27th April, Spectrum Medical Imaging

Acute knee pain is a pretty common presentation in general practice. In experienced hands, a thorough physical examination can narrow the differential diagnosis to a few common injuries. Often we have to resort to an MRI to confirm our suspicion. How reliable is the MRI diagnosis?

In a novel study to evaluate the reproducibility, repeatability, and agreement of MRI evaluation with the gross pathology examination at operation, in 23 patients undergoing total knee arthroplasty, MRIs were performed just before the surgery (1). MRI evaluation of knee cartilage showed moderate to strong correlation with gross pathology examination. MRI evaluation overestimates cartilage damage in the lateral condyle and underestimates it in the medial condyle. Education and experience of the radiologist play a role in MRI evaluation of knee chondral lesions.

  1. Marinetti A, Tessarolo F, Ventura L, Falzone A, Neri M, Piccoli F, Rigoni M, Masè M, Cortese F, Nollo G, Della Sala SW. Morphological MRI of knee cartilage: repeatability and reproducibility of damage evaluation and correlation with gross pathology examination. Eur Radiol. 2020 Jun;30(6):3226-3235. doi: 10.1007/s00330-019-06627-5. Epub 2020 Feb 13. PMID: 32055948.