Namal Perera
Bradford Royal Infirmary, UK
Title: Does magnetic resonance imaging delay diagnosis of symptomatic acute anterior cruciate ligament rupture?
Biography
Biography: Namal Perera
Abstract
Anterior cruciate ligament (ACL) tears are common injuries. Clinical diagnosis has often proved unreliable and MRI has often been used because of its high specificity and accuracy. Objective: ascertain the role of MRI in the diagnosis of suspected ACL injury and assess whether it may delay diagnosis. Methods: retrospective analysis of 78 patients undergoing primary ACL reconstruction following acute injury. Results: MRIs were performed in 72 of 78 patients (92.3%); MRI scan was used for gaining the diagnosis in 47.4% of patients, the remainder being diagnosed clinically. In the MRI-diagnosed group, the mean time to MRI was 75 days, with total delay to patient receiving diagnosis of 110 days. Patients in the MRI-diagnosed group waited longer for diagnosis and attended more outpatient appointments. Conclusions: despite evidence to the contrary, MRI is over-used for obtaining diagnosis or confirming isolated acute ACL injury. MRI is a largely unjustified cost and should be avoided in favour of clinical review by a specialist at an appropriate juncture.