Use magnetic resonance imaging to assess articular cartilage

Abstract

Magnetic resonance imaging (MRI) enables a noninvasive, three-dimensional assessment of the entire joint, simultaneously allowing the direct visualization of articular cartilage. Thus, MRI has become the imaging modality of choice in both clinical and research settings of musculoskeletal diseases, particular for osteoarthritis (OA). Although radiography, the current gold standard for the assessment of OA, has had recent significant technical advances, radiographic methods have significant limitations when used to measure disease progression. MRI allows accurate and reliable assessment of articular cartilage which is sensitive to change, providing the opportunity to better examine and understand preclinical and very subtle early abnormalities in articular cartilage, prior to the onset of radiographic disease. MRI enables quantitative (cartilage volume and thickness) and semiquantitative assessment of articular cartilage morphology, and quantitative assessment of cartilage matrix composition. Cartilage volume and defects have demonstrated adequate validity, accuracy, reliability and sensitivity to change. They are correlated to radiographic changes and clinical outcomes such as pain and joint replacement. Measures of cartilage matrix composition show promise as they seem to relate to cartilage morphology and symptoms. MRI-derived cartilage measurements provide a useful tool for exploring the effect of modifiable factors on articular cartilage prior to clinical disease and identifying the potential preventive strategies. MRI represents a useful approach to monitoring the natural history of OA and evaluating the effect of therapeutic agents. MRI assessment of articular cartilage has tremendous potential for large-scale epidemiological studies of OA progression, and for clinical trials of treatment response to disease-modifying OA drugs.

What is the predictive value of MRI for the occurrence of knee replacement surgery in knee osteoarthritis?

“…One major advantage of MRI is that it provides a comprehensive view of many of the joint structures 12. The joint structure most commonly measured by MRI in osteoarthritis of the knee is cartilage, specifically its changes in volume and thickness over time.…”

No Association between Daily Walking and Knee Structural Changes in People at Risk of or with Mild Knee Osteoarthritis. Prospective Data from the Multicenter Osteoarthritis Study

“…Due to the challenge with studying risk factors for progression of osteoarthritis in knees with advanced disease, we narrowed our sample to people at risk of developing or with mild OA. Studying cartilage loss in this population with no or mild OA using MRI with 1.0T magnet may not be optimal compared to newer MRI techniques(49). Finally, even though our data included a substantial number of knees with worsening as seen in Table 3, a longer follow-up would have been more ideal to detect radiographic structural changes in the knee joint.…”

Arthrose

“…1 .15) ; ■ le cliché axial du genou : il peut être réalisé en décubitus dorsal selon la technique de Laurin [50] ou la technique de Marchand [63] ou bien en charge ( fig . Sur ces trois clichés de base, il faudra systématiquement rechercher : ■ un pincement de l'interligne articulaire ; ■ une déviation en valgus et en varus (arthrose varisante ou valgisante) ; ■ une subluxation médiale du condyle interne par rapport au plateau tibial correspondant, qui peut être associée à une méniscose et donc à une sous-estimation de l'espace articulaire [90] ; ■ un ostéophyte marginal et/ou central ; ■ une ostéocondensation sous-chondrale (sclérose souschondrale) qui apparaît en cas d'arthrose sévère ; ■ la présence de formations sous-chondrales radiotransparentes correspondant aux pseudo-kystes dégénératifs (géodes) ; ■ une érosion de la corticale fémorale juste en amont de la trochlée fémorale, secondaire aux contraintes répétées de la patella contre la corticale osseuse en position d'extension du genou . Les techniques en décubitus sont de réalisation plus aisée mais en l'absence d'une contraction du quadriceps suffisante, un pincement de l'interligne fémoropatellaire peut ne pas y être mis en évidence, surtout au versant fémoropatellaire médial [57] .…”