Patients:Thousand one hundred forty-five consecutive patients with hemarthrosis after knee trauma.Interventions:Clinical examination and MRI.Main outcome measures:agreement between clinical examination and findings from MRI. We... (More)
Objective:Hemarthrosis after knee trauma often indicates serious joint injury. Few studies have evaluated agreement between clinical examination and findings from magnetic resonance imaging (MRI). We aimed to describe the agreement between acute clinical examination and subacute MRI findings after acute knee trauma with hemarthrosis and the importance of the subspecialty of the examiner.Design:Longitudinal cohort study. Agreement with MRI findings was evaluated by logistic regression.Setting:Helsingborg hospital.Patients:Thousand one hundred forty-five consecutive patients with hemarthrosis after knee trauma.Interventions:Clinical examination and MRI.Main outcome measures:agreement between clinical examination and findings from MRI. We considered the radiologist's report as the gold standard.Results:Median time (25th, 75th percentile) from injury to clinical examination was 2 (1, 7) days, and from injury to imaging was 8 (5, 15) days. The overall sensitivity and specificity of clinical examination versus MRI for major ligament injury or lateral patella dislocation (LPD) were 70% [95% confidence interval 67-73) and 66% (61-72), respectively. Orthopedic subspecialist knee had the highest agreement with anterior cruciate ligament rupture (adjusted odds ratios were 1.7 (95% confidence interval 1.2-2.3), 1.9 (1.2-3.0) and 5.9 (3.7-9.5) for orthopedic trainees, orthopedic subspecialists other, and orthopedic subspecialist knee, respectively]. For other ligament injuries and LPD, we did not find statistically significant differences.Conclusions:Clinical diagnosis after acute knee injury is relatively unreliable versus MRI findings even when performed by orthopedic specialists. However, the agreement is improved when the examination is performed by an orthopedic knee subspecialist.
(Less)
- author
- Brown, Jamie Sutherland
LU
; Frobell, Richard B.
LU
; Isacsson, Anders
LU
; Englund, Martin
LU
and Olsson, Ola
LU
- organization
- publishing date
- 2022-07-01
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- acute knee trauma, Anterior Cruciate Ligament, lateral collateral ligament, magnetic resonance imaging, medial collateral ligament, Patella dislocation, posterior cruciate ligament
- in
- Clinical Journal of Sport Medicine
- volume
- 32
- issue
- 4
- pages
- 6 pages
- publisher
- Lippincott Williams & Wilkins
- external identifiers
-
- pmid:34117155
- scopus:85133144339
- ISSN
- 1050-642X
- DOI
- 10.1097/JSM.0000000000000950
- language
- English
- LU publication?
- yes
- additional info
- Publisher Copyright: © 2022 Lippincott Williams and Wilkins. All rights reserved.
- id
- 9a4b7f3d-5fc1-4f38-bf3f-5e4792f6de10
- date added to LUP
- 2022-09-08 12:43:54
- date last changed
- 2024-04-15 04:35:31
@article{9a4b7f3d-5fc1-4f38-bf3f-5e4792f6de10,
abstract = {{<p>Objective:Hemarthrosis after knee trauma often indicates serious joint injury. Few studies have evaluated agreement between clinical examination and findings from magnetic resonance imaging (MRI). We aimed to describe the agreement between acute clinical examination and subacute MRI findings after acute knee trauma with hemarthrosis and the importance of the subspecialty of the examiner.Design:Longitudinal cohort study. Agreement with MRI findings was evaluated by logistic regression.Setting:Helsingborg hospital.Patients:Thousand one hundred forty-five consecutive patients with hemarthrosis after knee trauma.Interventions:Clinical examination and MRI.Main outcome measures:agreement between clinical examination and findings from MRI. We considered the radiologist's report as the gold standard.Results:Median time (25th, 75th percentile) from injury to clinical examination was 2 (1, 7) days, and from injury to imaging was 8 (5, 15) days. The overall sensitivity and specificity of clinical examination versus MRI for major ligament injury or lateral patella dislocation (LPD) were 70% [95% confidence interval 67-73) and 66% (61-72), respectively. Orthopedic subspecialist knee had the highest agreement with anterior cruciate ligament rupture (adjusted odds ratios were 1.7 (95% confidence interval 1.2-2.3), 1.9 (1.2-3.0) and 5.9 (3.7-9.5) for orthopedic trainees, orthopedic subspecialists other, and orthopedic subspecialist knee, respectively]. For other ligament injuries and LPD, we did not find statistically significant differences.Conclusions:Clinical diagnosis after acute knee injury is relatively unreliable versus MRI findings even when performed by orthopedic specialists. However, the agreement is improved when the examination is performed by an orthopedic knee subspecialist.</p>}},
author = {{Brown, Jamie Sutherland and Frobell, Richard B. and Isacsson, Anders and Englund, Martin and Olsson, Ola}},
issn = {{1050-642X}},
keywords = {{acute knee trauma; Anterior Cruciate Ligament; lateral collateral ligament; magnetic resonance imaging; medial collateral ligament; Patella dislocation; posterior cruciate ligament}},
language = {{eng}},
month = {{07}},
number = {{4}},
pages = {{401--406}},
publisher = {{Lippincott Williams & Wilkins}},
series = {{Clinical Journal of Sport Medicine}},
title = {{Agreement Between Clinical Examination and Magnetic Resonance Imaging in Acute Knee Trauma With Hemarthrosis}},
url = {{http://dx.doi.org/10.1097/JSM.0000000000000950}},
doi = {{10.1097/JSM.0000000000000950}},
volume = {{32}},
year = {{2022}},
}