Ultrasound versus Magnetic Resonance Imaging in Diagnosis of Traumatic Knee Injuries

Abstract

The knee joint is one of the most commonly injured joints in the body. Because of its complex structure, the joint is subjected to numerous pathologies and due to the recent increase in various sport activities; there has been a parallel increase in sport-induced internal dearangements of the knee. Ultrasound is emerging as a viable imaging modality in the diagnosis and assessment of the musculoskeletal system lesions especially in experienced hands. Advantages of ultrasound include it is non invasive, well accepted by patients, available, the ability to compare easily with the contralateral side, multi planar and dynamic evaluation, as well as its economic advantages. Unlike magnetic resonance imaging, the patient’s exact point of clinical tenderness can be correlated with underlying anatomical structures and associated pathology. The main strength of knee ultrasound is the assessment of para-articular disease. The specific structures best suited for ultrasound assessment include tendons, muscles and ligaments, as well as peri articular soft tissue masses. Joint effusions, synovial thickening, bursal fluid collections, intra-articular loose bodies, ganglion cysts and articular surface erosions. As regards the cruciates and meniscal lesions, sonography was found not to be the primary imaging tool for those pathologies which when clinically suspected, MRI is preferably advised. In Conclusion, Ultrasonography is safe, cheap and efficient tool in the evaluation of the periarticular soft tissues with limited screening role at the internal knee joint cruciate / meniscal derangements as well as some bony lesions involving its cortex and no role at the exclusively intra medullary bony lesions.