EC Orthopaedics

Rationale: MRI scan reports should accurately describe relevant pathologic and anatomic abnormalities which may be a source of symptoms, given this is the gold standard for non-invasive diagnosis of soft tissue knee conditions.

Objective: The aim of this study was to review MRI (magnetic resonance imaging) scan reports of patients with common soft tissue knee joint problems by two clinician groups; senior radiologists and specialist knee surgeons to determine, define and analyse similarities and discrepancies.

Methods: A retrospective cohort study was conducted using data collected from a consecutive series of patients seen by a single practitioner using a standardised, detailed proforma, in an outpatient Orthopaedic Department Knee Clinic in an English District Hospital. Patients were aged 18 to 45, with the first presentation of knee problems only with no history past history of knee problems, injuries or other polyarthropathy. From the selected cohort of 74 patients, there were 87 knee MRI scans (13 patients had bilateral scans), undertaken after the detailed clinical history and examination, which was documented in a standardised fashion. The MRI reports from both the consultant knee surgeon and the radiologist were entered into a database, along with demographic and clinical information. The reports were collated and analysed to determine whether they agreed, levels of agreement and key areas of discrepancy.

The null hypothesis and clinical expectation was that there was no discrepancy between MRI reports of radiologists and knee surgeons.

Results: Of 87 knee MRI reports, 14% (n = 12) completely agreed. 45% of the reports (n = 39) partially agreed and 41% (n = 36) completely disagreed. Of reports which partially agreed, 79% (n = 31) had a percentage agreement of ≤ 50%. There was strong agreement for meniscal and ACL tears.

Conclusion: This study reveals that discrepancies between MRI reports of two clinician groups are common, in this patient cohort. This has implications for both patients and practitioners.

Keywords: MRI; Knee; Soft Tissue Knee; Radiology

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