Prevalence of abnormal findings in 230 knees of asymptomatic adults using 3.0 T MRI

Abstract

Objective To identify abnormalities in asymptomatic sedentary individuals using 3.0 Tesla high-resolution MRI. Materials and methods The cohort comprised of 230 knees of 115 uninjured sedentary adults (51 males, 64 females; median age: 44 years). All participants had bilateral knee 3.0 T MRIs. Two senior musculoskeletal radiologists graded all intraarticular knee structures using validated scoring systems. Participants completed Knee Injury and Osteoarthritis Outcome Score questionnaires at the time of the MRI scan. Results MRI showed abnormalities in the majority (97%) of knees. Thirty percent knees had meniscal tears: horizontal (23%), complex (3%), vertical (2%), radial (2%) and bucket handle (1%). Cartilage and bone marrow abnormalities were prevalent at the patellofemoral joint (57% knees and 48% knees, respectively). Moderate and severe cartilage lesions were common, in 19% and 31% knees, respectively, while moderate and severe bone marrow oedema in 19% and 31% knees, respectively. Moderateintensity lesion in tendons was found in 21% knees and high-grade tendonitis in 6% knees-the patellar (11% and 2%, respectively) and quadriceps (7% and 2%, respectively) tendons being most affected. Three percent partial ligamentous ruptures were found, especially of the anterior cruciate ligament (2%). Conclusion Nearly all knees of asymptomatic adults showed abnormalities in at least one knee structure on MRI. Meniscal tears, cartilage and bone marrow lesions of the patellofemoral joint were the most common pathological findings. Bucket handle and complex meniscal tears were reported for the first time in asymptomatic knees.

The use of magnetic resonance imaging (MRI) of the knee in current clinical practice: A retrospective evaluation of the MRI reports within a large NHS trust

“…The rate of SONK was much lower in this study compared to previous literature (0.3% vs 3.4%) [17]. A reason for this is the range of patients included in this study was 1-98 and SONK has been found to be more common in older patients [17]. As a result, the overall rate is expected to be lower in this study as we included patients of all ages, whereas the previous study only included patients above 50 years old.…”

“…The rate of ACL ligament rupture found in this study was lower than previously reported (8% vs 17%) [14]. The rate of SONK was much lower in this study compared to previous literature (0.3% vs 3.4%) [17]. A reason for this is the range of patients included in this study was 1-98 and SONK has been found to be more common in older patients [17].…”

Identifying participants with knee osteoarthritis likely to benefit from physical therapy education and exercise: A hypothesis‐generating study

“…One explanation for the modest effect sizes may be the clinical complexity and heterogeneity of people with OA associated knee pain (Sinikallio et al., 2014). While radiological evidence of degeneration is a sentinel feature of knee OA, such findings are highly prevalent in pain free individuals (Horga et al., 2020) and the degree of structural change is not strongly associated with levels of reported pain (Bedson & Croft, 2008), suggesting that other factors require consideration. For example, people with higher Body Mass Index (BMI) experience greater pain than individuals with lower BMI even when taking into account OA severity (Weiss, 2014).…”

Comparison of 8-year knee osteoarthritis progression in 2 siblings: a case-based review

“…2). Supplemental searches were performed to expand on key topics identified in the original literature search, i.e., subchondral bone pathology [1], knee sleeves [2][3][4][5][19][20][21], bone marrow lesions [22][23][24][25][26], clinical risk factors for knee OA progression [27][28][29][30][31][32][33], OA phenotypes [34], nonpharmacological treatments for OA [35][36][37][38][39][40][41][42][43], and clinical practice guidelines for OA management [44].…”

“…Bone marrow lesions (sometimes called bone marrow edema) have been demonstrated to be present in individuals without [8,22] and with [23] clinical OA; to wax and wane with weight-bearing activity (e.g., in marathon runners [24,25]); and to be associated with incident knee pain in individuals at risk of OA [26], and with pain and disability for activities of daily living in patients with established OA [9]. Joint fluid overload correlates with symptoms.…”