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E1006. Clinical Significance of MRI Abnormalities of the Semimembranosus Tendon at the Knee
Authors
  1. Kim Lee; University of California, Los Angeles
  2. Benjamin Levine; University of California, Los Angeles
  3. Benjamin Plotkin; University of California, Los Angeles
  4. Leanne Seeger; University of California, Los Angeles
  5. Kambiz Motamedi; University of California, Los Angeles
Objective:
To determine the clinical significance of MRI abnormalities of the semimembranosus tendon (SMT) at the knee.

Materials and Methods:
After IRB approval, 121 consecutive knee MRIs from January– February 2017 were retrospectively reviewed. T2 signal of the SMT was assessed and characterized as normal, intermediate, or high. The presence of surrounding fluid, partial tear, tendon insertion striations, and other medial knee pathology (specifically Baker cyst and pes anserine bursitis) were assessed. A corresponding chart review of the referring clinicians’ notes was performed to document localization of knee pain and was categorized as medial pain, all other pain not medially localized, and generalized pain / miscellaneous symptoms such as limited range of motion.

Results:
Of the 121 MRIs, 58 (48%) demonstrated abnormal SMT signal. There was no correlation between abnormal tendon signal and medial knee symptoms (p = 0.3). Of the 121 MRIs, 6 (5%) demonstrated partial SMT tearing, 3 of which reported medial pain. Additionally, 15 out of the total 121 MRIs (12%) and 12 of the 58 abnormal MRIs (21%) demonstrated peri-tendinous fluid, with a correlation between abnormal signal and presence of fluid (p = 0.01). 102 of the total MRIs (84%) and 55 of the abnormal MRIs (95%) demonstrated normal tendon insertion striations, with a correlation between abnormal signal and presence of striations (p = 0.01). Lastly, 38 out of the total MRIs (31%) and 23 of the abnormal MRIs (40%) demonstrated the additional specified medial knee pathology, with a nonsignificant, but notable correlation between abnormal tendon signal and other medial knee pathology (p = 0.06).

Conclusion:
MRI abnormalities of the SMT in the knee are most often incidental and do not have a clinical correlation with reported medial knee symptoms. They are correlated with the presence of other pathology around the knee joint and with the presence of normal tendon insertion striations. Correlation with clinical symptoms and medialized knee pain should be considered prior to ascribing increased distal SMT signal to tendinopathy.