Clinical Diagnostic Tests Versus MRI Diagnosis of ACL Tears.

Clinical Scenario: The anterior cruciate ligament (ACL) injury is a common knee injury within varying athletic levels. Clinical diagnostic tests and magnetic resonance imaging (MRI) are two methods of evaluating ACL injuries. Clinical Question: Are clinical diagnostic tests as accurate as MRI when diagnosing ACL tears? Summary of Key Findings: Three cross-sectional design studies were included. One study found that clinical diagnostic tests were superior to MRI when diagnosing an ACL tear. Another study found that clinical diagnostic tests were equal to MRI when measuring sensitivity, but scored higher in specificity, positive predictive value, negative predictive value, and diagnostic accuracy. The last study found that clinical diagnostic tests scored higher than MRI on specificity and positive predictive value, were equal when measuring accuracy, and scored lower when measuring sensitivity and negative predictive value. Clinical Bottom Line: The evidence supports the use of clinical diagnostic tests when diagnosing an ACL tear. Strength of Recommendation: Level 2-3.