Article Text

Download PDFPDF
MRI of the knee in asymptomatic adolescent swimmers: a controlled study
  1. Ricardo Bernardi Soder1,
  2. Mariana Damian Mizerkowski1,
  3. Rose Petkowicz2,
  4. Matteo Baldisserotto3
  1. 1Hospital São Lucas, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
  2. 2Grêmio Náutico União, Porto Alegre, Brazil
  3. 3School of Medicine and Graduate School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
  1. Correspondence to Ricardo Bernardi Soder, Av Mariland, 1372, Apto 501, Mont'Serrat, Postal Code 90440-190, Porto Alegre, RS, Brazil; ricsoder{at}


Background Swimming is a widespread sporting activity generally regarded as an ideal form of exercise, which has little or no impact on the knees. However, overuse or repetitive microtrauma injuries may often affect the knee joint of young competitive swimmers. These early lesions are frequently asymptomatic for a considerable period of time before causing discomfort or joint pain.

Purpose The aim of the present study is to use MRI to evaluate the knee joints of asymptomatic young elite swimmers and to compare them with age- and sex-matched controls who do not practice any impact sports regularly.

Study design Cross-sectional case–control study.

Material and methods The authors performed a cross-sectional controlled study to evaluate 54 knees of 27 asymptomatic male adolescents aged 14–15 years, paired by age and weight. Participants were divided in two groups: 13 elite swimmers and 14 control adolescents. The authors performed all the exams using a 0.35-T open-field MRI unit and evaluated by two experienced radiologists blinded to study groups. The images were evaluated to detect the presence or absence of abnormalities.

Results One or more imaging abnormalities were detected in 18 knees in the group of swimmers (69.2%; p=0.013). The most prevalent findings in the athletes were infrapatellar fat pad edema (53.8%; p=0.049), followed by bone marrow edema (26.9%; p=0.022), edema of prefemoral fat pad (19%; p=0.022) and joint effusion (15.3%; p=0.047).

Conclusion Significantly more MRI abnormalities were found in the knee joints of asymptomatic adolescent elite swimmers. This high prevalence of positive imaging findings in swimmers may correspond to benign changes or preclinical lesions, which should be evaluated in a follow-up study.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Competing interest None.

  • Patient consent Obtained.

  • Ethics approval This study was approved by the Ethics in Research Committee of the Hospital São Lucas of Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil.

  • Provenance and peer review Not commissioned; externally peer reviewed.