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Crijns, Tom, Boersma, Emily, Janssen, Stein, Tonn, Melissa, Ring, David. (1401). Accuracy and Reliability of MRI Reports in Diagnosing the Symptomatic Knee in Patients Who Had Bilateral MRI. , 11(1), 23-28. doi: 10.22038/abjs.2022.52845.2619
Tom J Crijns; Emily Z Boersma; Stein J Janssen; Melissa D Tonn; David Ring. "Accuracy and Reliability of MRI Reports in Diagnosing the Symptomatic Knee in Patients Who Had Bilateral MRI". , 11, 1, 1401, 23-28. doi: 10.22038/abjs.2022.52845.2619
Crijns, Tom, Boersma, Emily, Janssen, Stein, Tonn, Melissa, Ring, David. (1401). 'Accuracy and Reliability of MRI Reports in Diagnosing the Symptomatic Knee in Patients Who Had Bilateral MRI', , 11(1), pp. 23-28. doi: 10.22038/abjs.2022.52845.2619
Crijns, Tom, Boersma, Emily, Janssen, Stein, Tonn, Melissa, Ring, David. Accuracy and Reliability of MRI Reports in Diagnosing the Symptomatic Knee in Patients Who Had Bilateral MRI. , 1401; 11(1): 23-28. doi: 10.22038/abjs.2022.52845.2619

Accuracy and Reliability of MRI Reports in Diagnosing the Symptomatic Knee in Patients Who Had Bilateral MRI

The Archives of Bone and Joint Surgery
مقاله 3، دوره 11، شماره 1، فروردین 2023، صفحه 23-28    اصل مقاله (464.46 K)
نوع مقاله: RESEARCH PAPER
شناسه دیجیتال (DOI): 10.22038/abjs.2022.52845.2619
نویسندگان
Tom J Crijns1؛ Emily Z Boersma2؛ Stein J Janssen3؛ Melissa D Tonn4؛ David Ring* 5
1Surgery and perioperative care, Dell Medical School -- The University of Texas at Austin
2Radboud university medical center, Radboud Institute for Health Sciences, Department of Surgery, Nijmegen, the Netherlands
3Orthopaedic surgery, Amsterdam University Medical Center, Amsterdam, The Netherlands
4Occupational Medicine & Pain Management, OccMD Group, Texas Health Dallas, Dallas, Texas, USA
5Dell Medical School -- The University of Texas at Austin
چکیده
Background: Newly symptomatic chronic musculoskeletal illness is often misinterpreted as new pathology, particularly 
when symptoms are first noticed after a noxious event. In this study, we were interested in the accuracy and reliability of 
identifying the symptomatic knee based on bilateral MRI reports.
Methods: We selected a consecutive sample of 30 occupational injury claimants, presenting with unilateral knee 
symptoms who had bilateral MRI on the same date. A group of blinded musculoskeletal radiologists dictated diagnostic 
reports, and all members of the Science of Variation Group (SOVG) were asked to indicate the symptomatic side based 
on the blinded reports. We compared diagnostic accuracy in a multilevel mixed-effects logistic regression model, and 
calculated interobserver agreement using Fleiss’ kappa. 
Results: Seventy-six surgeons completed the survey. The sensitivity of diagnosing the symptomatic side was 63%, 
the specificity was 58%, the positive predictive value was 70%, and the negative predictive value was 51%. There was 
slight agreement among observers (kappa= 0.17). Case descriptions did not improve diagnostic accuracy (Odds Ratio: 
1.04; 95% CI: 0.87 to 1.3; P=0.65).
Conclusion: Identifying the more symptomatic knee in adults based on MRI is unreliable and has limited accuracy, with or 
without information about demographics and mechanism of injury. With a dispute concerning the extent of the injury to a knee 
in a litigious, medico-legal setting such as Workers’ Compensation, consideration should be given to obtaining a comparison 
MRI of the uninjured, asymptomatic extremity.
Level of evidence: II
کلیدواژه‌ها
Accuracy؛ Knee injury؛ Magnetic resonance imaging؛ Reliability؛ Worker’s compensation insurance
مراجع
1. van Hoorn BT, Wilkens SC, Ring D. Gradual Onset
Diseases: Misperception of Disease Onset. J Hand
Surg Am. 2017; 42(12):971-977.e1. doi: 10.1016/j.
jhsa.2017.07.021.
2. Culvenor AG, Oiestad BE, Hart HF, Stefanik JJ,
Guermazi A, Crossley KM. Prevalence of knee
osteoarthritis features on magnetic resonance
imaging in asymptomatic uninjured adults: a
systematic review and meta-analysis. Br J Sports
Med. 2018; 53(20):1268-1278. doi: 10.1136/
bjsports-2018-099257.
3. Beals CT, Magnussen RA, Graham WC, Flanigan DC. The
Prevalence of Meniscal Pathology in Asymptomatic
Athletes. Sports Med. 2016; 46(10):1517-24. doi:
10.1007/s40279-016-0540-y.
4. Keng A, Sayre EC, Guermazi A, et al. Association
of body mass index with knee cartilage damage
in an asymptomatic population-based study. BMC
Musculoskelet Disord. 2017;18(1):517. doi: 10.1186/
s12891-017-1884-7.
5. Kornick J, Trefelner E, McCarthy S, Lange R,
Lynch K, Jokl P. Meniscal abnormalities in
the asymptomatic population at MR imaging.
Radiology. 1990; 177(2):463-465. doi: 10.1148/
radiology.177.2.2217786.
6. Liu TC, Leung N, Edwards L, Ring D, Bernacki E, Tonn
MD. Patients Older Than 40 Years With Unilateral
Occupational Claims for New Shoulder and Knee
Symptoms Have Bilateral MRI Changes. Clin Orthop
Relat Res. 2017; 475(10):2360-2365. doi: 10.1007/
s11999-017-5401-y.
7. Bachoura AM, Vranceanu AP, Ring D. Illness constructs
in musculoskeletal medicine. Orthop J Harvard Med
Sch. 2009; 11:115-124.
8. Dersh J, Polatin PB, Leeman G, Gatchel RJ. The
management of secondary gain and loss in
medicolegal settings: strengths and weaknesses.
J Occup Rehabil. 2004; 14(4):267-279. doi:
10.1023/b:joor.0000047429.73907.fa.
9. Landis JR, Koch GG. The measurement of observer
agreement for categorical data. Biometrics. 1977;
33(1):159-174.
10.Ring DC, Dobbs MB, Gioe TJ, Manner PA, Leopold SS.
Editorial: How the Words We Use Affect the Care We
Deliver. Clin Orthop Relat Res. 2016; 474(10):2079-
2080. doi: 10.1007/s11999-016-4993-y.
11.Sihvonen R, Paavola M, Malmivaara A, et al.
Arthroscopic partial meniscectomy versus sham
surgery for a degenerative meniscal tear. N Engl
J Med. 2013; 369(26):2515-2524. doi: 10.1056/
NEJMoa1305189.
12.Khan M, Evaniew N, Bedi A, Ayeni OR, Bhandari M.
Arthroscopic surgery for degenerative tears of the
meniscus: a systematic review and meta-analysis.
CMAJ. 2014; 186(14):1057-1064. doi: 10.1503/
cmaj.140433.
13.Sihvonen R, Englund M, Turkiewicz A, Jarvinen
TLN. Mechanical Symptoms and Arthroscopic
Partial Meniscectomy in Patients with Degenerative
Meniscus Tear: A Secondary Analysis of a Randomized
Trial. Ann Intern Med. 2016; 164(7):449-455. doi:
10.7326/M15-0899.
14.Brignardello-Petersen R, Guyatt GH, Buchbinder
R, et al. Knee arthroscopy versus conservative
management in patients with degenerative knee
disease: a systematic review. BMJ Open. 2017;
7(5):e016114. doi: 10.1136/bmjopen-2017-016114.
15.Zanetti M, Pfirrmann CWA, Schmid MR, Romero J, Seifert B, Hodler J. Patients with suspected meniscal
tears: prevalence of abnormalities seen on MRI of 100
symptomatic and 100 contralateral asymptomatic
knees. AJR Am J Roentgenol. 2003; 181(3):635-641.
doi: 10.2214/ajr.181.3.1810635.
16.Bhattacharyya T, Gale D, Dewire P, et al. The clinical
importance of meniscal tears demonstrated by
magnetic resonance imaging in osteoarthritis of the
knee. J Bone Joint Surg Am. 2003; 85 (1):4-9. doi:
10.2106/00004623-200301000-00002.
17.Briet JP, Houwert RM, Hageman MGJS, Hietbrink F,
Ring DC, Verleisdonk EJJM. Factors associated with
pain intensity and physical limitations after lateral
ankle sprains. Injury. 2016; 47(11):2565-2569. doi:
10.1016/j.injury.2016.09.016.
18.Becker SJE, Briet JP, Hageman MGJS, Ring D. Death,
taxes, and trapeziometacarpal arthrosis. Clin Orthop
Relat Res. 2013; 471(12):3738-44. doi: 10.1007/
s11999-013-3243-9.
19.Schwartzberg R, Reuss BL, Burkhart BG, Butterfield
M, Wu JY, McLean KW. High Prevalence of Superior
Labral Tears Diagnosed by MRI in Middle-Aged
Patients with Asymptomatic Shoulders. Orthop J
Sport Med. 2016; 4(1):2325967115623212. doi:
10.1177/2325967115623212.

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