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

  • Musculoskeletal
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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 (rT1GE = 0.73, P < 0.001; rDESS = 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.

Key Points

• Magnetic resonance imaging is useful for assessing burden of calcium-containing crystals (CaC).

• Gradient-echo sequences are superior to fast spin echo sequences for CaC imaging.

• Presence of CaC is associated with meniscus and cartilage degradation.

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Abbreviations

BMEP:

Bone marrow edema pattern

BCP:

Basic calcium phosphate

CaC:

Calcium-containing crystal

CPPD:

Calcium pyrophosphate deposition

DESS:

Dual echo steady-state

FSE:

Fast spin echo

GE:

Gradient echo

ICC:

Intra-class correlation coefficients

KL:

Kellgren–Lawrence

OA:

Osteoarthritis

OAI:

Osteoarthritis Initiative

WORMS:

Whole-Organ Magnetic Resonance Imaging Score

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Acknowledgments

The scientific guarantor of this publication is Dr. Thomas M. Link, MD, PhD, Department of Radiology and Biomedical Imaging, University of California, San Francisco. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. The OAI is a public-private partnership comprised of five contracts (N01-AR-2-2258; N01-AR-2-2259; N01-AR-2-2260; N01-AR-2-2261; N01-AR-2-2262) funded by the National Institutes of Health, a branch of the Department of Health and Human Services, and conducted by the OAI Study Investigators. Private funding partners include Merck Research Laboratories; Novartis Pharmaceuticals Corporation, GlaxoSmithKline; and Pfizer, Inc. Private sector funding for the OAI is managed by the Foundation for the National Institutes of Health. Written informed consent was obtained from all subjects in this study. Institutional Review Board approval was obtained. This manuscript was prepared using an OAI public use data set and has received the approval of the OAI Publications Committee based on a review of its scientific content and data interpretation. The analyses in this study were funded through the NIH (National Institute of Arthritis and Musculoskeletal and Skin Diseases grants R01AR064771 and P50-AR060752).

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Authors and Affiliations

  1. Department of Radiology and Biomedical Imaging, University of California, San Francisco, 185 Berry St, Suite 350, San Francisco, CA, 94107, USA

    Alexandra S. Gersing, Benedikt J. Schwaiger, Ursula Heilmeier, Gabby B. Joseph, Luca Facchetti, Martin Kretzschmar, Lynne S. Steinbach & Thomas M. Link

  2. Department of Epidemiology and Biostatistics, University of California, San Francisco, 550 16th Street, 2nd Floor, San Francisco, CA, 94158, USA

    John A. Lynch, Charles E. McCulloch & Michael C. Nevitt

Authors
  1. Alexandra S. Gersing
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  2. Benedikt J. Schwaiger
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  3. Ursula Heilmeier
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  4. Gabby B. Joseph
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  9. Michael C. Nevitt
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  10. Lynne S. Steinbach
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Correspondence to Alexandra S. Gersing.

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Gersing, A.S., Schwaiger, B.J., Heilmeier, U. et al. Evaluation of Chondrocalcinosis and Associated Knee Joint Degeneration Using MR Imaging: Data from the Osteoarthritis Initiative. Eur Radiol 27, 2497–2506 (2017). https://doi.org/10.1007/s00330-016-4608-8

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  • DOI: https://doi.org/10.1007/s00330-016-4608-8

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