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Walter SS, Fritz B, Kijowski R, Fritz J. 2D versus 3D MRI of osteoarthritis in clinical practice and research. Skeletal Radiol 2023; 52:2211-2224. [PMID: 36907953 DOI: 10.1007/s00256-023-04309-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 02/14/2023] [Accepted: 02/14/2023] [Indexed: 03/14/2023]
Abstract
Accurately detecting and characterizing articular cartilage defects is critical in assessing patients with osteoarthritis. While radiography is the first-line imaging modality, magnetic resonance imaging (MRI) is the most accurate for the noninvasive assessment of articular cartilage. Multiple semiquantitative grading systems for cartilage lesions in MRI were developed. The Outerbridge and modified Noyes grading systems are commonly used in clinical practice and for research. Other useful grading systems were developed for research, many of which are joint-specific. Both two-dimensional (2D) and three-dimensional (3D) pulse sequences are used to assess cartilage morphology and biochemical composition. MRI techniques for morphological assessment of articular cartilage can be categorized into 2D and 3D FSE/TSE spin-echo and gradient-recalled echo sequences. T2 mapping is most commonly used to qualitatively assess articular cartilage microstructural composition and integrity, extracellular matrix components, and water content. Quantitative techniques may be able to label articular cartilage alterations before morphological defects are visible. Accurate detection and characterization of shallow low-grade partial and small articular cartilage defects are the most challenging for any technique, but where high spatial resolution 3D MRI techniques perform best. This review article provides a practical overview of commonly used 2D and 3D MRI techniques for articular cartilage assessments in osteoarthritis.
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Affiliation(s)
- Sven S Walter
- Department of Radiology, Division of Musculoskeletal Radiology, NYU Grossman School of Medicine, 660 1St Ave, 3rd Floor, Rm 313, New York, NY, 10016, USA
- Department for Diagnostic and Interventional Radiology, Eberhard Karls University Tuebingen, University Hospital Tuebingen, 72076, Tübingen, Germany
| | - Benjamin Fritz
- Department of Radiology, Balgrist University Hospital, Forchstrasse 340, CH-8008, Zurich, Switzerland
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Richard Kijowski
- New York University Grossman School of Medicine, New York University, New York, NY, 10016, USA
| | - Jan Fritz
- Department of Radiology, Division of Musculoskeletal Radiology, NYU Grossman School of Medicine, 660 1St Ave, 3rd Floor, Rm 313, New York, NY, 10016, USA.
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Taneja AK, Chhabra A. 2-Dimensional and 3-Dimensional MR Imaging-Aid to Knee Preservation Surgery: Focus on Meniscus and Articular Cartilage. Semin Ultrasound CT MR 2023. [DOI: 10.1053/j.sult.2023.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Superolateral Hoffa Fat Pad Edema and Patellofemoral Maltracking: Systematic Review and Meta-Analysis. AJR Am J Roentgenol 2020; 215:545-558. [PMID: 32507017 DOI: 10.2214/ajr.19.22263] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVE. The purpose of this study is to clarify which imaging parameters of patellofemoral maltracking are associated with superolateral Hoffa fat pad (SHFP) edema. MATERIALS AND METHODS. A systematic search of the MEDLINE, Embase, and Cochrane Library databases was performed to identify studies evaluating the relationship between SHFP edema and patellofemoral maltracking. Parameters for assessing patellofemoral maltracking on MRI were reviewed for each study. Two reviewers performed study selection, methodologic quality assessment, and data extraction. RESULTS. Nine studies were eligible for inclusion in the present study. From the included studies, nine parameters assessing patellofemoral maltracking were analyzed: lateral patellofemoral angle, patellar tilt, patellar lateralization, trochlear depth, sulcus depth, sulcus angle, lateral trochlear inclination, distance between the tibial tuberosity and trochlear groove, and the Insall-Salvati ratio. Patients with SHFP edema had greater patellar tilt (standardized mean difference, 0.89°; 95% CI, 0.38-1.40°; p = 0.0006), greater patellar lateralization (standardized mean difference, 0.78 mm; 95% CI, 0.21-1.36 mm; p = 0.008), greater distance between the tibial tuberosity and trochlear groove (standardized mean difference, 0.96 mm; 95% CI, 0.48-1.44 mm; p < 0.0001), and higher Insall-Salvati ratio (standardized mean difference, 1.94; 95% CI, 1.29-2.60; p < 0.00001) than patients without SHFP edema. CONCLUSION. Patellofemoral maltracking imaging parameters, such as a more laterally displaced patella, greater TTTG distance, and patella alta, are correlated with SHFP edema.
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Spectrum of common and uncommon causes of knee joint hyaline cartilage degeneration and their key imaging features. Eur J Radiol 2020; 129:109097. [PMID: 32534353 DOI: 10.1016/j.ejrad.2020.109097] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 04/12/2020] [Accepted: 05/27/2020] [Indexed: 12/25/2022]
Abstract
Hyaline cartilage lining the surfaces of diarthrodial joints is an important construct for transmission of load and to reduce friction between the bones. Normal wear and tear accounts for about 3-5 percent knee cartilage loss ever year in otherwise healthy people after the age of 30 years. Several conditions and diseases lead to premature cartilage degeneration. Standardized description of cartilage loss, detailed evaluation of the joint health and determining the underlying etiology of cartilage loss are important for effective reporting, multidisciplinary communications and patient management. In this article, the authors discuss normal and abnormal imaging appearances of the hyaline cartilage of knee with focus on using controlled terminology and MRI classifications. The reader will benefit and learn key MR imaging features of a spectrum of common and uncommon conditions and diseases affecting the knee cartilage, such as trauma, secondary injury associated with meniscus and ligament injury related instability, arthritis, ischemia, idiopathic, and hereditary conditions including Matrix metalloproteinase-2 (MMP-2) mutations and mucopolysaccharidosis type IX disease with illustrative case examples.
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Li J, Sheng B, Liu X, Yu F, Lv F, Lv F, Yang H. Sharp margin of antero-inferior lateral femoral condyle as a risk factor for patellar tendon-lateral femoral condyle friction syndrome. Eur Radiol 2020; 30:2261-2269. [PMID: 31900701 DOI: 10.1007/s00330-019-06592-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 11/10/2019] [Accepted: 11/13/2019] [Indexed: 01/17/2023]
Abstract
OBJECTIVE To determine the correlation between patellar tendon-lateral femoral condyle friction syndrome (PLFFS) and the morphological characteristics of the antero-inferior part of the lateral femoral condyle (ALFC) to explore the potential pathogenesis. METHODS A total of 170 knees of 140 patients with PLFFS (PLFFS group) were retrospectively analyzed using magnetic resonance imaging (MRI) data for a 4-year period from our database. The Insall-Salvati ratio, shape of the ALFC (SALFC, defined as two subtypes: sharp versus blunt), lateral femoral condyle angle (LFCA), lateral trochlear length (LTL), and lateral trochlear height (LTH) were measured on MRI. Two groups were enrolled as controls: pure patella alta group (n = 192) and normal group (n = 172). All the parameters of the PLFFS group were compared with those of the two control groups. RESULTS The LFCA was significantly lower (p < 0.001) in the PLFFS group than in the pure patella alta group. The SALFC was significantly different (p < 0.001) in these two groups, whereas the Insall-Salvati ratio, LTH, and LTL showed no significant difference. The LFCA, LTH, SALFC, and the Insall-Salvati ratio in the PLFFS group were also significantly different (p < 0.001) with the normal group. Receiver operating characteristic (ROC) analysis showed the efficacy of the Insall-Salvati ratio and SALFC was better than that of the other parameters. CONCLUSIONS The morphological characteristics of ALFC are correlated with PLFFS. The sharp shape of ALFC may be an important causative co-factor along with patella alta in the pathogenesis of PLFFS. KEY POINTS • A sharp margin of the antero-inferior lateral femoral condyle is an important risk factor for the development of PLFFS in patients with patella alta. • Antero-inferior femoral condyle shape can easily be assessed with high intra- and inter-reader reliability PLFFS. • PLFFS is more common in young adults.
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Affiliation(s)
- Jia Li
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, 1 Youyi Road, Yuzhong Distract, Chongqing, 400016, People's Republic of China
| | - Bo Sheng
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, 1 Youyi Road, Yuzhong Distract, Chongqing, 400016, People's Republic of China
| | - Xin Liu
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, 1 Youyi Road, Yuzhong Distract, Chongqing, 400016, People's Republic of China
| | - Fan Yu
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, 1 Youyi Road, Yuzhong Distract, Chongqing, 400016, People's Republic of China
| | - Fajin Lv
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, 1 Youyi Road, Yuzhong Distract, Chongqing, 400016, People's Republic of China
| | - Furong Lv
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, 1 Youyi Road, Yuzhong Distract, Chongqing, 400016, People's Republic of China
| | - Haitao Yang
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, 1 Youyi Road, Yuzhong Distract, Chongqing, 400016, People's Republic of China.
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Superolateral Hoffa's fat pad oedema: Relationship with cartilage T2* value and patellofemoral maltracking. Eur J Radiol 2019; 118:122-129. [PMID: 31439231 DOI: 10.1016/j.ejrad.2019.07.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2019] [Revised: 05/25/2019] [Accepted: 07/10/2019] [Indexed: 01/17/2023]
Abstract
PURPOSE To determine (1) the association between superolateral Hoffa's fat pad (SHFP) oedema and early cartilage degeneration using T2* mapping and (2) whether patellofemoral maltracking is related to cartilage T2* values or SHFP oedema. MATERIALS AND METHODS In this retrospective study, 68 patients (71 knees) with anterior knee pain who had undergone 3-Tesla magnetic resonance imaging (MRI) were enrolled. Cartilage T2* values in medial and lateral patellofemoral compartment as well as patellofemoral maltracking parameters (trochlear angle, sulcus angle, patellar tilt angle, tibial tuberosity-to-trochlear groove [TT-TG] distance, and patellar-tendon to patellar-length [PT-PL] ratio) were compared between case group (24 knees with SHFP oedema) and control group (47 knees without the oedema). The associations between the patellofemoral maltracking and the cartilage T2* values as well as the SHFP oedema were investigated using logistic and linear regression analyses. RESULTS The case group showed significantly higher cartilage T2* value in the lateral patellar facet, wider sulcus angle, greater TT-TG distance, and higher PT-PL ratio than the control group. Both SHFP oedema and higher cartilage T2* value in the lateral patellar facet were significantly associated with wider sulcus angle, greater TT-TG distance, and higher PT-PL ratio. CONCLUSION SHFP oedema appears to be associated with inherent cartilage degeneration in the lateral patellar facet. Patellofemoral maltracking might be a risk factor for SHFP oedema and early cartilage damage in the lateral patellar facet.
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Atkinson HF, Birmingham TB, Moyer RF, Yacoub D, Kanko LE, Bryant DM, Thiessen JD, Thompson RT. MRI T2 and T1ρ relaxation in patients at risk for knee osteoarthritis: a systematic review and meta-analysis. BMC Musculoskelet Disord 2019; 20:182. [PMID: 31039785 PMCID: PMC6492327 DOI: 10.1186/s12891-019-2547-7] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 03/28/2019] [Indexed: 12/19/2022] Open
Abstract
Background Magnetic resonance imaging (MRI) T2 and T1ρ relaxation are increasingly being proposed as imaging biomarkers potentially capable of detecting biochemical changes in articular cartilage before structural changes are evident. We aimed to: 1) summarize MRI methods of published studies investigating T2 and T1ρ relaxation time in participants at risk for but without radiographic knee OA; and 2) compare T2 and T1ρ relaxation between participants at-risk for knee OA and healthy controls. Methods We conducted a systematic review of studies reporting T2 and T1ρ relaxation data that included both participants at risk for knee OA and healthy controls. Participant characteristics, MRI methodology, and T1ρ and T2 relaxation data were extracted. Standardized mean differences (SMDs) were calculated within each study. Pooled effect sizes were then calculated for six commonly segmented knee compartments. Results 55 articles met eligibility criteria. There was considerable variability between scanners, coils, software, scanning protocols, pulse sequences, and post-processing. Moderate risk of bias due to lack of blinding was common. Pooled effect sizes indicated participants at risk for knee OA had lengthened T2 relaxation time in all compartments (SMDs from 0.33 to 0.74; p < 0.01) and lengthened T1ρ relaxation time in the femoral compartments (SMD from 0.35 to 0.40; p < 0.001). Conclusions T2 and T1ρ relaxation distinguish participants at risk for knee OA from healthy controls. Greater standardization of MRI methods is both warranted and required for progress towards biomarker validation. Electronic supplementary material The online version of this article (10.1186/s12891-019-2547-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Hayden F Atkinson
- School of Physical Therapy, Faculty of Health Sciences, University of Western Ontario, London, Ontario, Canada.,Wolf Orthopaedic Biomechanics Laboratory, Fowler Kennedy Sport Medicine Clinic, University of Western Ontario, London, Ontario, Canada.,Bone and Joint Institute, University of Western Ontario, London, Ontario, Canada
| | - Trevor B Birmingham
- School of Physical Therapy, Faculty of Health Sciences, University of Western Ontario, London, Ontario, Canada. .,Wolf Orthopaedic Biomechanics Laboratory, Fowler Kennedy Sport Medicine Clinic, University of Western Ontario, London, Ontario, Canada. .,Bone and Joint Institute, University of Western Ontario, London, Ontario, Canada. .,Musculoskeletal Rehabilitation, Elborn College, University of Western Ontario, London, Ontario, N6G 1H1, Canada.
| | - Rebecca F Moyer
- Bone and Joint Institute, University of Western Ontario, London, Ontario, Canada.,School of Physiotherapy, Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Daniel Yacoub
- Faculty of Health Sciences, University of Western Ontario, London, Ontario, Canada
| | - Lauren E Kanko
- School of Physical Therapy, Faculty of Health Sciences, University of Western Ontario, London, Ontario, Canada.,Wolf Orthopaedic Biomechanics Laboratory, Fowler Kennedy Sport Medicine Clinic, University of Western Ontario, London, Ontario, Canada.,Bone and Joint Institute, University of Western Ontario, London, Ontario, Canada
| | - Dianne M Bryant
- School of Physical Therapy, Faculty of Health Sciences, University of Western Ontario, London, Ontario, Canada.,Wolf Orthopaedic Biomechanics Laboratory, Fowler Kennedy Sport Medicine Clinic, University of Western Ontario, London, Ontario, Canada.,Bone and Joint Institute, University of Western Ontario, London, Ontario, Canada
| | - Jonathan D Thiessen
- Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada.,Imaging Program, Lawson Health Research Institute, London, Ontario, Canada
| | - R Terry Thompson
- Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada.,Imaging Program, Lawson Health Research Institute, London, Ontario, Canada
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Jarraya M, Guermazi A, Felson D, Roemer F, Nevitt M, Torner J, Lewis C, Stefanik J. Is superolateral Hoffa's fat pad hyperintensity a marker of local patellofemoral joint disease? - The MOST study. Osteoarthritis Cartilage 2017; 25:1459-1467. [PMID: 28606557 PMCID: PMC5583732 DOI: 10.1016/j.joca.2017.05.020] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Revised: 05/13/2017] [Accepted: 05/31/2017] [Indexed: 02/02/2023]
Abstract
PURPOSE To determine the relation of superolateral Hoffa's fat pad (SHFP) hyperintensity to cartilage damage and bone marrow lesions (BMLs) in the patellofemoral joint (PFJ) and tibiofemoral joint (TFJ). METHODS We used data from the 60 and 84-month study visits from the Multicenter Osteoarthritis (MOST) study. SHFP hyperintensity and Hoffa-synovitis were graded from 0 to 3. Cartilage damage and BMLs were scored in the PFJ and TFJ. Structural damage was defined as: any cartilage damage, full-thickness cartilage damage and any BML. Worsening structural damage was defined as any increase in cartilage and BML scores. Logistic regression was used to determine the relation of SHFP hyperintensity and Hoffa-synovitis (>0) to structural damage, adjusting for age, sex and body mass index (BMI). RESULTS 1,094 knees were included in the study. Compared to knees without SHFP hyperintensity, those with SHFP hyperintensity had 1.2 (95% Confidence Interval (CI), 1.1-1.4), 1.7 (1.3-2.3) and 1.6 (1.3-1.9) times the prevalence of any cartilage damage, full-thickness cartilage damage, and BMLs in the lateral PFJ respectively, and 1.1 (1.0-1.2), 1.3 (1.0-1.8), and 1.2 (1.0-1.4) times the prevalence of any cartilage damage, full-thickness cartilage damage, and BMLs in the medial PFJ. SHFP hyperintensity was associated with worsening BMLs in the medial PFJ (RR: 1.4 (1.0-1.9)). In general, there was no relation between SHFP hyperintensity and TFJ outcomes. Hoffa-synovitis was associated both cross-sectionally and longitudinally with structural damage, regardless of definition, in all compartments. CONCLUSION SHFP hyperintensity may be a local marker of PFJ structural damage.
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Affiliation(s)
- M. Jarraya
- Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine, Boston, MA, United States,Department of Radiology, Mercy Catholic Medical Center, Darby, PA, United States,Address correspondence and reprint requests to: M. Jarraya, Mercy Catholic Medical Center, 1500 Lansdowne Avenue, Darby, 19023, PA, United States. (M. Jarraya)
| | - A. Guermazi
- Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine, Boston, MA, United States
| | - D.T. Felson
- Clinical Epidemiology Research and Training Unit, Boston University, Boston, MA, United States
| | - F.W. Roemer
- Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine, Boston, MA, United States,Department of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany
| | - M.C. Nevitt
- Department of Epidemiology and Biostatistics, UCSF, San Francisco, CA, United States
| | - J. Torner
- Department of Epidemiology, University of Iowa, Iowa City, IA, United States
| | - C.E. Lewis
- Department of Medicine, UAB Medicine, Birmingham, AL, United States
| | - J.J. Stefanik
- Clinical Epidemiology Research and Training Unit, Boston University, Boston, MA, United States,Department of Physical Therapy, Movement & Rehabilitation Sciences, Northeastern University, Boston, MA, United States
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Demehri S, Guermazi A, Kwoh CK. Diagnosis and Longitudinal Assessment of Osteoarthritis: Review of Available Imaging Techniques. Rheum Dis Clin North Am 2016; 42:607-620. [PMID: 27742017 DOI: 10.1016/j.rdc.2016.07.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Osteoarthritis (OA) is a major chronic and global health care problem. Recent technological advances in imaging and postprocessing techniques have enhanced the understanding and characterization of the pathophysiology of this chronic and prevalent disease. Although plain radiograph remains the modality of choice for initial assessment of OA, recent studies have shown that advanced cross-sectional imaging can improve the early detection, grading, structural damage quantification, and risk stratification of OA. This article discusses the currently available evidence regarding both the conventional and novel imaging modalities that can be used for evaluation of patients with OA and its longitudinal assessment.
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Affiliation(s)
- Shadpour Demehri
- Division of Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University, School of Medicine, 601 North Caroline Street, JHOC 5165, Baltimore, MD 21287, USA.
| | - Ali Guermazi
- Department of Radiology, Quantitative Imaging Center, Boston University School of Medicine, Boston, MA, USA
| | - C Kent Kwoh
- Division of Rheumatology, University of Arizona Arthritis Center, University of Arizona, Tucson, AZ, USA
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10
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Lee YH, Yang J, Jeong HK, Suh JS. Assessment of the patellofemoral cartilage: Correlation of knee pain score with magnetic resonance cartilage grading and magnetization transfer ratio asymmetry of glycosaminoglycan chemical exchange saturation transfer. Magn Reson Imaging 2016; 35:61-68. [PMID: 27580516 DOI: 10.1016/j.mri.2016.08.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Revised: 07/25/2016] [Accepted: 08/20/2016] [Indexed: 01/08/2023]
Abstract
PURPOSE Biochemical imaging of glycosaminoglycan chemical exchange saturation transfer (gagCEST) could predict the depletion of glycosaminoglycans (GAG) in early osteoarthritis. The purpose of this study was to evaluate the relationship between the magnetization transfer ratio asymmetry (MTRasym) of gagCEST images and visual analog scale (VAS) pain scores in the knee joint. MATERIALS AND METHODS This retrospective study was approved by the institutional review board. A phantom study was performed using hyaluronic acid to validate the MTRasym values of gagCEST images. Knee magnetic resonance (MR) images of 22 patients (male, 9; female, 13; mean age, 50.3years; age range; 25-79years) with knee pain were included in this study. The MR imaging (MRI) protocol involved standard knee MRI as well as gagCEST imaging, which allowed region-of-interest analyses of the patellar facet and femoral trochlea. The MTRasym at 1.0ppm was calculated at each region. The cartilages of the patellar facets and femoral trochlea were graded according to the Outerbridge classification system. Data regarding the VAS scores of knee pain were collected from the electronic medical records of the patients. Statistical analysis was performed using Spearman's correlation. RESULTS The results of the phantom study revealed excellent correlation between the MTRasym values and the concentration of GAGs (r=0.961; p=0.003). The cartilage grades on the MR images showed significant negative correlation with the MTRasym values in the patellar facet and femoral trochlea (r=-0.460; p=0.031 and r=-0.543; p=0.009, respectively). The VAS pain scores showed significant negative correlation with the MTRasym values in the patellar facet and femoral trochlea (r=-0.435; p=0.043 and r=-0.671; p=0.001, respectively). CONCLUSION The pain scores were associated with the morphological and biochemical changes in articular cartilages visualized on knee MR images. The biochemical changes, visualized in terms of the MTRasym values of the gagCEST images, exhibited greater correlation with the pain scores than the morphological changes visualized on conventional MR images; these results provide evidence supporting the theory regarding the association of patellofemoral osteoarthritis with knee pain scores.
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Affiliation(s)
- Young Han Lee
- Department of Radiology, Research Institute of Radiological Science, Medical Convergence Research Institute, and Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jaemoon Yang
- Department of Radiology, Research Institute of Radiological Science, Medical Convergence Research Institute, and Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Ha-Kyu Jeong
- Clinical Science, Philips Healthcare, Seoul, Republic of Korea
| | - Jin-Suck Suh
- Department of Radiology, Research Institute of Radiological Science, Medical Convergence Research Institute, and Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.
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Abstract
Chronic sports injuries of the knee joint are common and mainly caused by repetitive (micro) trauma and exertion. Chronic insertion tendinopathies and avulsion fractures and symptoms related to entrapment, friction and impingement can be pathophysiologically distinguished in athletes. In this review, we depict the characteristic magnetic resonance imaging (MRI) findings of the most commonly occurring pathologies.
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Affiliation(s)
- M Mannil
- Institut für Radiologie und Nuklearmedizin, Stadtspital Triemli, Birmensdorferstrasse 497, 8063, Zürich, Schweiz.
| | - G Andreisek
- Institut für Diagnostische und Interventionelle Radiologie, Universitätsspital Zürich, Universität Zürich, Zürich, Schweiz
| | - D Weishaupt
- Institut für Radiologie und Nuklearmedizin, Stadtspital Triemli, Birmensdorferstrasse 497, 8063, Zürich, Schweiz
| | - M A Fischer
- Institut für Diagnostische und Interventionelle Radiologie, Universitätsspital Zürich, Universität Zürich, Zürich, Schweiz.,Abteilung für Radiologie, Universitätsklinik Balgrist, Universität Zürich, Zürich, Schweiz
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12
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Magnetic resonance imaging of Hoffa's fat pad and relevance for osteoarthritis research: a narrative review. Osteoarthritis Cartilage 2016; 24:383-97. [PMID: 26455999 DOI: 10.1016/j.joca.2015.09.018] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2015] [Revised: 09/08/2015] [Accepted: 09/22/2015] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To give an illustrative overview of Hoffa's fat pad pathology with a radiologic emphasis on the anatomy, on technical considerations, and on imaging differential diagnoses in the context of osteoarthritis (OA) imaging research. DESIGN A PubMed database search including only English literature and covering a 20 year period was performed. The search was based on but no limited to the query terms "Hoffa", "Hoffa's fat pad" or "infrapatellar fat pad (IPFP)" in combination with "synovitis", "OA", and "magnetic resonance imaging (MRI)". The literature search yielded 289 publications that were screened for relevance; additional references were included when these were considered of importance. RESULTS Several anatomic variants and pathologic conditions may be encountered when assessing Hoffa's fat pad including tumors and tumor-like lesions such as osteochondroma, tenosynovial giant cell tumor (TGCT) (and pigmented nodular synovitis) and arthrofibrosis, traumatic changes including contusions and anatomic variants such as recesses. The latter may be accountable for differences in cross-sectional area or volume changes over time. Signal changes are commonly used in OA research as surrogate markers for synovitis but are non-specific findings. CONCLUSIONS Quantitative approaches to evaluate 3D parameters of Hoffa's fat pad are increasingly applied and their role in regard to structural progression and clinical manifestations of disease needs to be further elucidated. In applying such approaches, knowledge of the detailed anatomy and potential pitfalls that may be a result of anatomical variants, inflammatory disease manifestations and additional diverse pathologies encountered seems to be paramount.
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13
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Conventional and novel imaging modalities in osteoarthritis: current state of the evidence. Curr Opin Rheumatol 2015; 27:295-303. [PMID: 25803224 DOI: 10.1097/bor.0000000000000163] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Imaging modalities are currently an inseparable part of osteoarthritis diagnosis. In this review, we describe the current state of evidence regarding conventional and novel imaging modalities in evaluation of osteoarthritis. Modalities including radiography (qualitative and semi-quantitative assessments), ultrasonography, computed tomography [CT; conventional multidetector CT (MDCT), cone-beam CT (CBCT) and four-dimensional CT (4DCT)], MRI (MRI; semi-quantitative, quantitative and compositional) and PET and their applications are reviewed. RECENT FINDINGS Radiography is the modality of choice for initial assessment of osteoarthritis. However, due to its low sensitivity and specificity, numerous recent investigations have proposed MRI as a powerful addition to detect and grade osteoarthritis features, which are not apparent in radiography. Semi-quantitative MRI measurements are feasible to perform in routine clinical practice. Quantitative and compositional MRI measurements have extended the amount of information an MRI examination can provide regarding the three-dimensional shape and tissue composition of articular cartilage. 4DCT and CBCT are introduced as imaging examinations that may reveal biomechanical cartilage abnormalities in osteoarthritis joint by dynamic and weight-bearing evaluations, respectively. Recent PET studies may unveil the underlying metabolic activities that can be associated with osteoarthritis. SUMMARY In addition to the established role of radiographs, MRI is the advanced modality of choice for detection and quantification of various osteoarthritis features. 4DCT and CBCT may have specified applications when diagnosis of underlying motion abnormality or dynamic changes in weight-bearing situation is suspected. Future studies should elucidate the specific clinical applications of ultrasonography and PET.
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