MRI may be more trouble than it’s worth for diagnosing ACL tears

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 - Knee_Exam

Athletes suffering suspected tears of the anterior cruciate ligament (ACL) are often adequately assessed with clinical diagnostic tests performed in the clinician’s office. When these are inconclusive, diagnostic arthroscopy is the gold standard—and MRI is a generally low-value option due to its time and cost burdens.

That’s according to a review of the literature published online Nov. 15 in the Journal of Sport Rehabilitation.

Accurately diagnosing or ruling out an ACL tear with palpations and observations of patients performing positional and range-of-motion movements involving the knee “could save the patient, patient’s family, employer or school money by avoiding an MRI,” write study authors Megan Brady, EdD, of Drake University in Des Moines and Windee Weiss, PhD, of the University of Northern Iowa.

The authors note the commonality of ACL injuries in athletes across competition levels from recreational to professional: around 200,000 per year.

They call for more research to test the accuracy of MRI vs. the movement tests, allowing that the latter’s sensitivity and specificity are largely dependent on the proficiency of the clinician.

Journal publisher Human Kinetics has posted the study in full for free (click “PDF”):