MRI of the Knee with Arthroscopic Correlation

Department of Orthopaedic Surgery, University of Virginia, 400 Ray C. Hunt Drive, Suite 300, P.O. Box 800159, Charlottesville, VA 22908, USA.
Clinics in sports medicine (Impact Factor: 1.22). 07/2013; 32(3):507-23. DOI: 10.1016/j.csm.2013.03.004
Source: PubMed


Major advances in MRI and arthroscopy have allowed for enhanced diagnosis and subsequent management of ligamentous and soft tissue injuries of the knee. Recognition of the appearance of acute ACL and PCL injuries on MRI can enhance arthroscopic reconstruction. PCL injuries are often more subtle and can present with indirect signs. T2-weighted MRI imaging can examine which structures have been damaged in the posterolateral corner which may manifest arthroscopically as a drive-through sign. Characterization of PLC, meniscus, MCL injuries and OCD lesions on MRI have remarkable correlation with arthroscopic findings. This article focuses on current understanding of how MRI and athroscopy can enhance treatment of ligamentous and soft tissue injuries of the knee.

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    ABSTRACT: Background The knee is the largest and one of the most complex joints of the human body. Registered Advanced Nurse Practitioners frequently encounter patients with knee injuries as part of their practice due to the knees inherent instability and vulnerability to trauma. The posterolateral corner (PLC) of the knee has a complex anatomy of osseous, myotendinous and ligamentous structures to provide stability. PLC injuries may be present in 9.1% of acute knee injuries with haemarthrosis, and 68% of patients with tibial plateau fractures. Methods The following paper is a case study based on a patient who presented to the Emergency Department (ED), focusing on initial assessment and management of a patient who presented with an injury to the posterolateral knee Results This case study increases awareness of PLC injuries, and the importance of prompt recognition and management to ensure optimal outcomes for patients. The paper raises many discussion points including the benefits of collaborative care, the role of clinical diagnostic tests, analgesia, the various imaging required to supplement musculoskeletal and neuromuscular evaluation of these injuries and appropriate disposal. Conclusion Unrecognised injuries to the PLC can result in profound symptomatic knee instability. This case study highlights the diagnostic approach and challenges to managing patients with acute knee injuries, and specifically how timely assessment, prompt recognition and appropriate management in the ED assists in achieving optimal outcomes for patients.
    International Emergency Nursing 08/2014; 23(2). DOI:10.1016/j.ienj.2014.07.008 · 0.72 Impact Factor