Sonographic Evaluation of Internal Derangements of Knee Joint in Comparison to Magnetic Resonance Imaging (MRI)
Abstract
Background: Knee is the most complex joint and prone to injury. Ligament and meniscal injuries are common and a major cause of morbidity. Accurate diagnosis requires clinical history, examination and imaging. Magnetic resonance imaging (MRI) is the non invasive gold standard for detecting knee injuries, but ultrasonography (USG) is emerging as a cost-effective, non-invasive and dynamic alternative. Objectives: To evaluate role of sonographic assessment of internal derangements of knee joint in comparison to Magnetic Resonance Imaging. Methods: A Cross sectional study of 61 patients with knee joint pathology underwent USG & MRI for the diagnosis of internal derangements of knee joint between the period of October 2022 to September 2024 was conducted in Department of Radiology and Imaging, BIRDEM General Hospital, Dhaka, Bangladesh. Procedure details were recorded on specifically designed pro-forma. Results: A total of 61 patients (62.3% male; mean age 40 years) were included, with the 21–30-year age group most commonly affected. Right-knee involvement predominated (62.3%). The most frequent pathology identified by both USG and MRI was knee joint effusion (90.2% and 93.4%, respectively). Ultrasound showed good diagnostic performance overall, with good sensitivity and specificity for medial collateral ligament (MCL) tear, lateral collateral ligament (LCL) tear, and baker’s cyst, and good accuracy for anterior cruciate ligament (ACL ) tear, posterior cruciate ligament (PCL) tear, and patellar tendinopathy. Conclusions: Knee USG is highly accurate in diagnosing joint effusion, patellar tendinopathy, posterior cruciate ligament tear, medial collateral ligament tear, medial meniscal tear, lateral collateral ligament tear, osteophytes and baker’s cyst. MRI should be reserved for patients with inconclusive USG results. Therefore, USG should be used as the first-line modality for detecting knee pathologies. Bangladesh Medical Res Counc Bull 2026;52(2): 102-108