MR scanning of the acutely injured knee: Sensitive, but is it cost effective?
Arthroscopy: The Journal of Arthroscopic and Related Surgery
Cost-benefit analysis; Knee injuries, acute; MR imaging
Although magnetic resonance (MR) imaging has been established as an accurate diagnostic modality for knee pathology, the cost-effectiveness of this test is not known. In this investigation, we formulated a mathematical equation to assess cost-effectiveness and then used this formula to evaluate the use of knee MR as a diagnostic modality in acute knee injuries. We analyzed 105 consecutive MR scans performed at an imaging center with a diverse referral base, and identified 63 patients who had had symptoms for less than 6 months. Based on average regional medical costs, we calculated that diagnostic arthroscopy is more cost-effective than MR if 78% of the scanned patients eventually undergo arthroscopy. In our study population, 87% had arthroscopy after the MR scan. Therefore, in this patient cohort representing a diverse orthopedic community, arthroscopy alone would have been more costeffective. Careful analysis in this type of cost-benefit framework would be beneficial and may lead to the establishment of objective criteria by which MR can be used in the most cost-effective manner. © 1990.
Boden, S., Labropoulos, P., & Vailas, J. (1990). MR scanning of the acutely injured knee: Sensitive, but is it cost effective?. Arthroscopy: The Journal of Arthroscopic and Related Surgery, 6 (4). http://dx.doi.org/10.1016/0749-8063(90)90061-H