Journal
PHYSICIAN AND SPORTSMEDICINE
Volume 43, Issue 1, Pages 30-36Publisher
TAYLOR & FRANCIS LTD
DOI: 10.1080/00913847.2015.1009354
Keywords
Acute knee injury; MRI; primary care
Categories
Funding
- AKIC from the University of Calgary Sport Medicine Centre
- Knee Injury Working Group of the Alberta Bone and Joint Clinical Network
- Alberta Health Services
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Introduction. The routine use of magnetic resonance imaging (MRI) for the assessment of acute knee injuries is controversial. The goal of this study is to present an audit of patients seen in a dedicated Acute Knee Injury Clinic (AKIC) to determine the frequency and appropriateness of MRI utilization. Methods. A retrospective review identified all patients who had an MRI and a randomly selected control group without MRI. The MRI was classified based on whether it was ordered by the AKIC team or by an external clinician. The consensus-based ` Indications for Urgent MRI in Acute Soft Tissue Knee Problems' were applied to both groups. An MRI was considered appropriate if any of the indications were met. Results. The overall MRI utilization rate was 23% (142/611). Of the MRIs performed, 32% (46/142) met the indications. About 94% (33/35) of the MRIs ordered by the AKIC experts met the indications, compared to only 12% (13/107) of those ordered externally. No patients in the control group met the indications. Diagnoses were similar between groups. Discussion. These results suggest that application of guidelines by experts in knee evaluation can significantly reduce expensive MRI utilization in patients with acute knee injuries without negatively impacting the appropriate diagnosis and disposition.
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