Knee Surg Relat Res.  2015 Jun;27(2):95-100. 10.5792/ksrr.2015.27.2.95.

Is Knee Magnetic Resonance Imaging Overutilized in Current Practice?

Affiliations
  • 1Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seongnam, Korea. osktk@snubh.org
  • 2Department of Orthopaedic Surgery, Sinwoo Hospital, Seongnam, Korea.
  • 3Department of Orthopaedic Surgery, Joint Reconstruction Center, Yonsei Sarang Hospital, Bucheon, Korea.
  • 4Department of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
  • 5Department of Orthopaedic Surgery, Boramae Medical Center, Seoul, Korea.

Abstract

PURPOSE
To determine what proportion of patients visiting a tertiary knee clinic had pre-obtained knee magnetic resonance imaging (MRI) and to assess the impact of pre-obtained knee MRI on the selection of treatment plans.
MATERIALS AND METHODS
Six hundred and eighty patients were enrolled from patients who visited our knee clinic during a 6-month period. The proportion of patients with pre-obtained knee MRI was calculated, and associations of sociodemographic factors, disease category, and finally selected treatment options with knee MRI pre-obtainment were investigated. A utility assessment panel of five orthopaedic surgeons was formed and established utility assessment criteria. Two rounds of utility assessment (before and after MRI review) were performed.
RESULTS
Of the 680 patients, 185 (27%) had pre-obtained knee MRI. In the first round of utility assessment, 39%, 18%, and 43% of the 185 knee MRIs were evaluated as useful, equivocal, and arguably useless, respectively, and almost identical results were obtained in the second round. The proportion of assessed 'useful MRI' was higher in sports related injury (84%) and other conditions (91%) than in degenerative joint disease (18%) and nonspecific knee pain (31%). Utility assessment results among panels varied little for practice patterns and education duration.
CONCLUSIONS
This study suggests clinicians should reconsider and counsel patients the expected utility of knee MRI acquisition.

Keyword

Knee; Magnetic resonance imaging; Overuse
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