Prevalence of Clinically Relevant Findings on Magnetic Resonance Imaging in Middle‐Aged Adults With Knee Pain and Suspected Meniscal Tear: A Follow‐Up

Abstract

ObjectiveRadiographs are frequently obtained in patients with knee osteoarthritis (KOA), with magnetic resonance imaging (MRI) reserved for complex cases. There is little data on how often subsequent MRI reveals clinically actionable but unanticipated findings. The purpose of this study is to estimate the prevalence of these findings on MRI in patients managed nonoperatively for suspected meniscal tears.MethodsThe TeMPO study enrolled subjects aged 45‐85 years with knee pain, osteoarthritis (Kellgren‐Lawrence (KL) grade 0‐3), and suspected meniscal tear. We reviewed baseline MRI images and recorded notable findings, including subchondral insufficiency fractures of the knee (SIFK), avascular necrosis (AVN), tumors, and non‐subchondral fractures. Other baseline data included demographic characteristics, Knee Injury and Osteoarthritis Outcome Score (KOOS) pain scores, duration of knee symptoms, and KL grade.ResultsStudy‐ordered MRIs were performed on 760 subjects with 61 concerning findings identified (8.03%, 95% CI: 6.09%, 9.96%). Twenty‐five were SIFK, 10 were non‐subchondral fractures, 4 were AVN, 8 were benign tumors, and 14 were other clinically relevant findings.ConclusionsWe estimated the prevalence of clinically relevant incidental findings on MRI to be 8.03% in middle‐aged adults with mild to moderate KOA and suspected meniscal tear. These data may prompt clinicians to be more aware of the range of findings that can underlie knee symptoms, some of which could change management but may require different modalities of imaging to detect. Future research is needed to pinpoint factors associated with these concerning findings so that at‐risk patients can be identified and referred for advanced imaging.