What New MRI Research Reveals About Gender Differences with Knee Injuries

A surprising finding from a study of over 13,500 outpatients who had knee MRI exams was that men had a 20 percent higher incidence of anterior cruciate ligament (ACL) tears than women.

In a recent interview with Diagnostic Imaging, lead study author Jenifer Pitman, M.D., noted that this finding was in stark contrast to previous studies on ACL injuries but also noted the retrospective research, recently presented at the RSNA conference, was drawn from a broader population of 13,549 patients who presented with knee injuries at four outpatient facilities associated with Johns Hopkins Hospital.

“Many of the studies, if not most of the studies that have looked at the ACL so far have been in specific cohorts of patients, typically related to sports, and more often than not in that younger age group. But we did see more (ACL) tears in men than women, even in that younger age group, which we think potentially could be related to different mechanisms than have been looked at before. … That would be something that we want to look at in the future,” noted Dr. Pitman, an assistant professor of radiology at Johns Hopkins Medical Institute in Baltimore.

(Editor’s note: For additional coverage from the recent RSNA conference, click here.)

The researchers also found that older women had higher rates of medial collateral ligament (MCL) and medial meniscal tears than older men, a finding that may be related to higher rates of osteoarthritis and joint-related degeneration among women, according to Dr. Pitman. However, she pointed out there is a lack of clarity as to whether the degenerative condition precipitates these tears or vice versa.

“Is it the meniscal tear that came first and then the joint is degenerating after that, or is it the cartilage that is degenerating and sort of leading to a degenerate, degenerative type tear of the meniscus? … That is hopefully something that we'll be able to parse out when we dig more into the demographics behind the specific injury patterns that we saw,” posited Dr. Pitman.

(Editor’s note: For related content, see “Large Knee MRI Study Reveals Greater Incidence of ACL Tears in Men,” “MRI Study Emphasizes Exercise Over Weight Loss in Preserving Muscle Volume for Overweight Patients at Risk for Knee OA” and “New MRI Study Questions Use of Corticosteroid Injections for Knee OA.”)

For more insights from Dr. Pitman, watch the video below.

Reference

1. Ghasemi A, Ahlawat S, Fayad LM, Pitman J. Injury patterns in knee MRI: is there a gender gap? Presentation at the Radiological Society of North America (RSNA) annual meeting, November 30-December 4, 2025, Chicago.