DEVELOPMENTAL MENISCAL SIGNAL CHANGES: A DIAGNOSTIC DILEMMA IN PEDIATRIC KNEE MAGNETIC RESONANCE IMAGING

Aim: The menisci in pediatric patients often exhibit high signal intensity on knee MRIs due to vascularization, which may be misinterpreted as pathological. In this study, we aimed to analyze the prevalence of developmental meniscal signal alterations in pediatric knee MRIs and explore their relationship with age, sex, and magnetic field strength.Materials and Methods: This retrospective study reviewed knee MRIs of patients under 18 years of age, performed from January 2015 to June 2024. The cohort was divided into five age groups. Meniscal signal characteristics were assessed on T1-weighted (T1W) and proton density-weighted (PDW) sequences. The analysis focused on signal heterogeneity in both the medial and lateral menisci, with comparisons based on age, sex, and magnetic field strength of the MRI scanner (1.5 T vs. 3 T).Results: A total of 285 patients and 433 MRIs were included. Heterogeneous meniscal signals were more frequently observed in the medial meniscus, especially in T1W sequences. The frequency of these signals decreased with age in the lateral meniscus but remained consistent in the medial meniscus. Magnetic field strength at 3T showed higher heterogeneity compared to 1.5 T in Groups 2 and 3. Gender differences in signal characteristics were observed in Group 5, with males showing higher heterogeneity.Conclusion: Developmental meniscal signal changes in pediatric patients are primarily attributed to vascularization, particularly in the medial meniscus, and become more pronounced with higher magnetic field strengths. Increased physical activity likely contributes to meniscal signal heterogeneity, which should not be immediately interpreted as degeneration or tear. Recognition of these non-pathological signal alterations may help avoid unnecessary orthopedic consultations and surgical interventions.