MRI-Based Patterns of Meniscal Tears and Associated Intra-Articular Abnormalities in Patients at a Tertiary Care Center in Riyadh, Saudi Arabia: A Retrospective Cross-Sectional Study

Background: Meniscal tears are common intra-articular knee injuries that arise from acute trauma or degenerative change and frequently coexist with ligamentous and chondral abnormalities. Magnetic resonance imaging (MRI) allows noninvasive characterization of tear location, morphology, and associated pathology, but MRI-based data from Saudi Arabia are scarce. Objective: To describe the MRI patterns of meniscal tears and associated intra-articular abnormalities and their distribution by age, sex, and mechanism of injury, in patients evaluated at a tertiary care center in Riyadh, Saudi Arabia. Methods: In this retrospective cross-sectional study, consecutive patients aged ≥15 years with meniscal tears reported on knee MRI at King Abdulaziz Medical City, Riyadh, between January 2020 and December 2023 were included. Data were extracted from original radiology reports and electronic medical records. Groups were compared using chi-square or Fisher’s exact tests; unadjusted odds ratios (ORs) with 95% confidence intervals (CIs) were calculated, and p-values were adjusted using the Benjamini–Hochberg false discovery rate (FDR). Results: Of 496 patients (65.7% male; mean age 41.8 ± 13.2 years), 60.3% had a traumatic mechanism. The medial meniscus was involved in 415 patients (83.7%; isolated in 69.4%). Horizontal tears were the most frequently reported pattern (27.2%), followed by radial (19.6%) and root (19.4%) tears. Joint effusion (58.7%), anterior cruciate ligament (ACL) tear (36.1%), and cartilage loss (34.3%) were the most frequent associated findings. Traumatic cases were younger (median 34 vs. 51 years) and more often had isolated lateral meniscal, horizontal, vertical, bucket-handle, and complex tears and ACL tears (49.2% vs. 16.2%; OR 4.99, 95% CI 3.21–7.75), whereas degenerative cases more often had radial, root, and degenerative-pattern tears, cartilage loss (61.9% vs. 16.1%), and joint effusion. These associations remained significant after FDR adjustment. Surgical management was recorded in 67.1% of patients. Conclusions: In this hospital-based sample, meniscal tear patterns and associated MRI findings differed by age, sex, and mechanism of injury. Because the data derive from a single referral center and from original clinical reports, the findings describe a selected population, should not be extrapolated to the general Saudi population, and are hypothesis-generating.