American Journal of Roentgenology, Vol 167, 121-126, Copyright © 1996 by American Roentgen Ray Society

ARTICLES

MR imaging of anterior cruciate ligament injury: independent value of primary and secondary signs

EA Brandser, MA Riley, KS Berbaum, GY el-Khoury and DL Bennett
Department of Radiology, University of Iowa College of Medicine, University of Iowa Hospitals and Clinics, Iowa City 52242, USA.

OBJECTIVE. The purpose of this blinded study was to test the value of primary and secondary signs, independent of each other, for diagnosis of a tear of the anterior cruciate ligament (ACL) by means of MR imaging. MATERIALS AND METHODS. MR images of the knee in 74 patients who had the status of the ACL confirmed arthroscopically were blindly reviewed for status of the ACL three times: with primary signs masked, with secondary signs masked, and with no signs masked. On the basis of the observed signs at each session, the status of the ACL was predicted and the confidence in that prediction was noted. The MR imaging predictions were compared with the arthroscopic findings. The results were analyzed with receiver operating characteristic curves and stepwise discriminant analysis. RESULTS. We found no difference in diagnostic performance when only primary signs were used and when both primary and secondary signs were used. When using primary signs only, our observers performed significantly better than when using secondary signs alone. However, with secondary signs alone, our observers performed better than if left to chance for predicting ACL status. Of the secondary signs, our statistical analysis found bone contusion, anterior translation of the tibia, and an uncovered posterior horn of the lateral meniscus to be the most useful for diagnosis. CONCLUSION. Secondary signs do have value for deciding ACL status independent of primary signs. However, our observers performed much better when using primary signs instead of secondary signs. In the clinical setting, secondary signs do not help significantly in the diagnosis of ACL tears by means of MR imaging.
CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				J Bining, G Andrews, and B B Forster The ABCs of the anterior cruciate ligament: a primer for magnetic resonance imaging assessment of the normal, injured and surgically repaired anterior cruciate ligament Br. J. Sports Med., October 1, 2009; 43(11): 856 - 862. [Abstract] [Full Text] [PDF]

				C. H. Yeow, C. H. Cheong, K. S. Ng, P. V. S. Lee, and J. C. H. Goh Anterior Cruciate Ligament Failure and Cartilage Damage During Knee Joint Compression: A Preliminary Study Based on the Porcine Model Am. J. Sports Med., May 1, 2008; 36(5): 934 - 942. [Abstract] [Full Text] [PDF]

				S. S.-h. Chiu The anterior tibial translocation sign. Radiology, June 1, 2006; 239(3): 914 - 915. [Full Text] [PDF]

				J. S. Prince, T. Laor, and J. A. Bean MRI of Anterior Cruciate Ligament Injuries and Associated Findings in the Pediatric Knee: Changes with Skeletal Maturation Am. J. Roentgenol., September 1, 2005; 185(3): 756 - 762. [Abstract] [Full Text] [PDF]

				J. L. Jackson, P. G. O'Malley, and K. Kroenke Evaluation of Acute Knee Pain in Primary Care Ann Intern Med, October 7, 2003; 139(7): 575 - 588. [Abstract] [Full Text] [PDF]

				C. A. Helms The Impact of MR Imaging in Sports Medicine Radiology, September 1, 2002; 224(3): 631 - 635. [Abstract] [Full Text] [PDF]

				B. C. Vande Berg, F. E. Lecouvet, P. Poilvache, J.-E. Dubuc, B. Maldague, and J. Malghem Anterior Cruciate Ligament Tears and Associated Meniscal Lesions: Assessment at Dual-Detector Spiral CT Arthrography Radiology, May 1, 2002; (2002) 2232011024. [Abstract] [Full Text]

				A. A. De Smet, D. A. Asinger, and R. L. Johnson Abnormal Superior Popliteomeniscal Fascicle and Posterior Pericapsular Edema: Indirect MR Imaging Signs of a Lateral Meniscal Tear Am. J. Roentgenol., January 1, 2001; 176(1): 63 - 66. [Abstract] [Full Text]

				K. Lee, M. J. Siegel, D. M. Lau, C. F. Hildebolt, and M. J. Matava Anterior Cruciate Ligament Tears: MR Imaging-based Diagnosis in a Pediatric Population Radiology, December 1, 1999; 213(3): 697 - 704. [Abstract] [Full Text]

				P. A. Kaplan, R. H. Gehl, R. G. Dussault, M. W. Anderson, and D. R. Diduch Bone Contusions of the Posterior Lip of the Medial Tibial Plateau (Contrecoup Injury) and Associated Internal Derangements of the Knee at MR Imaging Radiology, June 1, 1999; 211(3): 747 - 753. [Abstract] [Full Text]

				B. C. Vande Berg, F. E. Lecouvet, P. Poilvache, J.-E. Dubuc, B. Maldague, and J. Malghem Anterior Cruciate Ligament Tears and Associated Meniscal Lesions: Assessment at Dual-Detector Spiral CT Arthrography Radiology, May 1, 2002; 223(2): 403 - 409. [Abstract] [Full Text] [PDF]