Magnetic Resonance Imaging (MRI)
Strong evidence supports that the MRI can provide confirmation of ACL injury and assist in identifying concomitant knee pathology such as other ligament, meniscal, or articular cartilage injury.

Rationale
Fifteen high strength and two moderate strength studies demonstrated that MRI has a high sensitivity and specificity in diagnosing ACL tears, but somewhat lower sensitivity and specificity at identifying concomitant injuries and other problems.2, 30, 38, 40, 41, 42, 55, 59, 65, 89, 91, 92, 97, 101, 105, 107, 116 

A combination of history, clinical examination (Lachman test), and radiographs has similar diagnostic accuracy as MRI for identifying ACL tears. An MRI could be used in conjunction with the history and physical examination.

Possible Harms of Implementation
There are no known harms associated with implementing this recommendation.

Future Research
Evaluation of the severity and significance of cartilage and subchondral bone injury with regards to the risk of developing future arthritis
 

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