COMPARATIVE EVALUATION OF ULTRASOUND AND MRI IN THE DIAGNOSIS OF KNEE JOINT PATHOLOGIES

Background: Knee joint pathologies are a major cause of disability, often involving ligaments, menisci, tendons, cartilage, and synovium. MRI is the gold standard for diagnosis, but its high cost, limited availability, and contraindications restrict its use.Ultrasound (USG) offers a non-invasive,inexpensive, and dynamic alternative,though its diagnostic accuracy for different knee conditions needs further evaluation. The present study aimed to assess the diagnostic performance of USG in detecting knee pathologies compared with MRI as the reference standard. Methods: A prospective comparative study was conducted on 100 patients presenting with knee pain, swelling, or restricted movement. All underwent high-resolution USG (GE LOGIQ E9) followed by MRI (SIEMENS Magnetom Vida 3T). Agreement was measured using kappa statistics, and sensitivity, specificity, PPV, NPV, and accuracy were calculated. Results:USG showed almost perfect agreement with MRI for medial meniscus tears (κ = 0.81),meniscal cysts (κ = 0.97), medial meniscal extrusion (κ = 0.99), MCL tears (κ = 0.87), Baker's cysts (κ = 0.98), and osteophytes (κ = 0.93). High diagnostic accuracy was achieved for joint effusion (89%),medial meniscus tears (93%),osteophytes (97.5%),meniscal cysts, meniscal extrusion, and Baker's cysts (all 100%). Substantial agreement was seen for joint effusion (κ = 0.71), patellar tendinopathy (κ= 0.76),and LCL tears (κ= 0.62).Lower sensitivity was noted for ACL tears (κ= 0.04),PCL tears (κ = 0.55),and meniscal degeneration (κ ≤ 0.26). Conclusion: Ultrasound is highly accurate for detecting superficial and peri-articular knee pathologies and can serve as a reliable first-line modality.However,MRI remains indispensable for evaluating deep intra-articular structures and degenerative changes.