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Findings Associated With Knee Pathology on MRI in Patients Without Osteoarthritis
James D Wylie1, Christopher A Makarewich, Zach M Working
1From the Department of Orthopaedics, Boston Children's Hospital, Boston, MA (Dr. Wylie), the Department of Orthopaedics, University of Utah, Salt Lake City, UT (Dr. Makarewich, Dr. Working, Dr. Jacobson, Dr. Schmidt, and Dr. Burks), and the Department of Radiology, University of Missouri, Columbia, MO (Dr. Crim).
Introduction:
We conducted a retrospective study in patients with minimal or no radiographically evident knee osteoarthritis to determine whether presenting signs and symptoms were predictive of knee pathology that was evident on MRI and could be treated with nonarthroplasty knee surgery or could alter nonsurgical treatment.
Methods:
We reviewed records of patients for whom sports medicine orthopaedic surgeons had ordered an MRI of the knee. Univariate analysis identified factors that were associated with positive MRI findings (eg, surgically treatable lesion, meniscal tear) or a finding that could alter treatment. We used multivariate logistic regression to determine independent predictors of evidence of pathology on MRI.
Results:
Of the 434 patients in the study, 281 (64.7%) had evidence of knee pathology on MRI. Acute injury, effusion, and ligamentous instability were among the independent predictors of positive MRI results. Patients with evidence of knee pathology on MRI were more likely to have undergone surgery.
Discussion:
Specific aspects of patient history and physical examination are associated with evidence of knee pathology on MRI.
Conclusions:
In patients without osteoarthritis, positive findings on knee MRI could be associated with a number of presenting signs and symptoms, and this information could aid physicians in deciding which patients should undergo knee MRIs. Additional prospective research is needed to validate the relationships discovered in our study.
Level Of Evidence:
Level III retrospective study.
