CLINICAL EXAMINATION FOR DIAGNOSIS OF MENISCAL INJURY (HOW ACCURATE DOES IT NEED TO BE!)

Abstract

The purpose of the study was to assess the accuracy of clinical examination to diagnose meniscal injury.

Internal Derangement of Knee is one of the most common conditions encountered in routine orthopaedic practice. The ultimate outcome depends upon timely management based on correct diagnosis. There are various tools available to diagnose this condition, mainly clinical examination, MRI & Arthroscopy. The individual method needs to be evaluated on the basis of merits and demerits depending upon the cost, time spent waiting for results and the degree of accuracy it provides.

The study was carried out retrospectively by looking at case notes of 98 patients, who had arthroscopy of the knees with or without MRI. An attempt was made to establish the correlation between the arthroscopic diagnosis and the clinical signs looked for to diagnose meniscal injury.

The result of the study showed that although the accuracy to diagnose the internal derangement prior to arthroscopy was fairly high, poor documentation of clinical examination findings, defeated the purpose of the assessment of accuracy. From patient’s management point of view, it appears that Arthroscopy & MRI have become indispensable tools in the evaluation of the injured knee. They can provide the physician and patient pre treatment prognosis. However they must be utilized as a complimentary to (not instead of) clinical evaluation and judgment. They become less cost-effective if used in a less responsible manner without the appropriate first-line investigations i.e. accurate clinical examination.