Abstract

Introduction: The knee is one of the major weights bearing joint that provides not only mobility and stability during physical activity, but also balance while standing. Sport injuries are injuries caused by sports activities and may lead to severe pain and disability. Magnetic Resonance Imaging (MRI) is established as the leading modality for noninvasive evaluation of the sports knee injuries with its multiplanar capabilities and excellent soft-tissue contrast.

The aim of the study: To investigate the accuracy of MRI in assessment of sport related knee injuries.

Materials and methods: This is a prospective study which includes 50 patients with knee injuries during sport activities from period of May 2020 to September 2021. All patients came to department of traumatology at University clinic for Surgery “St. Naum Ohridski “-Skopje, and after physical examination were sent for MRI examination at the department of radiology at the same clinic. In all patients Magnetic Resonance Images (MRI) was performed at 1.5 T MR in SAG T2 weighted images, SAG Proton Density (PD) weighted images, COR STIR weighted images, COR T1 weighted images, AX PD weighted images and additional weighted images if it is needed for evaluating the anterior cruciate ligament. The results from MRI were evaluated and also compared with the results from arthroscopy or surgery.

Results: 50 patients with knee sport injuries were included in study, from them 35 male and 15 female from age of 16 to 35. Depending on the sport which cases the injury 20 patients get knee injury while preforming handball, 10 football, 7 patients during ski activities, 3 patients during running and jumping, and the rest 10 patients from bicycling and other different sport activities. Depending on the MRI results: in 33 patient lesion of Anterior Cruciate Ligament (ACL) was detected on MRI, from which 7 patients were with complete lesion and 26 were with partial lesion. 3 patients have founding of bone edema and cartilage injuries. 2 patients have retinaculum lesions, 7 patients have meniscal lesion and 5 patients were with combined injuries of meniscal lesion and lesion of ACL. With comparison of the results from MRI finding with arthroscopy or surgery findings which were taken as a gold standard we get the accuracy of MRI in 66.7% of finding the meniscal complete lesion and 85.7% of meniscal incomplete lesion. The accuracy of MRI in detection the ACL lesion was 85.7% in complete ACL lesion and 80.8% for detection the ACL partial lesion. 100% for bone edema and cartilage lesion and also 100% for retinaculum lesion.

Conclusion: MRI is noninvasive diagnostic tool with high accuracy and it is the primary approach in sport knee injuries. Thus MRI is superior to the diagnostic arthroscopy and we recommend MRI as the primary diagnostic tool for the evaluation of sports knee injuries. This study has shown total accuracy of MRI in finding the sport knee injuries at 87%, which makes it valuable noninvasive diagnostic tool for primary sport injuries.