Comparing computerized tomography and magnetic resonance in the study of articular pathology of the knee

The authors present a comparison between the diagnostic accuracy of computed tomography (CT) and magnetic resonance imaging (MRI) in the articular pathologies of the knee. CT and MRI were performed in 30 patients who subsequently underwent surgery. CT and MRI results were compared on three bases: technique, definition of normal anatomy, and diagnostic accuracy. CT allowed a standardization of the technique, while MRI was superior in defining normal anatomy--especially in the study of capsulo-ligamentous structures. In all cases the use of both CT and MRI allowed a correct diagnosis, showing the site, extent and gravity of the lesion. CT proved to be superior to MRI in 4 cases, while MRI corrected CT diagnosis in 11 cases; in 15 patients both techniques had the same diagnostic accuracy. Meniscal tears were better identified by CT, while MRI was superior in the detection of ligamentous lesions and in the characterization of PVNS and tendinitis of the patellar tendon. In conclusion, MRI should be performed in selected cases only, or when CT cannot be trusted; on the other hand, it might also be used as a first-choice diagnostic procedure for synovial pathologies and acute lesions of the anterior cruciate ligament.