Background: Traumatic knee injuries are among the most common cases that should be evaluated by a forensic medicine specialist. The present study examined the accuracy and reliability of MRI and clinical examination in evaluation of meniscal and anterior and posterior cruciate ligaments in subjects who referred to the Yazd clinical forensic medicine ward depatrment.

Methods: In this study, 114 patients with complaint of traumatic knee injury who had undergone arthroscopy and MRI between October 2013 and May 2014 were included. Considering arthroscopy results as a gold standard, sensitivity, specificity, positive and negative predictive value, and accuracy of MRI and clinical examination were evaluated.

Findings: According to arthroscopic investigations, complete tearing of the anterior cruciate ligament (42.1%) and partial tearing of the anterior and posterior cruciate ligaments (26.3% each) were the most common reported complications. This study indicated that the accuracy of MRI for anterior cruciate ligament, posterior cruciate ligament, medial meniscus and lateral meniscus lesions were 68.4%, 81.6%, 71.9%, and 99.1% respectively. Moreover, the accuracy of clinical examination for anterior cruciate ligament, posterior cruciate ligament, and meniscal lesions were 59.6%, 78.9%, and 75.4% respectively.

Conclusion: The present study indicated that knee MRI and clinical examination results are not obligatory in concordance with arthroscopic findings. Moreover, based on the present results it seems that emphasis on clinical examination findings, is not adequate for assessment of traumatic knee injuries in forensic appraisal.