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

Laura A.M. Kemmeren, Edwin H.G. Oei, Marienke van Middelkoop, Denise Eygendaal, Tom M. Piscaer
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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.
3800 例人群中青少年膝关节核磁共振成像异常和正常变异的发生率
背景:许多青少年都有膝关节疼痛的经历,但只有部分青少年接受了详细的影像学检查。研究设计:横断面研究;证据级别:3.方法:本研究是一项基于人群的开放式队列研究的一部分,该研究关注从胎儿期到成年期的健康、生长和发育情况。2017年至2020年间,12至15岁的青少年接受了双膝核磁共振成像检查。这些核磁共振扫描以标准化方式评估异常和正常变异,以确定其患病率。结果:本研究共纳入 1910 名参与者(中位年龄 13.5 岁;四分位间范围 13.4-13.7 岁;52% 为女孩)。其中,370 人(19.4%)至少有一项异常或正常变异。膝关节周围的骨髓水肿是最普遍的发现,影响了 140 名(7.3%)参与者。107人(5.6%)发现了非溃疡性纤维瘤。共有 43 人(2.3%)具有 Osgood-Schlatter 病的特征,16 人(0.8%)具有 Sinding-Larsen-Johansson 综合征的特征,13 人(0.7%)患有骨软骨炎。有 40 人(2.1%)发现了盘状半月板等变异,21 人(1.1%)发现了双关节髌骨。异常或变异与参与者的特征之间存在多种关联,包括骨髓水肿更多见于男孩(几率比 [OR],2.44;95% CI,1.69-3.52)和 BMI-SD 较低者(OR,0.85;95% CI,0.73-0.98)。男孩更常出现 Osgood-Schlatter 和骨软骨炎(Osteochondritis dissecans)(OR,分别为 4.21 [95% CI,2.01-8.85] 和 OR,13.18 [95% CI,1.71-101.58])。盘状半月板与非西方种族(OR,2.06;95% CI,1.07-3.96)和较高的 BMI-SD (OR,2.34;95% CI,1.76-3.11)有关。结论:青少年膝关节核磁共振成像扫描的异常和正常变异很常见,参与治疗青少年膝关节疼痛的医生需要了解这一普遍性,以免这些孩子被过度治疗或误诊。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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