Association of MRI-derived muscle-fat composition with knee osteoarthritis severity: a gender-stratified X-ray and MRI correlation study

To examine the relationship between alterations in soft tissue and the intensity of knee osteoarthritis (OA), emphasizing gender disparities.

54.7% of participants were female and 45.3% male, with a majority aged 30–44 years and classified as obese (44.8%).
Muscle thickness remained stable across BMI categories; males had higher measurements than females.
Fat thickness increased with BMI; females had greater measurements than males.
The muscle-to-fat ratio decreased as BMI rose, with males having a higher ratio in the normal BMI category.
Weak negative correlation found between muscle-to-fat ratio and soft tissue degenerative changes and cartilage degenerative changes.

The muscle-to-fat ratio and fat thickness significantly influence degenerative changes in the knee, particularly in females.

Study limited to individuals who received both X-ray and MRI examinations.
Exclusion of patients with prior knee surgeries or significant injuries may limit generalizability.

The integration of MRI and X-ray enhances diagnostic precision for knee osteoarthritis.