The Diagnostic Value of Arthroscopic CT Scans in Knee Pathologies in Mali: Complementarity with MRI and Arthroscopy in Modern Practice

Introduction: Osteoarticular pathologies of the knee are a major public health problem in Mali. For a long time, these pathologies have been investigated using arthroscopic scanning. Objective: To determine the contribution of arthroscopic scanning to the diagnosis of knee joint pathologies in the era of MRI. Materials and Methods: A retrospective cross-sectional study surveyed 103 patients over a five-year period, each of whom underwent knee arthroscopy in the radiology department of the CMCR Pasteur in Bamako, Mali. Results: Joint noises and trauma with knee instability were the most common indications for arthroscopy, in 31.1% and 29.1% of cases, respectively. The results of the arthrography were pathological in 79.6% of cases. The left knee was the most affected, with 41.5%, but there was no statistically significant difference (P = 0.52). The medial meniscus was the most affected, with 68.2%. Tears were the main type of meniscal lesion (50%), and the posterior horn was the most common site in 68.2% of cases. The ACL was affected in 68.4% of cases, with complete tears being the most common at 47.4%. Stage 4 chondropathy was observed in 54.5% of cases. A few false negatives were observed on arthroscopic scanning with regard to meniscal and ligament damage. Some of these patients underwent MRI, which was abnormal in 80% of cases, or arthroscopy, which was abnormal in 90% of cases. Conclusion: Arthroscopy is an effective method for detecting cartilage and menisco-ligamentous lesions communicating with the joint cavity. False negatives may be encountered in cases of menisco-ligamentous damage. MRI and arthroscopy performed as complementary tests can provide guidance when arthroscopy results are normal.