Objectives To determine whether current magnetic resonance imaging (MRI) could detect superficial cartilage lesions that are observed during diagnostic arthroscopy in patients with knee pain who have not been diagnosed with joint disease. Methods Adult patients with knee pain of unclear origin lasting more than three months, scheduled for a therapeutic/diagnostic arthroscopy were recruited. Demographic and clinical data, pain assessment, MRI imaging, and observations of cartilage damage in the medial femoral condyle during arthroscopic procedure were documented. Patients were categorized based on the presence of cartilage damage assessed via MRI and/or direct visualization. Concordance between these assessments and its variation with age and patient-reported pain were examined. Results Out of the 95 patients recruited, 48 exhibited lesions in the medial femoral condyle (MFC) during arthroscopic examination, while only 24 of them showed lesions on the MRI scans. The thickness of the cartilage in the MFC was significantly lower in patients with cartilage damage detected by MRI compared with those without. Among patients with cartilage lesions identified during arthroscopy, those also showing lesions on the MRI had lower cartilage thickness and higher Outerbridge score than those without lesions on the MRI. Patients with detectable cartilage damage on the MRI were significantly older and reported higher levels of pain than those with damage detected only by arthroscopic examination. Conclusion Despite significant technological advancements in MRI, arthroscopy still proves superior in identifying mild structural cartilage lesions that are not identifiable by this technique.

中文翻译：

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关节镜检查在检测轻度软骨病变方面比 MRI 具有更高的鉴别能力


目的 确定目前的磁共振成像 （MRI） 是否可以检测未诊断为关节疾病的膝关节疼痛患者在诊断性关节镜检查中观察到的浅表软骨病变。方法 招募来源不明的膝关节疼痛持续 3 个月以上，计划进行治疗/诊断性关节镜检查的成年患者。记录了人口统计学和临床数据、疼痛评估、MRI 成像以及关节镜手术中股骨内侧髁软骨损伤的观察。根据通过 MRI 和/或直接可视化评估的软骨损伤对患者进行分类。检查了这些评估之间的一致性及其随年龄和患者报告的疼痛的变化。结果 在招募的 95 例患者中，48 例在关节镜检查时表现为股骨内侧髁 （MFC） 病变，而其中只有 24 例在 MRI 扫描中表现为病变。与 MRI 未检测到软骨损伤的患者相比，MFC 中软骨的厚度显着降低。在关节镜检查中发现软骨病变的患者中，与 MRI 上没有病变的患者相比，MRI 上也显示病变的患者软骨厚度较低，Outerbridge 评分较高。MRI 上可检测到软骨损伤的患者明显年龄较大，并且报告的疼痛程度高于仅通过关节镜检查检测到损伤的患者。结论 尽管 MRI 技术取得了重大进步，但关节镜检查在识别该技术无法识别的轻度结构软骨病变方面仍然表现出色。