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RSNA Press Release

At A Glance:
  • High levels of physical activity may result in knee damage and eventually arthritis for middle-aged men and women.
  • MRI showed evidence of knee abnormalities, including cartilage damage and ligament lesions, in active adults with no pain or other symptoms.
  • Osteoarthritis affects 27 million Americans.

Too Much Physical Activity May Lead to Arthritis

Released: November 30, 2009

Media Contacts: RSNA Newsroom 1-312-949-3233
Before 11/28/09 or after 12/03/09: RSNA Media Relations: 1-630- 590-7762

Linda Brooks
1-630-590-7738
lbrooks@rsna.org
Maureen Morley
1-630-590-7754
mmorley@rsna.org

CHICAGO — Middle-aged men and women who engage in high levels of physical activity may be unknowingly causing damage to their knees and increasing their risk for osteoarthritis, according to a study presented today at the annual meeting of the Radiological Society of North America (RSNA).

"Our data suggest that people with higher physical activity levels may be at greater risk for developing knee abnormalities and, thus, at higher risk for developing osteoarthritis," said Christoph Stehling, M.D., research fellow in the Department of Radiology and Biomedical Imaging at the University of California, San Francisco (UCSF) and radiology resident in the Department of Clinical Radiology, University of Muenster, Germany.

Osteoarthritis is a degenerative joint disease that causes pain, swelling and stiffness. According to the Centers for Disease Control and Prevention, osteoarthritis is the most common form of arthritis and affects an estimated 27 million American adults.

The UCSF study involved 236 asymptomatic participants who had not reported previous knee pain and were enrolled in the National Institutes of Health Osteoarthritis Initiative. Study participants included 136 women and 100 men, age 45 to 55, within a healthy weight range. The participants were separated into low-, middle-, and high-activity groups based on their responses to the Physical Activity Scale for the Elderly (PASE) questionnaire. PASE is a standard test that scores an older individual's physical activity level, based on the type of activity and the time spent doing it. Several factors contribute to the final PASE score, but a person whose activity level is classified as high typically might engage in several hours of walking, sports or other types of exercise per week, as well as yard work and other household chores.

Subsequent MRI analysis by two musculoskeletal radiologists indicated a relationship between physical activity levels and frequency and severity of knee damage. Specific knee abnormalities identified included meniscal lesions, cartilage lesions, bone marrow edema and ligament lesions. Abnormalities were associated solely with activity levels and were not age or gender specific.

"The prevalence of the knee abnormalities increased with the level of physical activity," Dr. Stehling said. "In addition, cartilage defects diagnosed in active people were more severe."

The findings also indicated that some activities carry a greater risk of knee damage over time.

"This study and previous studies by our group suggest that high-impact, weight-bearing physical activity, such as running and jumping, may be worse for cartilage health," Dr. Stehling said. "Conversely, low-impact activities, such as swimming and cycling, may protect diseased cartilage and prevent healthy cartilage from developing disease."

Dr. Stehling noted that there is a need for prospective studies to evaluate the influence of low-impact versus high-impact physical activity on disease progression.

Coauthors of the study are Nancy E. Lane, M.D., Michael C. Nevitt, Ph.D., M.P.H., Charles E. McCulloch, Ph.D., and Thomas M. Link, M.D., Ph.D.

# # #

Note: Copies of RSNA 2009 news releases and electronic images will be available online at RSNA.org/press09 beginning Monday, Nov. 30.

RSNA is an association of more than 44,000 radiologists, radiation oncologists, medical physicists and related scientists committed to excellence in patient care through education and research. The Society is based in Oak Brook, Ill. (RSNA.org)

Editor's note: The data in these releases may differ from those in the printed abstract and those actually presented at the meeting, as researchers continue to update their data right up until the meeting. To ensure you are using the most up-to-date information, please call the RSNA Newsroom at 1-312-949-3233.

For patient-friendly information on MRI, visit RadiologyInfo.org.

Abstract:

Images (.JPG format)

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Figure 1. A magnetic resonance (MR) image showing the right knee of a patient with low physical activity and low PASE Scale score and early deterioration of the patella cartilage.

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Figure 2. A magnetic resonance (MR) image showing the right knee of a patient with moderate physical activity, middle PASE Scale score and full thickness focal defect of the medial femur cartilage.

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Figure 3. A magnetic resonance (MR) image showing the right knee of a patient with moderate physical activity, middle PASE Scale score and full thickness focal defect of the medial femur cartilage.

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Figure 4. A magnetic resonance (MR) image showing the right knee of a patient with moderate physical activity, middle PASE Scale score and full thickness focal defect of the medial femur cartilage.

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Figure 5. A magnetic resonance (MR) image and coronal T1 weighted FSE image showing the right knee of a patient with high physical activity, high PASE Scale score and area of full thickness loss of the medial femur cartilage.

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Figure 6. A magnetic resonance (MR) image showing the right knee of a patient with high physical activity, high PASE Scale score and area of full thickness loss of the medial femur cartilage.

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Figure 7. A magnetic resonance (MR) image showing the right knee of a patient with high physical activity, high PASE Scale score and area of full thickness loss of the medial femur cartilage.

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Figure 8. A magnetic resonance (MR) image showing the right knee of a patient with moderate physical activity, middle PASE Scale score and horizontal tear of the posterior horn of the medial meniscus.

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Figure 9. A photograph of the Siemens Trio MRI scanner.

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Figure 10. A photograph of the Siemens Verio MRI scanner.

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