Abstract
To evaluate any discrepancy between radiological reports for clinical purposes and for medicolegal purposes and to quantify its economic impact on repayments made by private insurance companies for meniscal injuries of the knee. The medical records obtained pertaining to 108 knee injury patients (mean age 43.3 years) assessed over a period of 12 months were analysed. Clinical medical reports, aimed at assessing the lesion, and medicolegal reports, drawn up with a view to quantifying compensation, were compared. Unlike reports for clinical purposes in reports for medicolegal purposes, in the evaluation of meniscal lesions, in addition to morphological features of lesions, chronological, topographical, severity and exclusion criteria were applied. To estimate the economic impact resulting from the biological damage, we consulted an actuarial table based on the 9-point minor incapacity classification system. Meniscal lesions not compatible with a traumatic event and therefore not eligible for an insurance payout were found in 56 patients. Of these, 37 failed exclusion criteria, while 19 failed to meet chronological criteria. This difference resulted in a reduction in compensation made by private insurance companies with savings estimated with a saving between €203,715.41 and €622,315.39. The use of a clinical report for medicolegal purposes can be a source of valuation error, as chronological and/or dynamic information regarding the trauma mechanism may be lacking. Therefore, the use of a full radiological appraisal allows a better damage’s assessment and an adequate compensation for injuries.
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References
Muellner T, Weinstabl R, Schabus R et al (1997) The diagnosis of meniscal tears in athletes: a comparison of clinical and magnetic resonance imaging investigation. Am J Sports Med 25:7–12
Smaltino F, Tamburrini O, Buccelli C, De Ferrari F (2000) Radiologia forense. In: Villari N, Norelli GA (eds) Refertazione e archiviazione. Mediserve, Milano, pp 115–116
Smaltino F, Tamburrini O, Buccelli C, De Ferrari F (2000) Radiologia forense. In: Farneti A, Uslenghi CM, Cazzulani A et al (eds) L’indagine radiologica ai fini medico-legali e peritali nei vari ambiti (penale, civile, amministrativo). Mediserve, Milano, pp 270–275
Puccini C (2003) Istituzioni di medicina legale. In: Puccini C (ed) La causalità. Casa editrice ambrosiana, Milano, pp 61–67
Mandalia V, Fogg AJB, Chari R et al (2005) Bone bruising of the knee. Clin Rad 60:627–636
Bretlau T, Tuxøe J, Larsen L et al (2002) Bone bruise in the acutely injured knee. Knee Surg Sports Traumatol Arthrosc 10:96–101
Roemer FW, Frobel R, Hunter DJ et al (2009) MRI-detected subchondral bone marrow signal alterations of the knee joint: terminology, imaging appearance, relevance and radiological differential diagnosis. Osteoarthritis Cartilage 17:1115–1131
Sanders TG, Medynski MA, Feller JF et al (2000) Bone contusion patterns of the knee at MR imaging: footprint of the mechanism of injury. Radiographics 20:S135–S151
Kaplan PA, Gehl RH, Dussault RG et al (1999) Bone contusion of the posterior lip of the medial tibial plateau (contrecoup injury) and associated internal derangements of the knee at MR imaging. Radiology 211:747–753
Baxamusa TH, Galloway MT (2001) Irreducible knee dislocations secondary to interposed menisci. Am J Orthop 30:141–143
Genovese E, Angeretti MG, Ronga M, Leonardi A, Novario R, Callegari L, Fugazzola C (2007) Follow-up of collagen meniscus implants by MRI. Radiol Med 112(7):1036–1048
Ronga M, Grassi FA, Montoli C, Bulgheroni P, Genovese E, Cherubino P (2005) Treatment of deep cartilage defects of the ankle with matrix-induced autologous chondrocyte implantation (MACI). Foot Ankle Surg 11:29–33
Macarini L, Muscarella S, Lelario M, Stoppino L, Scalzo G, Scelzi A, Armillotta M, Sforza N, Vinci R (2011) Rotator cable at MR imaging: considerations on morphological aspects and biomechanical role. Radiol Med 116(1):102–113
Macarini L, Murrone M, Marini S, Mocci A, Ettorre GC (2004) MRI in ACL reconstructive surgery with PDLLA bioabsorbable interference screws: evaluation of degradation and osteointegration processes of bioabsorbable screws]. Radiol Med 107(1–2):47–57
Musumeci G, Loreto C, Carnazza ML, Coppolino F, Cardile V, Leonardi R (2011) Lubricin is expressed in chondrocytes derived from osteoarthritic cartilage encapsulated in poly (ethylene glycol) diacrylate scaffold. Eur J Histochem EJH 55(3):e31
Colao A, Marzullo P, Vallone G, Giaccio A, Ferone D, Rossi E, Scarpa R, Smaltino F, Lombardi G (1999) Ultrasonographic evidence of joint thickening reversibility in acromegalic patients treated with lanreotide for 12 months. Clin Endocrinol (Oxf) 51(5):611–618
Colao A, Cannavò S, Marzullo P, Pivonello R, Squadrito S, Vallone G, Almoto B, Bichisao E, Trimarchi F, Lombardi G (2003) Twelve months of treatment with octreotide-LAR reduces joint thickness in acromegaly. Eur J Endocrinol 148(1):31–38
Colao A, Pivonello R, Scarpa R, Vallone G, Ruosi C, Lombardi G (2005) The acromegalic arthropathy. J Endocrinol Invest 28(8 Suppl):24–31
Nurzynska D, DiMeglio F, Castaldo C, Latino F, Romano V, Miraglia R, Guerra G, Brunese L, Montagnani S (2012) Flatfoot in children: anatomy of decision making. Ital J Anat Embryol 117(2):98–106
Pinto A, Brunese L, Pinto F, Reali R, Daniele S, Romano L (2012) The concept of error and malpractice in radiology. Semin Ultrasound CT MRI 33(4):275–279
Thornton DD, Rubin DA (2000) Magnetic resonance imaging of the knee menisci. Semin Roentgenol 35:217–230
Tarhan NC, Chung CB, Mohana-Borges AVR et al (2004) Meniscal tears: role of axial MRI alone and in combination with other imaging planes. AJR Am J Roentgenol 183:9–15
Crues JV, Mink J, Levy TL et al (1987) Meniscal tears of the knee: accuracy of MR imaging. Radiology 164:445–448
Glashow JL, Katz R, Schneider M et al (1989) Double-blind assessment of the value of magnetic resonance imaging in the diagnosis of anterior cruciate and meniscal lesions. J Bone Joint Surg Am 71:113–119
Smaltino F, Tamburrini O, Buccelli C, De Ferrari F (2000) Radiologia forense. In: Tamburrini O, De Ferrari F, Pazzaglia UE (eds) L’imaging diagnostico nella valutazione medico-legale del ginocchio. Mediserve, Milano, pp 536–540
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Lelario, M., Ciuffreda, P., Lupo, P. et al. Financial impact of radiological reports on medical–legal evaluation of compensation for meniscal lesions. Musculoskelet Surg 97 (Suppl 2), 137–144 (2013). https://doi.org/10.1007/s12306-013-0282-z
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DOI: https://doi.org/10.1007/s12306-013-0282-z