The Pattern Of Findings In Double Contrast Knee Arthrography And Comparison With Results At Arthrotomy In Nairobi

Abstract

A retrospective and prospective study was carried out between July 1988 and Jul), 1990. During this period 171 consecutive double contrast knee arthrograms were done at the Nairobi Hospital and studied for purposes of this dissertation. The various types of knee derangements seen on double contrast arthrography were analysed. 28% of these patients also had arthrotomy done. In patients where arthrotomy records were available comparison and correlationship between double contrast knee arthrography and arthrotomy were made .

The commonest pathology, demonstrated was meniscal tears - either medial or lateral meniscus. The commonest tear was of the medial meniscus posterior horn (45.5%). Other lesions demonstrated included Baker's cysts (18.2%), Discoid menisci (2.4%), Cruciate ligament tears (2.4%), Loose body (3.0%) and Collateral ligament tears (2.4%). The patients age ranged from 6 to 60 years, and the commonest age group was 20 to 30 years. The male to female ratio was 1.8:1.0. The overall arthrographic accuracy calculated compared with arthrotomy was 90.5%. Arthrography was found to be accurate in

diagnosing medial meniscal lesions and had a sensitivity of 0.92. where as arthrography was inaccurate in diagnosing lateral meniscal with a low sensitivity of 0.50. It is recommended that arthroqraphy is safe, easy to perform. virtually free of cornplications , not time consuming and an accurate procedure in diagnosing internal derangements of the knee. It is recommended as the first diagnostic tool of choice , and in those cases where arthrographic findings are equivocal and do not match with clinical findings , particularly in injuries to the lateral meniscus, other diagnostic aids e.g Arthroscopy or Exploratory arthrotomy should be undertaken.