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Cost Cutters Suggest Getting Rid of High-Cost MRIs for Some Knee Injuries

Magnetic resonance imaging (MRI) is a good diagnostic tool, but a well-trained doctor is just as good. This is the conclusion of a study from the Section of Sports Medicine at the University of Kentucky. Fifty patients with knee problems were studied. The doctor's exam was compared to an MRI for each patient. All patients had either a tear of the meniscus or a torn anterior cruciate ligament (ACL).

The authors report no difference in diagnosis of meniscal or ACL tears when using the doctor's exam compared to an MRI. Both methods gave equal results. There were cases of false positives and false negatives with both methods. A false positive results means the MRI or exam showed a problem, but nothing was found during the operation. A false negative occurs when the MRI or exam doesn't show a problem and there really is a torn cartilage or ligament.

MRIs have become the "gold standard" of diagnosis for knee injuries. Some doctors have called this into question. They say MRIs are high in cost, and a doctor's exam is just as good. This study supports the use of MRI in difficult cases. But the authors conclude the MRI isn't needed for every case.

References: Yavuz Kocabey, MD, et al. The Value of Clinical Examination Versus Magnetic Resonance Imaging in the Diagnosis of Meniscal Tears and Anterior Cruciate Ligament Rupture. In Arthroscopy. September 2004. Vol. 20. No. 7. Pp. 696-700.

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