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Clinical versus MRI grading of the medial collateral ligament in acute knee injury

Brown JS, Olsson O, Isacsson A, Englund M

Research in Sports Medicine: An International Journal 2024 Jan-Jun;32(1):12-16

primary study

Sensitivity, specificity, and agreement between clinical and magnetic resonance imaging (MRI) gradings of the medial collateral ligament (MCL) after acute knee injury were evaluated in 362 patients. Ninety-seven per cent were injured during sports/recreation. Sensitivity and specificity of MRI for grade II or III MCL injury was 68% (95% CI 58 to 77%) and 90% (95% CI 86 to 93%), respectively. Weighted Kappa analysis showed moderate agreement between clinical and MRI grading (0.56 95% CI 0.48 to 0.65). Findings were similar for patients with and without concomitant cruciate ligament rupture (0.57 95% CI 0.48 to 0.66 and 0.55 95% CI 0.35 to 0.75, respectively) and for specialists in orthopaedics and knee sub-specialists (0.55 95% CI 0.39 to 0.70 and 0.57 [95% CI 0.47 to 0.67, respectively). Agreement between clinical and MRI grading of MCL injuries by orthopaedic specialists in a general hospital is at least moderate regardless of the presence of cruciate ligament injury.

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