A 20-year-old man sustained an open medial dislocation of the ankle without an associated fracture after a low-energy inversion injury. Prompt debridement and reduction with primary wound closure of the skin were performed without suture of the capsule. Immobilisation in a non-weight-bearing cast for 30 days followed by ankle bracing for two weeks and subsequent physiotherapy, produced full functional recovery by three months. At follow-up at one year there was a full range of pain-free movement, although the radiographs and MR scan showed early post-traumatic degenerative change at the medial aspect of the tibiotalar and the calcaneocuboid joints.

Introduction MRI accuracy in detecting knee lesions is a discussed controversy. Not always different knee lesions, diagnosed by MRI are confirmed by arthroscopy. The aim of this study is to correlate the accuracy of history, physical examination and MRI in evaluating meniscal and ACL lesions.

Methods A prospective comparative study was performed to compare anamnestic and clinical data, MRI findings and arthroscopic findings to better understand the role of these methods and to assess if there are significative differences between various knee disorders. One hundred patients undergoing to arthroscopy for knee injuries were evaluated before surgery, registering anamnestic data, clinical examination and MRI findings. At the time of surgery every finding was registered and then compared with the previous acquired data.

Results The most accurate data for diagnosis appears from history and clinical examination. The study showed a statistically significative differences between the RMI and arthroscopic findings. Differences between radiologist were detected in MRI data.

Conclusion The results of such type of study, underlining the reliability and accuracy of patient’s history, clinical examination and MRI, comparing the different results among them and in various knee injuries. The accuracy of every test is the first step for an evidence based decision analysis process and represent a step forward an efficacious and economical pattern in diagnosis.