Diagnostic value of physical examination and MRI for complete rupture of anterior cruciate ligament

Objective To compare and evaluate the diagnostic value of physical examination and magnetic resonance imaging (MRI) for complete rupture of anterior cruciate hgament (ACL). Meth-ods We performed retrospective study on 115 patients with knee injuries, who were diagnosed as liga-ment or menisci injury. All the patients were examined by MRI and physical examination, the latter of which included the anterior drawer test (ADT), the Lachman test and the pivot shift test (PST). Arthro-scopy was performed in all patients within three days after the patients were admitted, which was consid-ered as a gold standard for definition of complete ACL tear. Then, chnical epidemic methods were em-ployed to evaluate and compare the sensitivity (Se), specificity (Sp), positive predictive value (PPV),negative predictive value (NPV), accuracy (π), negative likelihood and positive likelihood of three tests. Results Arthroscopy showed complete ACL rupture in 41 patients. Sensitivity, specificity, posi-tive predictive value, negative predictive value, accuracy, positive likelihood rate and negative likelihood rate of the physical examination versus MRI were 95.1% vs 92.7%, 87.8% vs 97.3%), 81.3% vs 95.0%, 97.0% vs 96.0%, 90.4% vs 95.7%, 7.80 vs 34.33 and 0.06 vs 0.08, respectively.Conclusions On diagnosis of complete ACL rupture, MRI has higher value than physical examination.In the meantime, standard physical examination can attain high diagnostic value and should not be ignored in clinical practice. Key words: Anterior cruciate ligament; Magnetic resonance imaging; Physical examination