Jul 2026· British Medical Bulletin· Vol 159 1· 0 citations
Medicine
TL;DR
Paired-design synthesis with arthroscopic verification gives less biased estimates of comparative accuracy than unpaired designs, and composite clinical examination by an experienced clinician retains diagnostic value alongside MRI.
BACKGROUND
Simple elbow dislocations are common injuries; however, the comprehensive magnetic resonance imaging (MRI) injury patterns remain incompletely understood. This systematic review aimed to determine the prevalence and patterns of soft tissue and acute traumatic osteochondral injuries on MRI following simple elbow dislocations.
METHODS
We systematically searched PubMed and Scopus databases from 2000-2025 using a validated search strategy. Studies reporting MRI findings in adult or predominantly adult simple elbow dislocation cohorts were included. Quality assessment used the Newcastle-Ottawa Scale. Pooled prevalence estimates with 95% confidence intervals (CIs) were calculated using random-effects models with logit transformation. GRADE methodology assessed evidence quality.
RESULTS
Eight studies were included, with 267 participants providing baseline MRI data. Seven studies contributed to each analysis of any collateral-ligament injury: medial collateral ligament (MCL) 90.6% (95% CI: 78.6%-96.2%; I2=69.0%) and lateral collateral ligament (LCL) 94.3% (95% CI: 86.3%-97.8%; I2=35.8%). Only 3 studies contributed compatible complete-tear data: MCL 53.0% (95% CI: 8.6%-93.1%; I2=86.6%) and LCL 59.4% (95% CI: 21.0%-88.9%; I2=69.5%). Two studies contributed acute traumatic osteochondral data, giving a pooled estimate of 57.2% (95% CI: 42.2%-70.9%; I2=59.7%). In a reader-choice sensitivity analysis, replacing the senior radiologist's assessment in the larger study with the junior radiologist's assessment reduced the estimate to 37.4%.
CONCLUSION
MRI abnormalities involving both medial and lateral stabilizing structures are common after simple elbow dislocation, but their prognostic significance remains uncertain. MRI may be considered selectively when post-reduction stability is uncertain or further anatomical definition may influence management; the available evidence does not support routine use after every otherwise stable simple elbow dislocation.
LEVEL OF EVIDENCE
Level IV; Descriptive Epidemiology Study; Systematic Review.
N. Sachinis, Vijay Bhardwaj, M. Scaglia et al.· Journal of shoulder and elbo...· 0 citations
Meniscal ramp lesions were frequently detected on MRI in patients undergoing ACL reconstruction, although less commonly observed at the time of surgery, although less commonly observed at the time of surgery.
Erik Lerjefors, Riccardo Cristiani, Christoffer von Essen et al.· Arthroscopy: The Journal of...· 0 citations
PCL-PCA is highly sensitive in diagnosing ACL tear as an indirect and secondary parameter, followed by PCL angle, then by PCL inclination angle, and lastly by anterior drawer sign, which provided an excellent distinction between patients with and without an ACL tear.
K. Bhinder, Aroosa Kanwal, Madiha Saeed Wahla et al.· Nigerian Medical Journal· 0 citations
The strong association with ACL injury and having a potentially important role in knee stabilisation, their injuries need to be given due importance by radiologists and should not be underreported.
Knee osteoarthritis (KOA) is a prevalent degenerative joint disease characterized by progressive structural and functional impairment. While magnetic resonance imaging (MRI) is regarded as the reference standard for assessing joint pathology, ultrasonography (US) offers a cost-effective, accessible, and dynamic alternative. This study aimed to evaluate the concordance between US and MRI findings in assessing key structural features of KOA.
In this prospective cross-sectional study, 320 patients fulfilling the American College of Rheumatology (ACR) criteria for KOA underwent both standardized US and MRI of the affected knee. Imaging assessments included cartilage integrity, meniscal extrusion, marginal osteophytes, and joint effusion. MRI served as the reference imaging modality for calculating the diagnostic performance of US. Cohen’s kappa (κ), Spearman correlation, intraclass correlation coefficients (ICC), and Bland–Altman analyses were applied to evaluate agreement between modalities, while sensitivity, specificity, and diagnostic accuracy of US were calculated using MRI as the reference standard.
Good agreement was observed between US and MRI for osteophytes (κ = 0.79), joint effusion (κ = 0.67), and meniscal extrusion (κ = 0.52–0.72), whereas cartilage grading showed moderate agreement (κ = 0.52). US demonstrated high diagnostic performance for joint effusion (sensitivity = 98.7%, specificity = 100%) and strong correlations for quantitative meniscal extrusion (ρ = 0.79–0.96; ICC = 0.84–0.93, 95% CI: 0.600–0.957). Bland–Altman analysis demonstrated minimal measurement bias and narrow limits of agreement between the two imaging modalities.
US provides a reliable, noninvasive, and accurate assessment of structural alterations in KOA, demonstrating strong agreement with MRI in evaluating joint effusion, osteophytes, and meniscal extrusion. These findings support the use of US as a valuable complementary imaging modality in the comprehensive evaluation of knee osteoarthritis, particularly when standardized imaging protocols are applied.
H. Majidi, Shima Sharifi, F. Roodposhti et al.· BMC Musculoskeletal Disorder...· 0 citations
Background/Objectives: Posterolateral meniscocapsular detachment represents a potentially underrecognized component of knee trauma in patients with anterior cruciate ligament (ACL) injury. Altered rotational kinematics in ACL-deficient knees may increase stress on posterolateral corner structures. Although an association between ACL tears and posterolateral abnormalities has been reported, the true diagnostic performance of magnetic resonance imaging (MRI) for these lesions remains incompletely defined. This study aimed to evaluate the diagnostic accuracy of MRI for posterolateral meniscocapsular detachment in patients with confirmed ACL injury, to describe associated meniscal tears, and to assess the association between lateral tibial plateau bone marrow edema, age, and sex with the presence of detachment. Methods: In this retrospective study, 117 knee MRI examinations (1.5 T and 3 T) of patients with native ACL rupture or ACL graft failure were reviewed. Two readers independently assessed posterolateral meniscocapsular detachment. Ramp lesions, other meniscal tears and lateral compartment bone marrow edema were evaluated in consensus. Arthroscopy served as the reference standard. Diagnostic performance and inter-observer agreement were calculated. Detachment was considered present only when both readers independently identified the lesion. Results: MRI demonstrated high specificity (90.8%; 95% CI: 83.7–95.5%) for posterolateral meniscocapsular detachment, and promising sensitivity (87.5%; 95% CI: 47.3–99.7%) based on a small number of confirmed cases (n = 8); this estimate should be interpreted with caution given the wide confidence interval. One arthroscopically confirmed lesion was missed, and false-positive findings were limited. MRI also showed good diagnostic performance for ramp lesions and other associated meniscal tears, assessed as secondary endpoints. Lateral tibial plateau bone marrow edema, age, and sex were not significantly associated with detachment. Conclusions: Routine MRI shows high specificity and promising, although preliminary, sensitivity for detecting posterolateral meniscocapsular detachment in ACL-injured knees; given the small number of confirmed cases, this estimate warrants confirmation in larger cohorts. Careful multiplanar assessment and detailed anatomical knowledge are essential to optimize detection. Accurate preoperative MRI characterization may help guide surgical planning and reduce the risk of missed posterolateral meniscocapsular pathology at arthroscopy.
T. Bonanzinga, Elena Tosi, A. Favaro et al.· Diagnostics· 0 citations
