Skeletal Radiology

, Volume 37, Issue 9, pp 805–811 | Cite as

Do MRI features at baseline predict radiographic joint space narrowing in the medial compartment of the osteoarthritic knee 2 years later?

  • Ruby Madan-SharmaEmail author
  • Margreet Kloppenburg
  • Peter R. Kornaat
  • Stella A. Botha-Scheepers
  • Marie-Pierre Hellio Le Graverand
  • Johannes L. Bloem
  • Iain Watt
Scientific Article



The purpose of the study was to relate magnetic resonance imaging (MRI) features at baseline with radiographically determined joint space narrowing (JSN) in the medial compartment of the knee after 2 years in a group of patients with symptomatic osteoarthritis at multiple joint sites.

Materials and methods

MRI of the knee and standardized radiographs were obtained at baseline and after 2 years in 186 patients (81% female; aged 43–76 years; mean 60 years). MRI was analyzed for bone marrow lesions, cysts, osteophytes, hyaline cartilage defects, joint effusion, and meniscal pathology in the medial compartment. Radiographs were scored semiquantitatively for JSN in the medial tibiofemoral joint using the Osteoarthritis Research Society International (OARSI) atlas. Radiological progression was defined as ≥1 grade increase. Associations between baseline magnetic resonance (MR) parameters and subsequent radiographic JSN changes were assessed using logistic regression. Relative risk (RR) was then calculated.


Radiographic progression of JSN was observed in 17 (9.1%) of 186 patients. Eleven patients had a Kellgren and Lawrence (KL) score of ≥2. A significant association was observed between all patients and meniscal tears (RR 3.57; confidence interval (CI) 1.08–10.0) and meniscal subluxation (RR 2.73; CI 1.20–5.41), between KL < 2 and meniscal subluxation (RR 11.3; CI 2.49–29.49) and KL ≥ 2 and meniscus tears (RR 8.91; CI 1.13–22.84) and radiographic JSN 2 years later. Follow-up MR in 15 of 17 patients with progressive JSN showed only new meniscal abnormalities and no progression of cartilage loss.


Meniscal pathology (tears and/or meniscal subluxation) was the only MRI parameter to be associated with subsequent radiographic progression of JSN in the medial tibiofemoral compartment on a radiograph 2 years later, as assessed by the OARSI score.


Knee MRI Osteoarthritis Meniscus pathology 


Open Access

This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.


  1. 1.
    Felson DT. An update on the pathogenesis and epidemiology of osteoarthritis. Radiol Clin North Am 2004; 42(1): 1–9, v.CrossRefGoogle Scholar
  2. 2.
    Felson DT, Zhang Y, Hannan MT et al. The incidence and natural history of knee osteoarthritis in the elderly. The Framingham Osteoarthritis Study. Arthritis Rheum 1995; 38(10): 1500–1505.CrossRefGoogle Scholar
  3. 3.
    Brandt KD, Fife RS, Braunstein EM, Katz B. Radiographic grading of the severity of knee osteoarthritis: relation of the Kellgren and Lawrence grade to a grade based on joint space narrowing, and correlation with arthroscopic evidence of articular cartilage degeneration. Arthritis Rheum 1991; 34(11): 1381–1386.CrossRefGoogle Scholar
  4. 4.
    Hodler J, Resnick D. Current status of imaging of articular cartilage. Skeletal Radiol 1996; 25(8): 703–709.CrossRefGoogle Scholar
  5. 5.
    Buckland-Wright JC, Macfarlane DG, Lynch JA, Jasani MK, Bradshaw CR. Joint space width measures cartilage thickness in osteoarthritis of the knee: high resolution plain film and double contrast macroradiographic investigation. Ann Rheum Dis 1995; 54(4): 263–268.CrossRefGoogle Scholar
  6. 6.
    Adams JG, McAlindon T, Dimasi M, Carey J, Eustace S. Contribution of meniscal extrusion and cartilage loss to joint space narrowing in osteoarthritis. Clin Radiol 1999; 54(8): 502–506.CrossRefGoogle Scholar
  7. 7.
    Hill CL, Gale DG, Chaisson CE et al. Knee effusions, popliteal cysts, and synovial thickening: association with knee pain in osteoarthritis. J Rheumatol 2001; 28(6): 1330–1337.PubMedGoogle Scholar
  8. 8.
    Boegard T, Rudling O, Petersson IF, Jonsson K. Correlation between radiographically diagnosed osteophytes and magnetic resonance detected cartilage defects in the tibiofemoral joint. Ann Rheum Dis 1998; 57(7): 401–407.CrossRefGoogle Scholar
  9. 9.
    Boegard T. Radiography and bone scintigraphy in osteoarthritis of the knee—comparison with MR imaging. Acta Radiol Suppl 1998; 418: 7–37.PubMedGoogle Scholar
  10. 10.
    Link TM, Steinbach LS, Ghosh S et al. Osteoarthritis: MR imaging findings in different stages of disease and correlation with clinical findings. Radiology 2003; 226(2): 373–381.CrossRefGoogle Scholar
  11. 11.
    Hunter DJ, March L, Sambrook PN. The association of cartilage volume with knee pain. Osteoarthritis Cartilage 2003; 11(10): 725–729.CrossRefGoogle Scholar
  12. 12.
    Felson DT, Chaisson CE, Hill CL et al. The association of bone marrow lesions with pain in knee osteoarthritis. Ann Intern Med 2001; 134(7): 541–549.CrossRefGoogle Scholar
  13. 13.
    Kornaat PR, Kloppenburg M, Sharma R et al. Bone marrow edema-like lesions change in volume in the majority of patients with osteoarthritis; associations with clinical features. Eur Radiol 2007; 17(12): 3073–3078.CrossRefGoogle Scholar
  14. 14.
    Riyazi N, Meulenbelt I, Kroon HM et al. Evidence for familial aggregation of hand, hip, and spine but not knee osteoarthritis in siblings with multiple joint involvement: the GARP study. Ann Rheum Dis 2005; 64(3): 438–443.CrossRefGoogle Scholar
  15. 15.
    Kellgren JH, Lawrence JS. Radiological assessment of osteoarthrosis. Ann Rheum Dis 1957; 16(4): 494–502.CrossRefGoogle Scholar
  16. 16.
    Altman R, Asch E, Bloch D, Bole G, et al. Development of criteria for the classification and reporting of osteoarthritis. Classification of osteoarthritis of the knee. Diagnostic and Therapeutic Criteria Committee of the American Rheumatism Association. Arthritis Rheum 1986;29(8):1039–49.CrossRefGoogle Scholar
  17. 17.
    Altman R, Alarcon G, Appelrouth D et al. The American College of Rheumatology criteria for the classification and reporting of osteoarthritis of the hip. Arthritis Rheum 1991; 34(5): 505–514.CrossRefGoogle Scholar
  18. 18.
    Kothari M, Guermazi A, von Ingersleben G et al. Fixed-flexion radiography of the knee provides reproducible joint space width measurements in osteoarthritis. Eur Radiol 2004; 14(9): 1568–1573.CrossRefGoogle Scholar
  19. 19.
    Altman RD, Hochberg M, Murphy WA, Jr., Wolfe F, Lequesne M. Atlas of individual radiographic features in osteoarthritis. Osteoarthritis Cartilage 1995; 3(Suppl A): 3–70.PubMedGoogle Scholar
  20. 20.
    Altman RD, Gold GE. Atlas of individual radiographic features in osteoarthritis, revised. Osteoarthritis Cartilage 2007; 15(Suppl A): A1–56.CrossRefGoogle Scholar
  21. 21.
    Kornaat PR, Watt I, Riyazi N, Kloppenburg M, Bloem JL. The relationship between the MRI features of mild osteoarthritis in the patellofemoral and tibiofemoral compartments of the knee. European Radiology 2005; 15(8): 1538–1543.CrossRefGoogle Scholar
  22. 22.
    Yulish BS, Montanez J, Goodfellow DB, Bryan PJ, Mulopulos GP, Modic MT. Chondromalacia patellae: assessment with MR imaging. Radiology 1987; 164(3): 763–766.CrossRefGoogle Scholar
  23. 23.
    Mink JH, Deutsch AL. Occult cartilage and bone injuries of the knee: detection, classification, and assessment with MR imaging. Radiology 1989; 170(3 Pt 1): 823–829.CrossRefGoogle Scholar
  24. 24.
    Stoller DW, Martin C, Crues JV, III, Kaplan L, Mink JH. Meniscal tears: pathologic correlation with MR imaging. Radiology 1987; 163(3): 731–735.CrossRefGoogle Scholar
  25. 25.
    McCauley TR, Kornaat PR, Jee WH. Central osteophytes in the knee: prevalence and association with cartilage defects on MR imaging. Am J Roentgenol 2001; 176(2): 359–364.CrossRefGoogle Scholar
  26. 26.
    Zhang J, Yu KF. What's the relative risk? A method of correcting the odds ratio in cohort studies of common outcomes. JAMA 1998; 280(19): 1690–1691.CrossRefGoogle Scholar
  27. 27.
    Hunter DJ, Zhang YQ, Tu X et al. Change in joint space width: hyaline articular cartilage loss or alteration in meniscus? Arthritis Rheum 2006; 54(8): 2488–2495.CrossRefGoogle Scholar
  28. 28.
    Meister K, Indelicato PA, Spanier S, Franklin J, Batts J. Histology of the torn meniscus: a comparison of histologic differences in meniscal tissue between tears in anterior cruciate ligament-intact and anterior cruciate ligament-deficient knees. Am J Sports Med 2004; 32(6): 1479–1483.CrossRefGoogle Scholar
  29. 29.
    Ding C, Martel-Pelletier J, Pelletier JP et al. Knee meniscal extrusion in a largely non-osteoarthritic cohort: association with greater loss of cartilage volume. Arthritis Res Ther 2007; 9(2): R21.CrossRefGoogle Scholar
  30. 30.
    Lerer DB, Umans HR, Hu MX, Jones MH. The role of meniscal root pathology and radial meniscal tear in medial meniscal extrusion. Skeletal Radiol 2004; 33(10): 569–574.CrossRefGoogle Scholar
  31. 31.
    Watrin A, Ruaud JP, Olivier PT et al. T2 mapping of rat patellar cartilage. Radiology 2001; 219(2): 395–402.CrossRefGoogle Scholar
  32. 32.
    Hunter DJ, Zhang YQ, Niu JB et al. The association of meniscal pathologic changes with cartilage loss in symptomatic knee osteoarthritis. Arthritis Rheum 2006; 54(3): 795–801.CrossRefGoogle Scholar
  33. 33.
    Felson DT, McLaughlin S, Goggins J et al. Bone marrow edema and its relation to progression of knee osteoarthritis. Ann Intern Med 2003; 139(5 Pt 1): 330–336.CrossRefGoogle Scholar
  34. 34.
    Hunter DJ, Zhang Y, Niu J et al. Increase in bone marrow lesions associated with cartilage loss: a longitudinal magnetic resonance imaging study of knee osteoarthritis. Arthritis Rheum 2006; 54(5): 1529–1535.CrossRefGoogle Scholar

Copyright information

© The Author(s) 2008

Open AccessThis is an open access article distributed under the terms of the Creative Commons Attribution Noncommercial License (, which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.

Authors and Affiliations

  • Ruby Madan-Sharma
    • 1
    Email author
  • Margreet Kloppenburg
    • 2
  • Peter R. Kornaat
    • 1
  • Stella A. Botha-Scheepers
    • 2
  • Marie-Pierre Hellio Le Graverand
    • 3
  • Johannes L. Bloem
    • 1
  • Iain Watt
    • 1
  1. 1.Department of RadiologyLeiden University Medical CenterLeidenNetherlands
  2. 2.Department of RheumatologyLeiden University Medical CenterLeidenNetherlands
  3. 3.Pfizer GrotonGrotonUSA

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