Paper highlights shortage of orthopaedic skill

knee problems referred for imaging in the two groups.In any evaluation such variations in case mix must be carefully controlled for,5 particularly if results form the basis of recommendations for clinical practice.It is curious that there was no orthopaedic input to the study.An orthopaedic consultant with an interest in the knee should be able to sort out most patients with knee pain on clinical grounds.Indeed, for some clinical diagnoses, such as anterior knee pain, magnetic resonance imaging has little proved clinical value.24Not all general practitioners will understand the implications of the findings of magnetic resonance imaging.The sensitivity of imaging for a lateral meniscal lesion, for example, is not particularly high (approximately 08).3Similarly, loose bodies may be missed.The patient may be falsely reassured and appropriate treatment delayed or denied.From the above it might be assumed that we are not enthusiastic about magnetic resonance imaging of the knee.On the contrary, we expect the use of this type of imaging for knee and other problems to continue to increase.We are merely suggesting that widespread use is likely to lead to increased rather than decreased overall costs.When used judiciously, magnetic resonance imaging of the knee has a proved diagnostic and therapeutic impact and is associated with improvements in quality of life.4We consider that patients with knee problems are best served by being seen quickly by an experienced orthopaedic surgeon, who can make appropriate referrals to a radiologist.