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Meniscal Damage on Knee MRI in the General Population

Only about one third of people with meniscal damage reported knee pain, aching, or stiffness.

Magnetic resonance imaging of the knee often reveals meniscal tears. However, whether a meniscal tear is responsible for the symptoms that prompted the MRI is not always clear. In this study from Massachusetts, 991 volunteers (age, 50) — recruited through random-digit dialing — underwent routine MRI and conventional radiography of the right knee and completed symptom questionnaires.

The prevalence of meniscal damage (tears or destruction) was 35%. Only about one third of people with meniscal damage reported having knee symptoms (pain, aching, or stiffness) within the previous month. Meniscal tears were found in 45% of people who reported knee symptoms on most days but also in 26% of people with lesser or no symptoms.

The prevalence of substantial radiographic osteoarthritis was 18%. Meniscal damage was much more common in people with radiographic osteoarthritis than in people without (82% vs. 25%). Among people with osteoarthritis (in both a subgroup with symptoms on most days and a subgroup without such symptoms), the prevalence of at least one meniscal tear was about 60%.

Comment: This study illustrates the complex interplay between knee symptoms, meniscal injury, and osteoarthritis. Many patients with meniscal tears are asymptomatic; in symptomatic patients who have both osteoarthritis and meniscal damage, the cause of symptoms can be unclear. Clinicians should consider these observations when invasive procedures are contemplated for patients with knee pain.

— Allan S. Brett, MD

Published in Journal Watch General Medicine September 18, 2008

Citation(s):

Englund M et al. Incidental meniscal findings on knee MRI in middle-aged and elderly persons. N Engl J Med 2008 Sep 11; 359:1108.

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