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  • Title: Diagnosis of acute knee ligament injuries: the value of stress radiography compared with clinical examination, stability under anaesthesia and arthroscopic or operative findings.
    Author: Harilainen A, Myllynen P, Rauste J, Silvennoinen E.
    Journal: Ann Chir Gynaecol; 1986; 75(1):37-43. PubMed ID: 3707024.
    Abstract:
    A consecutive series of 85 stress radiographic examinations was performed in order to evaluate the clinical reliability and use of stress radiography in disclosing acute knee ligament injuries. Eighty-three examinations were performed within one week of the injury. Sagittal stress examination discovered 27% of the 37 anterior cruciate ligament (ACL) tears and all four posterior cruciate tears. Valgus stress detected 56% of the medial collateral tears. The specificity of stress radiography was even reduced by the number of false positive stress results (n = 25) in posterior drawer or valgus-varus examinations. An ACL tear was, however, an isolated or major ligament injury in twenty (80%) of the false positive results. Clinical examination revealed all the medial collateral tears whereas only 40% of the anterior cruciate tears. The most reliable method for diagnosing acute knee injuries where clinical examination has failed in disclosing instability is examination under anaesthesia supplemented by acute arthroscopy.
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