title: Risk factors for medial meniscal pathology on knee MRI in older US adults: a multicentre prospective cohort study.
abstract: OBJECTIVE
  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.
authors.affiliation: Lund University, Lund, Sweden. martin.englund@med.lu.se
authors.forename: Martin
authors.initials: M
authors.lastname: Englund
authors.forename: David T
authors.initials: DT
authors.lastname: Felson
authors.forename: Ali
authors.initials: A
authors.lastname: Guermazi
authors.forename: Frank W
authors.initials: FW
authors.lastname: Roemer
authors.forename: Ke
authors.initials: K
authors.lastname: Wang
authors.forename: Michel D
authors.initials: MD
authors.lastname: Crema
authors.forename: John A
authors.initials: JA
authors.lastname: Lynch
authors.forename: Leena
authors.initials: L
authors.lastname: Sharma
authors.forename: Neil A
authors.initials: NA
authors.lastname: Segal
authors.forename: Cora E
authors.initials: CE
authors.lastname: Lewis
authors.forename: Michael C
authors.initials: MC
authors.lastname: Nevitt
mesh_terms: D000368:Aged; D004812:Epidemiologic Methods; D005260:Female; D005384:Finger Joint / Q000473:pathology; D006801:Humans; D016916:Joint Deformities, Acquired / Q000473:pathology; D007718:Knee Injuries / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008592:Menisci, Tibial / Q000473:pathology*; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D020370:Osteoarthritis, Knee / Q000473:pathology*; D000070600:Tibial Meniscus Injuries