Most collegiate hoopsters pounding the court day after day show no signs of serious knee injury. However, an MRI-based study published online June 22 in the Clinical Journal of Sport Medicine shows that no pain is no assurance of no damage.

Researchers at Stanford University, led by George Pappas, MD, PhD, now with South Carolina Sports Medicine & Orthopaedic Center, imaged the asymptomatic knees of 24 NCAA Division I players (12 male, 12 female) using a 3.0-T MRI scanner before and after the end of a single competitive season.

“Every knee imaged had at least one structural abnormality both preseason and postseason,” the team reports.

Perhaps unsurprisingly, the postseason findings were markedly worse, clinically speaking, than those in the preseason.

Specifically, the researchers observed high preseason and postseason prevalence of fat pad edema (75 percent preseason and 81 percent postseason), patellar tendinopathy (83 percent and 90 percent) and quadriceps tendinopathy (75 percent and 90 percent).

They also recorded intrameniscal signal change in 50 percent of preseason knees and 62 percent of postseason knees, although they found no discrete tears.

Further, bone marrow edema turned up in 75 percent and 86 percent of knees in the preseason and postseason, respectively, while cartilage findings were present in 71 percent and 81 percent of knees in the preseason and postseason, respectively.

And the cartilage injury score increased significantly in the postseason compared with the preseason, the authors report.

“A high prevalence of abnormal knee MRI findings was observed in a population of asymptomatic young elite athletes,” Pappas et al. write in their conclusions. “These preliminary data suggest that high-intensity basketball may have potentially deleterious effects on articular cartilage.”