Magnetic resonance imaging of meniscal degeneration in asymptomatic knees

Histopathological studies have suggested that spontaneous degeneration of knee menisci predisposes to symptomatic tears. We used magnetic resonance (MR) imaging to study noninvasively 20 patients with documented meniscal tears in one knee but asymptomatic contralateral knees, 18 normal controls, and 15 patients with symptomatic nonmeniscal knee disorders. A scoring system for MR signal changes was developed, and differences between the three groups were tested for significance by a multivariate analysis of covariance. MR signal changes in the menisci begin at around 30 years of age, progress with age, occur in both men and women, and occur in subjects who are inactive as well as those who undergo habitual knee stress exercises. Most subjects with documented meniscal tears in one knee have MR signals in the asymptomatic contralateral knee that reflect a more advanced degree of meniscal degeneration than in age-comparable normal controls or patients with nonmeniscal knee disorders. After adjustment for potential confounding variables, weight, and sex, the mean scores in the asymptomatic knee of patients with meniscal disease are significantly higher than those of normal controls (p = 0.021) and nonmeniscal disease patients (p = 0.019). These results document the occurrence of age-dependent degeneration within knee menisci, and support the hypothesis that a segment of the population has pre-existing meniscal degeneration predisposing them to traumatic or spontaneous meniscal tears.