A comparison of MRI and arthroscopic findings of intraarticular soft tissue injury of the knee at Kenyatta National Hospital, Kenya

Background: Musculoskeletal system disorders rank as the second most common cause of disability universally contributing to 169,264,000 Disability-Adjusted Life Years (DALYs). The knee joint is particularly susceptible to injury especially of the ligaments and menisci. A comparison between MRI and arthroscopic findings will help determine the reliability of MRI reports in knee injury patients and guide their management in our setting. Objective: To compare the MRI and arthroscopic findings of patients with intra-articular soft tissue injury of the knee at Kenyatta National Hospital, Kenya. Methodology: This was a retrospective cross-sectional study from January 1st 2018 to December 31st 2022. Seventy two participants were recruited for the study and the nature of injuries on MRI and at arthroscopy were analyzed. Results: MRI had a sensitivity of 83.8%, 87.5%, 100% and 50% for medial meniscal, lateral meniscal, ACL and PCL tears respectively. It had a specificity of 77.1%, 85%, 96.6% and 98.5% for the same. Accuracy was highest for ACL injury detection by MRI (97.2%), followed by PCL injury detection (95.8%), and lateral meniscal tear detection (86.1%). The accuracy of MRI was lowest for medial meniscal injury detection (80.5%). Conclusion: Overall, MRI and arthroscopy have comparable diagnostic effectiveness for detecting intra-articular soft tissue injuries of the cruciate ligaments as well as high sensitivity, specificity, and accuracy for detecting medial and lateral meniscal tears. These findings suggest that MRI is a useful diagnostic tool in the evaluation of knee injuries and should be carried out in patients presenting with intra-articular soft tissue injuries of the knee.