Risk factors for medial meniscal pathology on knee MRI in older US adults: A multicentre prospective cohort study

Martin Englund*, David T. Felson, Ali Guermazi, Frank W. Roemer, Ke Wang, Michel D. Crema, John A. Lynch, Leena Sharma, Neil A. Segal, Cora E. Lewis, Michael C. Nevitt

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

94 Scopus citations


Objectives: Meniscal pathology in which the aetiology is often unclear is a frequent finding on knee MRI. This study investigates potential risk factors for medial meniscal lesions or extrusion in middle-aged and elderly persons. Methods: Prospective cohort study using population-based subjects from Birmingham, Alabama and Iowa City, Iowa, USA (the Multicenter Osteoarthritis Study). 644 men and women aged 50-79 years with or at high risk of knee osteoarthritis (Kellgren and Lawrence grade 0-2) but with normal medial meniscal status at baseline were studied. Paired baseline and 30-month 1.0 T knee MRI were scored for meniscal lesions and extrusion (pathology) and the following systemic, knee-specific and compartment-specific potential risk factors were evaluated: age, sex, body mass index, bony enlargement of finger joints, knee trauma, leg-length inequality and knee alignment. Results: Of 791 knees, 77 (9.7%) had medial meniscal pathology at 30 months follow-up. 61 of the 77 (81%) had no report of trauma during follow-up. Including all potential risk factors in the multivariable model, the adjusted OR for medial meniscal pathology was 4.14 (95% CI 2.06 to 8.31) for knee trauma during follow-up, 1.64 (1.00 to 2.70) for five or more bony enlargements of finger joints (vs ≤4) and 2.00 (1.18 to 3.40) for varus alignment (vs not varus) at baseline examination. Obesity was a risk factor for the development of meniscal extrusion, OR 3.04 (1.04 to 8.93) but not for meniscal lesions, OR 1.15 (0.52 to 2.54). Conclusions: Apart from knee trauma, possible generalised osteoarthritis, expressed as multiple bony enlargements of finger joints, varus alignment and obesity are risk factors for medial meniscal pathology.

Original languageEnglish (US)
Pages (from-to)1733-1739
Number of pages7
JournalAnnals of the rheumatic diseases
Issue number10
StatePublished - Oct 2011

ASJC Scopus subject areas

  • General Biochemistry, Genetics and Molecular Biology
  • Immunology and Allergy
  • Rheumatology
  • Immunology


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