Accuracy of MRI of ACL Tears in Patients with Knee Injury in Relation to Arthroscopy

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Background: Anterior cruciate ligament tear is a common problem in people who get knee injury, and it mostly happen when the knee twist suddenly during sports or fall. It makes the knee painful and unstable, and many patients cannot walk properly. Doctors use arthroscopy to see the ligament directly, but magnetic resonance imaging is used a lot because it is simple and non-invasive. Objective: To determine the diagnostic accuracy of Magnetic resonance imaging to detect anterior cruciate ligament tears in patients with knee injury taking arthroscopy as gold standard. Study Design: Cross-sectional validation study. Duration and Place of Study: This study was done from November 2024 to April 2025 in the Radiology Department of Benazir Bhutto Hospital, Rawalpindi. Methodology: A total of 165 patients aged 16–65 years with knee injury were included by consecutive sampling. All patients first had magnetic resonance imaging and later arthroscopy by the same team. Magnetic resonance imaging findings were compared with arthroscopy, which was taken as the gold standard. True positive, false positive, true negative and false negative values were calculated. A 2×2 table was used to find sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy. Results: Magnetic resonance imaging showed anterior cruciate ligament tear in 68 patients (41.2%), while arthroscopy confirmed tear in 50 patients (30.3%). There were 45 true positive cases, 23 false positive cases, 5 false negative cases and 92 true negative cases. The sensitivity of magnetic resonance imaging was 90.00%, specificity was 80.00%, diagnostic accuracy was 83.00%, positive predictive value was 66.20% and negative predictive value was 94.80%. Conclusion: This study showed that magnetic resonance imaging has good accuracy for finding anterior cruciate ligament tears.

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