MR CARTILAGE IMAGING IN KNEE JOINT OSTEOARTHRITIS

Abstract

OA is a major public health problem. Plain radiography is useful for defining OA, but has weak associations with symptoms, limited sensitivity to change, as well as poor prediction of cartilage loss and need for joint replacement. In addition, considerable changes occur before development of first radiographic abnormalities. MRI has increased our understanding of early joint changes. MRI has emerged as the leading method of imaging soft tissue structures around joints. It is the best imaging technique for assessment of articular cartilage. Visualization of cartilage damage with MRI has the potential to provide morphologic, biochemical and physiological information about cartilage and other joint tissues. The fundamental trade-off between image resolution and signal to noise ratio still limits the ability to image with high resolution in an efficient manner. 3.0T systems may allow for fast routine imaging or higher resolution studies. This study utilized MOAKS instrument for semiquantitative assessment of knee joint OA. The study presented MRI as a good tool that can detect early features suggestive of knee osteoarthritis that cannot be visualised on conventional radiography. Some OA pathologic processes can only be detected by MRI e.g. cartilage defects, meniscal damage and subluxation, BMLs and synovial affection. This study confirmed a close association between radiographic and MRI-based assessments of knee joint structures. For patients displaying minimal damage on radiographs our study showed that they already had important pathological changes in a variety of joint tissues, including bones, cartilage and menisci, with a steep rise in the extent of pathologic damage at PFC in KL grades of 0-2 and MFTC in KL grades of 2-3. We found that the different gradings of pathology displayed a high level of correlation, especially in the medial femorotibial compartment. Strong associations were found between cartilage loss and KL grade. Clinical presentation and pain presented in Lequesne severity score correlated with cartilage loss especially in medial femorotibial compartment. To conclude, Our results show that MR cartilage imaging can be implemented in the imaging of OA patients for better depiction and quantification of cartilage loss which is the main pathological articular feature of OA.