ORTHOPEDICS | Healio.com/Orthopedics n Feature Article abstract Full article available online at Healio.com/Orthopedics. Search: 20130724-24 The purpose of this study was to evaluate the ability of 3.0-Tesla magnetic resonance imaging (MRI) to accurately assess knee articular cartilage lesions. Sixteen patients who had knee 3.0-T MRI and underwent knee arthroscopy for partial meniscectomy were included. Three fellowship-trained sports medicine orthopedic surgeons re- viewed all images. Articular lesions on MRI were graded from I to IV and compared with arthroscopic grading using the Outerbridge and the International Cartilage Repair Society (ICRS) classifications. The articular surface was divided into 6 regions. Based on MRI findings, of the 288 articular surface evaluations, 113 (39%) surface evaluations were classified as disease-positive (grade 2 to 4). Kappa interrater reli- ability scores for MRI evaluation, Outerbridge classification, and ICRS classification were 0.13, 0.54, and 0.41, respectively. Using the Outerbridge classification as a ref- erence standard, the sensitivity, specificity, and accuracy were 57%, 71%, and 63%, respectively. Using the ICRS classification, sensitivity, specificity, and accuracy were 59%, 71%, and 69%, respectively. When isolating the articular grading to the se- nior author on MRI evaluation vs Outerbridge classification, the sensitivity, specificity, and accuracy were 54%, 92%, and 75%, respectively. Based on the current findings, 3.0-T MRI is as an invaluable noninvasive tool with good diagnostic value for assessing articular cartilage lesions of the knee, although it may not be as sensitive and accurate as previously reported. The authors are from the Department of Orthopaedic Surgery (MER, DCV, GFH, SJN, RM, CTV); the Department of Biokinesiology and Physical Therapy (WSB); the Department of Radiology (PMC, RM), Keck School of Medicine, University of Southern California, Los Angeles; and the Department of Orthopaedic Surgery (RM), Kaiser Permanente, Baldwin Park, California. The authors have no relevant financial relationships to disclose. Correspondence should be addressed to: Diego C. Villacis, MD, Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, 1200 N State St, GNH 3900, Los Angeles, CA 90033 (diego.villacis@gmail.com). doi: 10.3928/01477447-20130724-24 3.0-Tesla MRI and Arthroscopy for Assessment of Knee Articular Cartilage Lesions MARTY E. REED, MD; DIEGO C. VILLACIS, MD; GEORGE F. (RICK) HATCH III, MD; WENDY S. BURKE, PT, DPT, MS; PATRICK M. COLLETTI, MD; STEVEN J. NARVY, MD; RAFFY MIRZAYAN, MD; C. THOMAS VANGSNESS JR, MD Figure: Coronal (A) and sagittal (B) 3.0-Tesla mag- netic resonance images using a T2-weighted proton density magnetic resonance image with fat suppres- sion sequence showing a full-thickness defect of the cartilage involving the posterior aspect of the me- dial femoral condyle. This finding was classified as a grade 4 lesion and was confirmed during arthroscopy on the Outerbridge and International Cartilage Repair Society classifications. A B e1060