Abstract

Knee pain is a prevalent clinical concern with diverse etiologies, ranging from acute trauma to degenerative and inflammatory conditions. Accurate diagnosis is crucial for effective treatment planning. While clinical examination and radiography are often used initially, they may miss subtle internal derangements. In this study we aim to assess the role of MRI in evaluation of knee joint anomalies. A total of 101 patients with clinically suspected knee pathology underwent knee MRI using a 1.5 Tesla scanner. MRI sequences included axial, sagittal, and coronal views using T1, T2, PD, and fat-saturated protocols. Findings were interpreted by experienced musculoskeletal adiologists. ACL injuries were the most common pathology, with 18.8% complete tears and 17.8% partial tears. PCL abnormalities were less frequent (9.9% partial tears, 5.0% complete tears). MCL tears were observed in 5.9%, while LCL injuries were rare (2.0%). The medial meniscus showed pathological changes in 39.6%, mainly Grade II tears and degeneration. Lateral meniscus abnormalities were infrequent (8.9%). Joint effusions were present in 64.4% of cases, with mild effusion being most common. Osteoarthritic changes were detected in 17.8%, chondromalacia in 7.9%, and bone contusions in 4%. MRI is a highly effective modality for the evaluation of knee pain, providing detailed visualization of soft tissue and bony structures. It significantly improves diagnostic accuracy for ligamentous, meniscal, and joint pathologies, particularly in cases where clinical and radiographic assessments are inconclusive. MRI should be considered the imaging modality of choice in symptomatic patients with suspected internal derangements.

• 1.   Agaliotis, M., Mackey, M. G., Jan, S., & Fransen, M. (2014). Burden of reduced work productivity among people with chronic knee pain: A systematic review. In Occupational and Environmental Medicine. https://doi. org/10.1136/oemed-2013-101997
• 2.   Arumugam, V., Ganesan, G. R., & Natarajan, P. (2015). MRI Evaluation of Acute Internal Derangement of Knee. Open Journal of Radiology. https://doi.org/10.4236/ojrad. 2015.52011
• 3.   Avcu, S., Altun, E., Akpinar, I., Bulut, M. D., Eresov, K., & Biren, T. (2010). Knee joint examinations by magnetic resonance imaging: The correlation of pathology, age, and sex. North American Journal of Medical Sciences, 2(4), 202–204. https://doi.org/10.4297/ najms.2010.2202
• 4.   Baker, P., Reading, I., Cooper, C., & Coggon, D. (2003). Knee disorders in the general population and their relation to occupation. Occupational and Environmental Medicine. https://doi.org/10.1136/oem.60.10.794
• 5.   Benjaminse, A., Gokeler, A., & Van Der Schans, C. P. (2006). Clinical diagnosis of an anterior cruciate ligament rupture: A metaanalysis. In Journal of Orthopaedic and Sports Physical Therapy. https://doi.org/10.2519/ jospt.2006.2011
• 6.   Bijlsma, J. W. J., Berenbaum, F., & Lafeber, F. P. J. G. (2011). Osteoarthritis: An update with relevance for clinical practice. In The Lancet. https://doi.org/10.1016/S0140- 6736(11)60243-2
• 7.   Bunt, C. W., Jonas, C. E., & Chang, J. G. (2018). Knee pain in adults and adolescents: The initial evaluation. American Family Physician.91 IJMHS / Volume 12, Number 2 / July – December 2025
• 8.   Cui, A., Li, H., Wang, D., Zhong, J., Chen, Y., & Lu, H. (2020). Global, regional prevalence, incidence and risk factors of knee osteoarthritis in population-based studies. EClinicalMedicine. https://doi.org/10.1016/j. eclinm.2020.100587
• 9.   Falkowski, W., Gaszyńska, M., Drzewiecka, A., Drzewiecki, A., Korczak, W., Madejska, M., Rudzka, A., Krysińska, A., Woźniak, W., & Magielski, J. (2025). Physical Activity and Knee Joint Injuries - Risk Factors, Management and Prognosis. Journal of Education, Health and Sport, 80(SE-Medical Sciences), 59973. https:// doi.org/10.12775/JEHS.2025.80.59973
• 10.   Farrokhi, S., Chen, Y. F., Piva, S. R., Fitzgerald, G. K., Jeong, J. H., & Kwoh, C. K. (2016). The influence of knee pain location on symptoms, functional status, and knee-related quality of life in older adults with chronic knee pain: Data from the osteoarthritis initiative. Clinical Journal of Pain. https://doi.org/10.1097/ AJP.0000000000000291
• 11.   Guermazi, A., Roemer, F. W., Burstein, D., & Hayashi, D. (2011). Why radiography should no longer be considered a surrogate outcome measure for longitudinal assessment of cartilage in knee osteoarthritis. In Arthritis Research and Therapy. https://doi. org/10.1186/ar3488
• 12.   Helito, P. V. P., Peters, B., Helito, C. P., & Van Dyck, P. (2018). Imaging evaluation of the multiligament injured knee. Annals of Joint. https://doi.org/10.21037/aoj.2018.09.03
• 13.   Howell, R., Kumar, N. S., Patel, N., & Tom, J. (2014). Degenerative meniscus: Pathogenesis, diagnosis, and treatment options. World Journal of Orthopedics. https://doi. org/10.5312/wjo.v5.i5.597
• 14.   Hunter, D. J., & Bierma-Zeinstra, S. (2019). Osteoarthritis. In The Lancet. https://doi. org/10.1016/S0140-6736(19)30417-9
• 15.   Katz, J. W., & Fingeroth, R. J. (1986). The diagnostic accuracy of ruptures of the anterior cruciate ligament comparing the Lachman test, the anterior drawer sign, and the pivot shift test in acute and chronic knee injuries. The American Journal of Sports Medicine. https:// doi.org/10.1177/036354658601400115
• 16.   Klara, K., Collins, J. E., Gurary, E., Elman, S. A., Stenquist, D. S., Losina, E., & Katz, J. N. (2016). Reliability and accuracy of crosssectional radiographic assessment of severe knee osteoarthritis: Role of training and experience. Journal of Rheumatology. https:// doi.org/10.3899/jrheum.151300
• 17.   McWilliams, D. F., Leeb, B. F., Muthuri, S. G., Doherty, M., & Zhang, W. (2011). Occupational risk factors for osteoarthritis of the knee: A meta-analysis. Osteoarthritis and Cartilage. https://doi.org/10.1016/j.joca.2011.02.016
• 18.   Miranda, H., Viikari-Juntura, E., Martikainen, R., & Riihimäki, H. (2002). A prospective study on knee pain and its risk factors. Osteoarthritis and Cartilage. https://doi.org/10.1053/ joca.2002.0796
• 19.   O’Keeffe, S. A., Hogan, B. A., Eustace, S. J., & Kavanagh, E. C. (2009). Overuse Injuries of the Knee. In Magnetic Resonance Imaging Clinics of North America. https://doi.org/10.1016/j. mric.2009.06.010
• 20.   Peat, G., McCarney, R., & Croft, P. (2001). Knee pain and osteoarthritis in older adults: A review of community burden and current use of primary health care. In Annals of the Rheumatic Diseases. https://doi.org/10.1136/ ard.60.2.91
• 21.   Scott, D. L., Wolfe, F., & Huizinga, T. W. J. (2010). Rheumatoid arthritis. The Lancet. https://doi. org/10.1016/S0140-6736(10)60826-4
• 22.   Sokal, P. A., Norris, R., Maddox, T. W., & Oldershaw, R. A. (2022). The diagnostic accuracy of clinical tests for anterior cruciate ligament tears are comparable but the Lachman test has been previously overestimated: a systematic review and meta-analysis. In Knee Surgery, Sports Traumatology, Arthroscopy. https://doi.org/10.1007/s00167-022-06898-4
• 23.   Swagerty, D. L., & Hellinger, D. (2001). Radiographic assessment of osteoarthritis. American Family Physician.
• 24.   Thati, S. (2021). Gender differences in osteoarthritis of knee: An Indian perspective. In Journal of Mid-Life Health. https://doi. org/10.4103/jmh.jmh_35_21
• 25.   Urwin, M., Symmons, D., Allison, T., Brammah, T., Busby, H., Roxby, M., Simmons, A., & Williams, G. (1998). Estimating the burden of musculoskeletal disorders in the community: The comparative prevalence of symptoms at different anatomical sites, and the relation to social deprivation. Annals of the Rheumatic Diseases. https://doi.org/10.1136/ ard.57.11.649
• 26.   Yasen, S. K. (2023). Common knee injuries, diagnosis and management. In Surgery (United Kingdom). https://doi.org/10.1016/j. mpsur.2023.02.

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Funding