Magnetic Resonance Imaging of the Knee in Asymptomatic Professional Basketball Players

Patellar Cartilage: T2 Values and Morphologic Abnormalities at 3.0-T MR Imaging in Relation to Physical Activity in Asymptomatic Subjects from the Osteoarthritis Initiative

“…Physically active subjects (mean age, 33 years) had a high prevalence of focal cartilage abnormalities. In some studies (54)(55)(56), the most frequent fi ndings in physically active subjects were abnormalities in meniscal signal intensity or tears (13%-50%), bone marrow edema (up to 41%), or joint effusion (up to 35%). Two studies performed at 1.5 T also found cartilage lesions: Kaplan et al ( 56 ) examined both knees of 20 basketball players.…”

Inter-rater reliability of the McKenzie System of Mechanical Diagnosis and Therapy in the examination of the knee

“…In summary, it has been suggested that MRI findings should be interpreted with caution as findings do not indicate symptoms or functional level (Kaplan et al, 2005). With evidence demonstrating the presence of asymptomatic pathology in the knee, it is reasonable to question not only the diagnostic utility of detecting pathology but also whether one can be certain an implicated structure is the cause of an individual's symptoms.…”

“…These values are substantially higher than those previously reported by LaPrade et al (1994) who concluded that emphasis is needed on the importance of matching MRI findings with the history and physical examination after finding a prevalence rate of 5.6% for asymptomatic meniscal tear in 54 men and women with no previous history of knee pain or trauma. What should be noted is that Kaplan et al (2005), LaPrade et al (1994) and Zanetti et al (2002), screened subjects for knee pathology prior to their participation.…”

“…The reported psychometric properties and hence the diagnostic accuracy of many of the commonly used OSTs are influenced by a number of factors including but not limited to rater experience, varied interpretation of the result findings, lack of a standardized approach to performance of the test and study design-related bias (Cook et al, 2012;Hegedus et al, 2007;Geraets et al, 2015;Lange et al, 2014;Leblanc et al, 2015;Peeler et al, 2010). Moreover, research around medical imaging such as magnetic resonance imaging (MRI) have investigated the limitation of findings through the presence of asymptomatic pathology and abnormalities (Beattie et al, 2008;Boks, Vroegindeweij, Koes, Hunink &Bierma-Zeinstra, 2006;Kaplan, Schurhoff, Selesnick, Thorpe & Uribe, 2005;LaPrade, Burnett, Veenstra & Hodgman, 1994). With the relationship between pain and radiographic pathology not fully understood and limitations in reported diagnostic accuracy of OSTs, it has been suggested that specifically defined criteria used by non-pathoanatomical classification systems may offer better utility and should be considered as an alternative to the current model .…”

“…Studying athletes and active individuals, a number of articles have highlighted the presence of previously undiagnosed anatomical abnormalities with medical imaging in pain-free individuals (Beattie et al, 2008;Boks et al, 2006;Kaplan et al, 2005;LaPrade et al, 1994). Kaplan et al (2005) reviewed the knee MRI findings of 20 National Basketball Association (NBA) players that met the inclusion criteria of no history of knee pain or surgery and had negative tests on physical examination for the presence of knee abnormalities such as meniscal and ligamentous disruptions and patella-femoral joint pain. The findings of the study, looking at players ranging from 21 to 36 years old, found that 47.5% of the evaluated knees had articular cartilage lesions and 20% of knees had meniscal tears.…”