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. 2024 Oct;52(12):3039-3045.
doi: 10.1177/03635465241277162. Epub 2024 Sep 15.

Prevalence of Abnormalities and Normal Variants in the Adolescent Knee on MRI in a Population-Based Cohort of 3800 Knees

Laura A M Kemmeren  1 , Edwin H G Oei  2 , Marienke van Middelkoop  3 , Denise Eygendaal  1 , Tom M Piscaer  1
Affiliations

Prevalence of Abnormalities and Normal Variants in the Adolescent Knee on MRI in a Population-Based Cohort of 3800 Knees

Laura A M Kemmeren et al. Am J Sports Med. 2024 Oct.

Abstract

Background: Many adolescents experience knee pain, and only some undergo detailed imaging. In this population, the prevalence of abnormalities and normal variants on magnetic resonance imaging (MRI) scans is unknown.

Purpose: To investigate the prevalence of abnormalities and normal variants of the knee on MRI scans and their relationship with participant characteristics in the general young adolescent population.

Study design: Cross-sectional study; Level of evidence, 3.

Methods: This study was part of an open population-based cohort study that focuses on health, growth, and development from fetal life until adulthood. Between 2017 and 2020, adolescents aged 12 to 15 years underwent MRI of both knees. These MRI scans were assessed in a standardized way for abnormalities and normal variants to determine their prevalence. Logistic regression was used to analyze the presence of abnormalities and normal variants in relation to sex, height, weight, body mass index-standard deviation (BMI-SD), and ethnicity.

Results: A total of 1910 participants (median age, 13.5 years; interquartile range, 13.4-13.7 years; 52% girls) were included in this study. Of them, 370 (19.4%) participants had at least 1 abnormality or normal variant. Bone marrow edema around the knee was the most prevalent finding, affecting 140 (7.3%) participants. In 107 (5.6%) participants, nonossifying fibromas were found. A total of 43 (2.3%) participants had characteristics of Osgood-Schlatter disease, 16 (0.8%) showed characteristics of Sinding-Larsen-Johansson syndrome, and osteochondritis dissecans was found in 13 (0.7%) participants. Variants such as discoid menisci were found in 40 (2.1%) participants and a bipartite patella in 21 (1.1%) participants. There were multiple associations between abnormalities or variants and participant characteristics, including bone marrow edema being more often present in boys (odds ratio [OR], 2.44; 95% CI, 1.69-3.52) and those with a lower BMI-SD (OR, 0.85; 95% CI, 0.73-0.98). Osgood-Schlatter and osteochondritis dissecans were more often present in boys (OR, 4.21 [95% CI, 2.01-8.85] and OR, 13.18 [95% CI, 1.71-101.58], respectively). Discoid menisci were associated with a non-Western ethnicity (OR, 2.06; 95% CI, 1.07-3.96) and higher BMI-SD (OR, 2.34; 95% CI, 1.76-3.11).

Conclusion: Abnormalities and normal variants on MRI scans of the knees are common in adolescents. Physicians who are involved in the treatment of adolescents with knee pain need to be aware of this prevalence so that these children will not be overtreated or misdiagnosed.

Keywords: aging athlete; anatomy; articular cartilage; epidemiology; knee; magnetic resonance imaging; meniscus; osteochondritis dissecans; patella; patellar tendon; pediatric sports medicine.

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Conflict of interest statement

One or more of the authors has declared the following potential conflict of interest or source of funding: The Generation R Study is made possible by financial support from Erasmus Medical Center, Rotterdam; Erasmus University Rotterdam; ZonMw; the Netherlands Organisation for Scientific Research (NWO); and the Ministry of Health, Welfare and Sport of the Netherlands. The Anna Foundation (Nederlands Orthopedisch Research en Educatie Fonds) supports the work of L.A.M.K. through a research grant. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.

Figures

Figure 1.
Figure 1.
Flow diagram for the study sample selection. MRI, magnetic resonance imaging.
See this image and copyright information in PMC

References

    1. Bitton R. The economic burden of osteoarthritis. Am J Manag Care. 2009;15(8)(suppl):S230-S235. - PubMed
    1. Cairney J, Veldhuizen S. Organized sport and physical activity participation and body mass index in children and youth: a longitudinal study. Prev Med Rep. 2017;6:336-338. - PMC - PubMed
    1. Cheng Q, Zhao FC. Comparison of 1.5- and 3.0-T magnetic resonance imaging for evaluating lesions of the knee: a systematic review and meta-analysis (PRISMA-compliant article). Medicine (Baltimore). 2018;97(38):e12401. - PMC - PubMed
    1. Cole TJ, Lobstein T. Extended international (IOTF) body mass index cut-offs for thinness, overweight and obesity. Pediatr Obes. 2012;7(4):284-294. - PubMed
    1. Douglas G. Practical Statistics for Medical Research. Vol 1. Chapman and Hall; 1991.