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What happens if your diagnosis is unclear?
A routine physical examination
and x-rays help orthopedic surgeons to diagnose most, but not all, knee
injuries. If your diagnosis is unclear, which can happen for a number
of reasons, there are several options available. First, you can wait for
a period of time (usually several weeks) and then have a second physical
examination. During this period of time, the swelling and muscle spasm
from the original injury gradually goes away making it possible to more
easily determine how you have injured your knee.
If the diagnosis still remains
unclear, or if you might have injured more than one structure inside your
knee, then you may be offered the choice of having an MRI done. In general,
an MRI scan is a safe and a relatively simple procedure, as long as you
do not suffer from claustrophobia. The ability for an MRI to accurately
determine the type of knee injury depends upon where the pathology or
problem is located inside the knee. In a study which compared the results
of 3,000 MRI scans performed at several different hospitals with what
was discovered by surgeons when they operated on the knee, it was found
that the MRI scan accurately detected the problem most of the time. The
accuracy rate changed according to which structure was injured, with the
following accuracy rates:
- anterior cruciate ligament (ACL) tears: 78 to 97% accurate
- medial meniscal tears: 64 to 95% accurate
- lateral meniscus tears: 83 to 94% accurate
- posterior cruciate ligament (PCL) tears: 99% accurate
In most cases, you and your
surgeon can make all important treatment decisions about your injury without
having an MRI scan.
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