Association of Quadriceps Adiposity With an Increase in Knee Cartilage, Meniscus, or Bone Marrow Lesions Over Three Years

Abstract

Objective. To evaluate the association of fatty infiltration of the quadriceps and vastus medialis (VM) with an increase in knee cartilage, meniscus, or bone marrow lesions, using magnetic resonance imaging (MRI) in knee osteoarthritis (OA) over 3 years.Methods. Participants (n = 69) with and without radiographic knee OA underwent MRI at baseline and 3 years later. Chemical shift-based water/fat MRI was used to quantify the intramuscular fat fraction and the lean anatomical cross-sectional area (ACSA) for the VM and entire quadriceps muscles. MRI images of the knee were analyzed using the semiquantitative modified whole-organ MRI score (mWORMS) grading to assess change in lesions in the articular cartilage, meniscus, and bone marrow. Logistic regression was used to assess whether baseline quadriceps and VM fat fraction and lean ACSA were associated with an increase in mWORMS scores. Odds ratios (ORs) were adjusted for age, sex, and body mass index.Results. Overall, of the 69 subjects, 43 (62%) had an increase in cartilage lesions (26 of 43), meniscus lesions (19 of 43), or bone marrow lesions (22 of 43) scores. The quadriceps (OR 2.13 [95% confidence interval (95% CI) 1.09-4.15]) and VM (OR 2.05 [95% CI 1.25-3.36]) fat fraction were both associated with an increase in cartilage, meniscus, or bone marrow lesion scores over 3 years. The association of quadriceps or VM lean ACSA with the outcomes was not significant.Conclusion. These longitudinal findings using quantitative MRI methods for assessment of muscle adiposity highlight the role of quadriceps adiposity, specifically in the VM, in knee OA progression. However, studies in larger cohorts are needed to confirm these findings.

Osteoarthritis year in review 2021: imaging

“…One study using chemical shift-based water/fat MRI, found that the intramuscular fat fraction in the quadriceps and vastus medialis muscles was associated with increase of cartilage, meniscus, or BML scores on MRI over 3 years. The lean anatomical cross-sectional area of those muscles was not significantly associated with knee OA progression 45 . Consistent with the previous study, another study using ultrasound found that rectus femoris and vastus lateralis muscle echogenicity, representing fat content and fibrosis, was associated with mobility performance in women with knee OA, while, muscle thickness and subcutaneous fat thickness were not 46 .…”

Enhanced echo intensity in vastus medialis is associated with worsening of functional disabilities and symptoms in patients with knee osteoarthritis: a 3-year longitudinal study

“…Another study [6] indicated that an increase in VM fat content was related to cartilage loss but not to worsening knee symptoms. Further, a recent study [7] also suggested that the greater quadriceps fatty in ltration, speci cally in the VM, was associated with cartilage loss. All these ndings indicate towards a possible association of the VM muscle degeneration and progression of knee OA.…”

“…Few previous studies [5][6][7] have indicated that the vastus medialis (VM) muscle degeneration is associated with future cartilage loss. Wang et al [5] showed that the cross-sectional area (CSA) of the VM was negatively associated with cartilage volume loss and worsening symptoms over a period of two years.…”

Associations of muscle size and fatty infiltration with bone mineral density of the proximal femur bone

“…The modern Dixon technique uses water/fat separation magnetic resonance imaging (MRI) based on chemical shift, which quantifies intramuscular adipose tissue and shows good consistency with magnetic resonance spectroscopy (MRS) ( 12 ). However, MRI not only visualizes the anatomical structure but also quantifies the proton density fat fraction (PDFF) with good spatial resolution, short acquisition time, and accurate fat quantification ( 13 , 14 ).…”