Evaluation of Chondrocalcinosis and Associated Knee Joint Degeneration Using MR Imaging: Data from the Osteoarthritis Initiative

Abstract

Objectives To evaluate the ability of different MRI sequences to detect chondrocalcinosis within knee cartilage and menisci, and to analyze the association with joint degeneration. Methods Subjects with radiographic knee chondrocalcinosis (n = 90, age 67.7 ± 7.3 years, 50 women) were selected from the Osteoarthritis Initiative and matched to controls without radiographic chondrocalcinosis (n = 90). Visualization of calcium-containing crystals (CaC) was compared between 3D T1-weighted gradient-echo (T1GE), 3D dual echo steady-state (DESS), 2D intermediate-weighted (IW), and proton density (PD)-weighted fast spin-echo (FSE) sequences obtained with 3T MRI and correlated with a semiquantitative CaC score obtained from radiographs. Structural abnormalities were assessed using Whole-Organ MRI Score (WORMS) and logistic regression models were used to compare cartilage compartments with and without CaC. Results Correlations between CaC counts of MRI sequences and degree of radiographic calcifications were highest for GE (r T1GE = 0.73, P < 0.001; r DESS = 0.68, P < 0.001) compared to other sequences (P > 0.05). Meniscus WORMS was significantly higher in subjects with chondrocalcinosis compared to controls (P = 0.005). Cartilage defects were significantly more frequent in compartments with CaC than without (patella: P = 0.006; lateral tibia: P < 0.001; lateral femur condyle: P = 0.017). Conclusions Gradient-echo sequences were most useful for the detection of chondrocalcinosis and presence of CaC was associated with higher prevalence of cartilage and meniscal damage.

Tool for osteoarthritis risk prediction (TOARP) over 8 years using baseline clinical data, X‐ray, and MRI: Data from the osteoarthritis initiative

“…In addition to cartilage T 2 , it would be beneficial to study other quantitative cartilage assessments such as T 1 rho mapping; however, only T 2 was available in the OAI. We did not specifically assess chondrocalcinosis (CPPD) in this cohort, but we did assess this in a different study where we analyzed 2122 subjects and found CPPD only in 99 subjects (4.7%) 55 ; given the small number of subjects with CPPD we do not expect a significant impact of CPPD in this relatively young cohort with no or only mild degenerative changes. Bone marrow edema pattern and effusion were not included, which may be considered another limitation; however, these are less frequent in early stages of degenerative joint disease and are not stable (often appearing and resolving).…”

Natural history of new horizontal meniscal tears in individuals at risk for and with mild to moderate osteoarthritis: data from osteoarthritis initiative

“…Inter-and intrareader reproducibility of WORMS scoring has been performed in previous studies [28,29]. Reproducibility for WORMS subscores for menisci and cartilage was based on calculation of intraclass correlation coefficients (ICC).…”

Osteoarthritis year in review 2017: updates on imaging advancements

“…They found that synovitis change was associated with cartilage deterioration, but not with change in pain 19 . Using WORMS method, presence of knee chondrocalcinosis and calcium-containing crystals were assessed in association with prevalence of cartilage and meniscal damages in a cross-sectional setting 20 . Knees with chondrocalcinosis had higher concurrent and longitudinal pain.…”