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The Painful Knee: Arthroscopy or MR Imaging?

Department of Orthopaedic Surgery, Baylor University Medical Center, Dallas.

While neither arthroscopy nor magnetic resonance (MR) imaging is perfect, both can delineate pathologic changes in the knee with reasonable accuracy. The greatest advantage of MR imaging is that it is noninvasive and can be used to detect pathologic changes both inside and outside the synovial cavity. Arthroscopy has the distinct advantage of allowing definitive treatment at the time of diagnosis in most cases, but carries with it the potential risks associated with any invasive diagnostic technique. Both modalities are expensive, and their judicious use is therefore dictated, especially in this era of cost containment. The decision to use one or both studies is best made by the orthopaedic surgeon.