Our aim was to evaluate the indications for patients undergoing magnetic resonance imaging (MRI) of the knee prior to referral to an orthopaedic specialist, and ascertain whether these scans altered initial management. We retrospectively reviewed all referrals received by a single specialist knee surgeon over a 1-year period. Patient demographics, relevant history, examination findings and past surgical procedures were documented. Patients having undergone MRI prior to referral were identified and indications for the scans recorded. These were reviewed against The NHS guidelines for Primary Care Physicians to identify if the imaging performed was appropriate in each case.Aims and objectives
Materials and Method
Abstract. Aims. The aim of this study was to evaluate the indications for patients presenting with knee pain undergoing magnetic resonance imaging of the knee prior to referral to the orthopaedic department and to ascertain whether plain radiograph imagining would be more beneficial prior to an MRI scan. Method. A retrospective review of all referrals received by the hospital over a 6-month period was performed. Patients with knee pain that underwent an MRI scan were classified into two age groups, under 50 years and over 50 years old. Patients having undergone Magnetic resonance imaging (MRI) prior to referral were identified, and findings of the scan were recorded. These patients were reviewed further to see if a plain radiograph had been completed prior to or after the MRI. Results. A total of 414 patients were referred. In the over 50's 228 MRI scans were performed. Of these 103/228 patients the predominate finding was meniscal tears and 72/228 had a finding of osteoarthritis. A plain radiograph of the knee was completed 99/228 cases, 28/99 before the MRI. In the under 50's 186 scans were performed and of these 85/186 the predominate finding was meniscal tears. A plain radiograph of the knee was completed in only eighty-three (83/186) cases, (69/83) before the MRI. Conclusion. In over 50s, 57% of patients (129 of 228) did not have a knee X-ray before having an MRI. For a single hospitals referral over 6 months these unnecessary MRI of knee cost the
Background:. Tuberculosis (TB) is endemic in the sub-saharan Africa (SSA), and up to 70% of adults with TB are infected with Human Immunodeficiency Virus (HIV). In clinical practice, where extra-pulmonary TB (i.e spine) is suspected, treatment is often empirically initiated on clinical and radiological features as access to resources is not always easy. If it looks like TB, is it always TB?. Objective:. To demonstrate that, “if it looks like TB, it might not be TB”. Design:. Retrospective record-based study. Methods:. The aim of the study was to audit retrospectively the histology results of all patients who underwent incisional (percutaneous core biopsy) and excisional (radical debridement) of spine, whenever the diagnosis of TB spine was suspected. Data were collected using case sheets of 206 spine patients from the medical records from a newly established orthopaedic spine unit database, as well as histology results from the