Findings Associated With Knee Pathology on MRI in Patients Without Osteoarthritis. Issue 11 (November 2017)

• Record Type: Journal Article
• Authors: Wylie, James D.; Makarewich, Christopher A.; Working, Zach M.; Jacobson, Lance; Schmidt, Robert L.; Crim, Julia R.; Burks, Robert T.
• Is Part Of: Journal of the American Academy of Orthopaedic Surgeons. Volume 25:Issue 11(2017)
• Publication Date: 2017-11
• Subjects: knee magnetic resonance imaging -- patient history -- physical examination -- positive findings -- osteoarthritis -- knee imaging -- ligamentous instability examination -- MRI; Orthopedics -- Periodicals; Orthopedic surgery -- Periodicals; Joint Diseases -- Periodicals; Orthopedics -- Periodicals; Orthopedic surgery; Orthopedics; Periodicals; 616.7005
• DOI: 10.5435/JAAOS-D-16-00797
• Languages: English
• ISSNs: 1067-151X

Abstract

Abstract : 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