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First published on July 21, 2006, doi:10.1177/0363546506290189
This version was published on December 1, 2006
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Right arrow Imaging Studies
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The American Journal of Sports Medicine 34:1984-1991 (2006)
© 2006 American Orthopaedic Society for Sports Medicine

Magnetic Resonance Imaging Abnormalities in Symptomatic and Contralateral Knees

Prevalence and Associations With Traumatic History in General Practice

Simone S. Boks, MD*,{dagger}, Dammis Vroegindeweij, MD, PhD{ddagger}, Bart W. Koes, PhD{dagger}, Myriam M. G. M. Hunink, MD, PhD§ and Sita M. A. Bierma-Zeinstra, PhD{dagger}

From the {dagger} Department of General Practice, Erasmus MC, Rotterdam, Netherlands, the {ddagger} Department of Radiology, Medical Centre Rijnmond-Zuid, Rotterdam, Netherlands, the § Department of Radiology and Department of Epidemiology & Biostatistics, Erasmus MC, Rotterdam, Netherlands

* Address correspondence to Simone S. Boks, MD, Duistere Steeg 4, 8051 ZR Hattem, Netherlands (e-mail: s.boks{at}erasmusmc.nl).

Background: After trauma, internal knee lesions are found in approximately two thirds of patients. However, magnetic resonance imaging abnormalities have also been described in asymptomatic volunteers.

Hypothesis: Not all visualized lesions in symptomatic posttraumatic knees are the result of recent trauma; there are subgroups of lesions that may be preexistent.

Study Design: Cross-sectional study (prevalence); Level of evidence, 2.

Methods: Patients visiting their general practitioners after knee trauma were invited for magnetic resonance imaging of both knees. Prevalence of knee abnormalities was compared between symptomatic and asymptomatic knees. Multivariable analysis was performed to investigate the association between lesions that were seen in symptomatic and asymptomatic knees (ie, effusion and meniscal tears) and recent trauma, history of old trauma, age, and osteoarthritis.

Results: In 134 participants, ligament lesions were found almost exclusively in symptomatic knees. Meniscal lesions and effusion were almost equally found in symptomatic and asymptomatic knees. Effusion was related to recent trauma (odds ratio, 14.0; 95% confidence interval, 5.0–39.6) and osteoarthritis (odds ratio, 4.7; 95% confidence interval, 1.4–15.5) but not to history of old trauma and age. Meniscal tears were more common in older patients (odds ratio, 1.09; 95% confidence interval, 1.05–1.12) but were not related to osteoarthritis. History of old trauma was more strongly related to the group of radial, longitudinal, and complex meniscal tears (odds ratio, 8.6; 95% confidence interval, 3.3–22.5) than to horizontal tears (odds ratio, 2.3; 95% confidence interval, 0.9–5.6). Recent trauma was not related to horizontal meniscal tears but was strongly related to other types of meniscal tears (odds ratio, 3.2; 95% confidence interval, 1.4–6.9).

Conclusion: Ligament knee lesions are most probably the result of recent trauma. Radial, longitudinal, and complex meniscal tears are strongly related to trauma, whereas horizontal meniscal tears and effusion may be preexistent in many cases.

Key Words: knee • trauma • magnetic resonance imaging (MRI) • general practice




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