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Word of the Day

Knee findings on MRI are common in older adults with or without pain

Clinical Question:
What is the likelihood of finding abnormalities on magnetic resonance imaging of radiographically normal knees?

Bottom Line:
Most adults (86% - 92%) older than 50 years without osteoarthritis as diagnosed by x-ray will have knee damage found on magnetic resonance imaging (MRI). Abnormalities are common in patients with or without pain and are independent of weight. (LOE = 2b)

Guermazi A, Niu J, Hayashi D, et al. Prevalence of abnormalities in knees detected by MRI in adults without knee osteoarthritis: population based observational study (Framingham Osteoarthritis Study). BMJ 2012;345:e5339.  [PMID:22932918]

Study Design:
Cohort (prospective)



This population-based study recruited 992 adults at least 50 years old (mean age = 62 years) from a single community to participate in the study. The authors included all recruits, though only 29% reported painful knees. Then they ran all patients through an MRI and then took x-rays of their knees, excluding patients (n = 253) with evidence of osteoarthritis. Radiologists reading the scans were masked to patient data and the other scan results. Of the patients without radiographic evidence of osteoarthritis, 89% had at least one type of abnormality on MRI, including osteophytes (74%), cartilage damage (69%), and bone marrow lesions (52%). Meniscal lesions were present in 35% of men and 15% of women. Damage was similar in patients with and without knee pain, and was not related to degree of obesity.


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