Skip to main content
SpringerLink
Log in

MR imaging findings in the follow-up of patients with different stages of knee osteoarthritis and the correlation with clinical symptoms

  • Musculoskeletal
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objective: To assess the rate of cartilage loss, the change in bone marrow edema pattern and internal joint derangement at 1.5-T MRI in patients with knee osteoarthritis and to correlate these findings with the clinical Western Ontario and McMaster University Osteoarthitis (WOMAC) score. Methods: Forty subjects (mean age 57.7±15 years; 16 females and 24 males) were recruited: 6 healthy volunteers (OA0), 17 patients with mild osteoarthritis (OA1) and 17 with severe osteoarthritis (OA2) based on the Kellgren-Lawrence scale. MR scans, radiographs and WOMAC scores were obtained at baseline, first follow-up (1.4±0.67 years; n=40) and second follow-up (2.4±0.4 years; n=26). Cartilage morphology, bone marrow edema (BME), meniscal and ligamentous pathology were assessed on MR images and quantified by two radiologists in consensus. Results:Full-thickness cartilage lesions were observed in 12/17 OA2 at baseline, in 13/17 at the first follow-up and in 7/10 at the second follow-up. Cartilage loss was found in eight patients at the first follow-up and five at the second follow-up. BME was observed in 23/40 patients at baseline, in 22/40 at the first follow-up and in 12/26 at the second follow-up. Changes in BME were visualized in 19/22 and 4/13 patients at the first and second follow-up, respectively. Changes in WOMAC scores over time did not correlate significantly with the amount of cartilage loss and the change in BME (P>0.05). Conclusion:MRI is well suited to monitor the progression of OA in the longitudinal follow-up since it shows cartilage defects, BME and internal joint derangement, pathologies that are not visualized by radiographs. The lack of significant correlation between MRI findings and clinical findings is not unexpected, has been previously described and may in part be due to the fact that patients get more accustomed to their pain as the knee progressively degenerates.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

Explore related subjects

Discover the latest articles, news and stories from top researchers in related subjects.

References

  1. Felson D, Naimark A, Anderson J, Kazis L, Castelli W, Meenan RF (1987) The prevalence of knee osteoarthritis in the elderly. The Framingham osteoarthritis study. Arthritis Rheum 30(8):914–918

    Article  PubMed  CAS  Google Scholar 

  2. Felson DT (2004) An update on the pathogenesis and epidemiology of osteoarthritis. Radiol Clin North Am 42(1):1–9

    Article  PubMed  Google Scholar 

  3. Abadie E, Ethgen D, Avouac B et al (2004) Recommendations for the use of new methods to assess the efficacy of disease-modifying drugs in the treatment of osteoarthritis. Osteoarthr Cartil 12(4):263–268

    Article  PubMed  Google Scholar 

  4. Kellgren J, Lawrence J (1957) Radiological assessment of osteoarthritis. Ann Rheum Dis 16:494–501

    PubMed  CAS  Google Scholar 

  5. Hannan M, Felson DT, Pincus T (2000) Analysis of discordance between radiographic changes and knee pain in osteoarthritis of the knee. J Rheumatol 27:1513–1517

    PubMed  CAS  Google Scholar 

  6. Link TM, Steinbach LS, Ghosh S et al (2003) Osteoarthritis: MR imaging findings in different stages of disease and correlation with clinical findings. Radiology 226(2):373–381

    Article  PubMed  Google Scholar 

  7. Cicuttini FM, Jones G, Forbes A, Wluka AE (2004) Rate of cartilage loss at two years predicts subsequent total knee arthroplasty: a prospective study. Ann Rheum Dis 63(9):1124–1127

    Article  PubMed  CAS  Google Scholar 

  8. Dieppe PA, Cushnaghan J, Shepstone L (1997) The Bristol ‘OA500’ study: progression of osteoarthritis (OA) over 3 years and the relationship between clinical and radiographic changes at the knee joint. Osteoarthr Cartil 5(2) 87–97

    Article  PubMed  CAS  Google Scholar 

  9. Fernandez-Madrid F, Karvonen R, Teitge R, Miller P, Negendank W (1994) MR features of osteoarthritis of the knee. Magn Reson Imaging 12:703–709

    Article  PubMed  CAS  Google Scholar 

  10. Felson D, Chaisson C, Hill C et al (2001) The association of bone marrow lesions with pain in knee osteoarthritis. Ann Intern Med 134:541–549

    PubMed  CAS  Google Scholar 

  11. Zanetti M, Bruder E, Romero J, Holder J (2000) Bone marrow edema pattern in osteoarthritic knees: correlation between MR imaging and histologic findings. Radiology 215:835–840

    PubMed  CAS  Google Scholar 

  12. Roemer FW, Guermazi A, Lynch JA et al (2005) Short tau inversion recovery and proton density-weighted fat suppressed sequences for the evaluation of osteoarthritis of the knee with a 1.0 T dedicated extremity MRI: development of a time-efficient sequence protocol. Eur Radiol 15(5):978–987

    Article  PubMed  Google Scholar 

  13. Guermazi A, Zaim S, Taouli B, Miaux Y, Petrfy CG, Genant HG (2003) MR findings in knee osteoarthritis. Eur Radiol 13(6): 1370–1386

    Article  PubMed  Google Scholar 

  14. Peterfy CG, Dijke CF, Janzen DL et al (1994) Quantification of articular cartilage in the knee with pulse saturation transfer subtraction and fat-suppressed MR imaging: optimization and validation. Radiology 192:485–491

    PubMed  CAS  Google Scholar 

  15. Hohe J, Faber S, Stammberger T, Reiser M, Englmeier K, Eckstein F (2000) A technique for 3D in vivo quantification of proton density and magnetization transfer coefficients of knee joint cartilage. Osteoarthr Cartil 8:426–433

    Article  PubMed  CAS  Google Scholar 

  16. Hyhlik-Durr A, Faber S, Burgkart R et al (2000) Precision of tibial cartilage morphometry with a coronal water-excitation MR sequence. Eur Radiol 10:297–303

    Article  PubMed  CAS  Google Scholar 

  17. Cicuttini FM, Wluka AE, Wang Y, Stuckey SL (2004) Longitudinal study of changes in tibial and femoral cartilage in knee osteoarthritis. Arthritis Rheum 50(1):94–97

    Article  PubMed  CAS  Google Scholar 

  18. Raynauld JP, Martel-Pelletier J, Berthiaume MJ et al (2004) Quantitative magnetic resonance imaging evaluation of knee osteoarthritis progression over two years and correlation with clinical symptoms and radiologic changes. Arthritis Rheum 50(2):476–487

    Article  PubMed  Google Scholar 

  19. Wluka AE, Wolfe R, Stuckey S, Cicuttini FM (2004) How does tibial cartilage volume relate to symptoms in subjects with knee osteoarthritis? Ann Rheum Dis 63(3):264–268

    Article  PubMed  CAS  Google Scholar 

  20. Bellamy N, Buchanan W, Goldsmith C, Campbell J, Stitt L (1988) Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol, 1988. 15:1833–1840

    PubMed  CAS  Google Scholar 

  21. Noyes FR, Stabler CL (1989) A system for grading articular cartilage lesions at arthroscopy. Am J Sports Med 17:505–513

    Article  PubMed  CAS  Google Scholar 

  22. Recht M, Piraino D, Paletta G, Schils J, Belhobek G (1996) Accuracy of fat-suppressed three-dimensional spoiled gradient-echo FLASH MR Imaging in the detection of patellofemoral articular cartilage abnormalities. Radiology 198:209–212

    PubMed  CAS  Google Scholar 

  23. Felson DT, McLaughlin S, Goggins J et al (2003) Bone marrow edema and its relation to progression of knee osteoarthritis. Ann Intern Med 139: 330–336

    PubMed  Google Scholar 

  24. Cicuttini FM, Wang YY, Forbes A, Wluka AE, Glisson M (2003) Comparison between patella cartilage volume and radiological assessment of the patellofemoral joint. Clin Exp Rheumatol 21(3): 321–326

    PubMed  CAS  Google Scholar 

  25. Gandy SJ, Dieppe PA, Keen MC, Maciewicz RA, Watt I, Waterton JC (2002) No loss of cartilage volume over three years in patients with knee osteoarthritis as assessed by magnetic resonance imaging. Osteoarthr Cartil 10(12):929–937

    Article  PubMed  CAS  Google Scholar 

  26. Wluka AE, Stuckey S, Snaddon J, Cicuttini FM (2002) The determinants of change in tibial cartilage volume in osteoarthritic knees. Arthritis Rheum 46(8):2065–2072

    Article  PubMed  Google Scholar 

  27. Eckstein F, Heudorfer L, Faber SC, Burgkart R, Englmeier KH, Reiser M (2002) Long-term and resegmentation precision of quantitative cartilage MR imaging (qMRI). Osteoarthr Cartil 10(12):922–928

    Article  PubMed  CAS  Google Scholar 

  28. Raynauld JP, Kauffmann C, Beaudoin G et al (2003) Reliability of a quantification imaging system using magnetic resonance images to measure cartilage thickness and volume in human normal and osteoarthritic knees. Osteoarthr Cartil 11(5):351–360

    Article  PubMed  Google Scholar 

  29. Peterfy CG, Guermazi A, Zaim S et al (2004) Whole-Organ Magnetic Resonance Imaging Score (WORMS) of the knee in osteoarthritis. Osteoarthr Cartil 12(3):177–190

    Article  PubMed  CAS  Google Scholar 

  30. Dougados M, Nguyen M, Berdah L, Mazieres B, Vignon E, Lequesne M (1996) Radiological progression of hip osteoarthritis: definition, risk factors and correlations with clinical status. Ann Rheum Dis 55(6):356–362

    Article  PubMed  CAS  Google Scholar 

  31. Biswal S, Hastie T, Andriacchi TP, Bergman GA, Dillingham MF, Lang P (2002) Risk factors for progressive cartilage loss in the knee: a longitudinal magnetic resonance imaging study in 43 patients. Arthritis Rheum 46(11):2884–2892

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

This work is supported by Société Française de Radiologie, Philippe Foundation, Guerbet and is funded by NIH grant award program number AG17762. The authors acknowledge Ying Lu, PhD, and Niles Bruce, RT, for their substantial collaboration.

Author information

Authors and Affiliations

  1. Department of Radiology, University of California San Francisco, 185 Berry Street, Suite 350, Box 0628, 94143-0946, San Francisco, CA, USA

    Catherine M. Phan, Thomas M. Link, Gabrielle Blumenkrantz, Timothy C. Dunn, Lynne S. Steinbach & Sharmila Majumdar

  2. Department of Orthopedic Surgery, University of California San Francisco, San Francisco, CA, USA

    Michael D. Ries & Sharmila Majumdar

Authors
  1. Catherine M. Phan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Thomas M. Link
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Gabrielle Blumenkrantz
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Timothy C. Dunn
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Michael D. Ries
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Lynne S. Steinbach
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Sharmila Majumdar
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Catherine M. Phan.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Phan, C.M., Link, T.M., Blumenkrantz, G. et al. MR imaging findings in the follow-up of patients with different stages of knee osteoarthritis and the correlation with clinical symptoms. Eur Radiol 16, 608–618 (2006). https://doi.org/10.1007/s00330-005-0004-5

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00330-005-0004-5

Keywords

Search

Navigation