Quantitative magnetic resonance imaging evaluation of knee osteoarthritis progression over two years and correlation with clinical symptoms and radiologic changes.

OBJECTIVE To evaluate the change in osteoarthritic (OA) knee cartilage volume over a two-year period with the use of magnetic resonance imaging (MRI) and to correlate the MRI changes with radiologic changes. METHODS Thirty-two patients with symptomatic knee OA underwent MRI of the knee at baseline and at 6, 12, 18, and 24 months. Loss of cartilage volumes were computed and contrasted with changes in clinical variables for OA and with standardized semiflexed knee radiographs at baseline at 1 and 2 years. RESULTS Progression of cartilage loss at all followup points was statistically significant (P < 0.0001), with a mean +/- SD of 3.8 +/- 5.1% for global cartilage loss and 4.3 +/- 6.5% for medial compartment cartilage loss at 6 months, 3.6 +/- 5.1% and 4.2 +/- 7.5% at 12 months, and 6.1 +/- 7.2% and 7.6 +/- 8.6% at 24 months. Discriminant function analysis identified 2 groups of patients, those who progressed slowly (<2% of global cartilage loss; n = 21) and those who progressed rapidly (>15% of global cartilage loss; n = 11) over the 2 years of study. At baseline, there was a greater proportion of women (P = 0.001), a lower range of motion (P = 0.01), a greater circumference and higher level of pain (P = 0.05) and stiffness in the study knee, and a higher body mass index in the fast progressor group compared with the slow progressor group. No statistical correlation between loss of cartilage volume and radiographic changes was seen. CONCLUSION Quantitative MRI can measure the progression of knee OA precisely and can help to identify patients with rapidly progressing disease. These findings indicate that MRI could be helpful in assessing the effects of treatment with structure-modifying agents in OA.

[1]  J. Sánchez-Guerrero,et al.  Silicone breast implants and rheumatic disease. Clinical, immunologic, and epidemiologic studies. , 1994, Arthritis and rheumatism.

[2]  F. Cicuttini,et al.  Supplementary vitamin E does not affect the loss of cartilage volume in knee osteoarthritis: a 2 year double blind randomized placebo controlled study. , 2002, The Journal of rheumatology.

[3]  R. Moskowitz,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. , 1986, Arthritis and rheumatism.

[4]  The influence of the resolution and contrast on measuring the articular cartilage volume in magnetic resonance images. , 2000, Magnetic resonance imaging.

[5]  F Eckstein,et al.  In vivo reproducibility of three-dimensional cartilage volume and thickness measurements with MR imaging. , 1998, AJR. American journal of roentgenology.

[6]  M. Dougados,et al.  Inter-observer reliability of the arthroscopic quantification of chondropathy of the knee. , 1998, Osteoarthritis and cartilage.

[7]  F. Cicuttini,et al.  Tibial and femoral cartilage changes in knee osteoarthritis , 2001, Annals of the rheumatic diseases.

[8]  R. Burgkart,et al.  Precision of tibial cartilage morphometry with a coronal water-excitation MR sequence , 2000, European Radiology.

[9]  C A McGibbon,et al.  A general computing method for spatial cartilage thickness from co-planar MRI. , 1998, Medical engineering & physics.

[10]  M. Langer,et al.  Human articular cartilage: in vitro correlation of MRI and histologic findings , 1998, European Radiology.

[11]  T P Andriacchi,et al.  Methods for evaluating the progression of osteoarthritis. , 2000, Journal of rehabilitation research and development.

[12]  F. Cicuttini,et al.  Rate of knee cartilage loss after partial meniscectomy. , 2002, The Journal of rheumatology.

[13]  H K Genant,et al.  Emerging applications of magnetic resonance imaging in the evaluation of articular cartilage. , 1996, Radiologic clinics of North America.

[14]  R. Altman,et al.  Radiographic progression of knee osteoarthritis in a Czech cohort. , 2000, Clinical and experimental rheumatology.

[15]  M. Hochberg,et al.  Reliability of a quantification imaging system using magnetic resonance images to measure cartilage thickness and volume in human normal and osteoarthritic knees. , 2003, Osteoarthritis and cartilage.

[16]  T. Spector,et al.  Osteoarthritis: New Insights. Part 1: The Disease and Its Risk Factors , 2000, Annals of Internal Medicine.

[17]  F. Cicuttini,et al.  Comparison and reproducibility of fast and conventional spoiled gradient‐echo magnetic resonance sequences in the determination of knee cartilage volume , 2000, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[18]  P A Dieppe,et al.  No loss of cartilage volume over three years in patients with knee osteoarthritis as assessed by magnetic resonance imaging. , 2002, Osteoarthritis and cartilage.

[19]  J. Lynch,et al.  Quantitative microfocal radiographic assessment of osteoarthritis of the knee from weight bearing tunnel and semiflexed standing views. , 1994, The Journal of rheumatology.

[20]  F Eckstein,et al.  Non-invasive determination of cartilage thickness throughout joint surfaces using magnetic resonance imaging. , 1997, Journal of biomechanics.

[21]  J. Lynch,et al.  Joint space width measures cartilage thickness in osteoarthritis of the knee: high resolution plain film and double contrast macroradiographic investigation. , 1995, Annals of the rheumatic diseases.

[22]  M. Dougados,et al.  Radiological progression of hip osteoarthritis: definition, risk factors and correlations with clinical status. , 1996, Annals of the rheumatic diseases.

[23]  I. Petersson,et al.  Correlation between radiographically diagnosed osteophytes and magnetic resonance detected cartilage defects in the tibiofemoral joint , 1998, Annals of the rheumatic diseases.

[24]  E. Vignon,et al.  Quantitative evaluation of joint space width in femorotibial osteoarthritis: comparison of three radiographic views. , 1998, Osteoarthritis and cartilage.

[25]  M. Dougados,et al.  Variability in knee radiographing: implication for definition of radiological progression in medial knee osteoarthritis , 1998, Annals of the rheumatic diseases.

[26]  B. Swoboda,et al.  Measurement of cartilage thickness in the human knee-joint by magnetic resonance imaging using a three-dimensional gradient-echo sequence , 1999, International Orthopaedics.

[27]  Stephen L. Gandy,et al.  Diurnal variation in the femoral articular cartilage of the knee in young adult humans , 2000, Magnetic resonance in medicine.

[28]  M. Reiser,et al.  Assessment of normal patellar cartilage volume and thickness using MRI: an analysis of currently available pulse sequences , 1996, Skeletal Radiology.

[29]  T D Cooke,et al.  Radiographic assessment of progression in osteoarthritis. , 1987, Arthritis and rheumatism.

[30]  B. Swoboda,et al.  Cartilage thickness measurement in magnetic resonance imaging. , 1996, Osteoarthritis and cartilage.

[31]  Trevor Hastie,et al.  Risk factors for progressive cartilage loss in the knee: a longitudinal magnetic resonance imaging study in forty-three patients. , 2002, Arthritis and rheumatism.

[32]  S. Faber,et al.  A technique for 3D in vivo quantification of proton density and magnetization transfer coefficients of knee joint cartilage. , 2000, Osteoarthritis and cartilage.

[33]  F Eckstein,et al.  A non-invasive technique for 3-dimensional assessment of articular cartilage thickness based on MRI. Part 2: Validation using CT arthrography. , 1997, Magnetic resonance imaging.

[34]  F Eckstein,et al.  Accuracy of cartilage volume and thickness measurements with magnetic resonance imaging. , 1998, Clinical orthopaedics and related research.

[35]  M. Jergas,et al.  Accurate assessment of precision errors: How to measure the reproducibility of bone densitometry techniques , 2005, Osteoporosis International.

[36]  M. Dougados,et al.  Evaluation of the structure-modifying effects of diacerein in hip osteoarthritis: ECHODIAH, a three-year, placebo-controlled trial. Evaluation of the Chondromodulating Effect of Diacerein in OA of the Hip. , 2001, Arthritis and rheumatism.

[37]  H. Genant,et al.  Accuracy of T2-weighted fast spin-echo MR imaging with fat saturation in detecting cartilage defects in the knee: comparison with arthroscopy in 130 patients. , 1999, AJR. American journal of roentgenology.

[38]  J. Buckland-Wright,et al.  Quantitative radiography of osteoarthritis. , 1994, Annals of the rheumatic diseases.

[39]  M. Dougados,et al.  Quantitative MR imaging evaluation of chondropathy in osteoarthritic knees. , 1998, Radiology.

[40]  C. Hayne,et al.  Substantial superiority of semiflexed (MTP) views in knee osteoarthritis: a comparative radiographic study, without fluoroscopy, of standing extended, semiflexed (MTP), and schuss views. , 1999, The Journal of rheumatology.

[41]  F. Cicuttini,et al.  Comparison of tibial cartilage volume and radiologic grade of the tibiofemoral joint. , 2003, Arthritis and rheumatism.

[42]  Nicholas Bellamy,et al.  Design and conduct of clinical trials in patients with osteoarthritis : Recommendations from a task force of the Osteoarthritic Research Society , 1996 .

[43]  J. Lawrence,et al.  Osteo-Arthrosis: Prevalence in the Population and Relationship between Symptoms and X-ray Changes , 1966, Annals of the rheumatic diseases.

[44]  L R Frank,et al.  Articular cartilage in the knee: mapping of the physiologic parameters at MR imaging with a local gradient coil--preliminary results. , 1999, Radiology.

[45]  J C Buckland-Wright,et al.  Accuracy and precision of joint space width measurements in standard and macroradiographs of osteoarthritic knees. , 1995, Annals of the rheumatic diseases.

[46]  Maximilian Reiser,et al.  Quantitative relationships of normal cartilage volumes of the human knee joint – assessment by magnetic resonance imaging , 1998, Anatomy and Embryology.

[47]  Leena Sharma,et al.  The influence of alignment on risk of knee osteoarthritis progression according to baseline stage of disease. , 2002, Arthritis and rheumatism.

[48]  J. Lynch,et al.  Precision of joint space width measurement in knee osteoarthritis from digital image analysis of high definition macroradiographs. , 1993, Osteoarthritis and cartilage.

[49]  I. Pataki,et al.  Assessment of cartilage volume in the femorotibial joint with magnetic resonance imaging and 3D computer reconstruction. , 1994, The Journal of rheumatology.

[50]  D G Disler,et al.  Articular cartilage volume in the knee: semiautomated determination from three-dimensional reformations of MR images. , 1996, Radiology.

[51]  C. Goldsmith,et al.  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. , 1988, The Journal of rheumatology.

[52]  J. Kellgren,et al.  Radiological Assessment of Osteo-Arthrosis , 1957, Annals of the rheumatic diseases.

[53]  Eric Lejeune,et al.  Long-term effects of glucosamine sulphate on osteoarthritis progression: a randomised, placebo-controlled clinical trial , 2001, The Lancet.

[54]  T Stammberger,et al.  A method for quantifying time dependent changes in MR signal intensity of articular cartilage as a function of tissue deformation in intact joints. , 1999, Medical engineering & physics.

[55]  T Stammberger,et al.  Interobserver reproducibility of quantitative cartilage measurements: comparison of B-spline snakes and manual segmentation. , 1999, Magnetic resonance imaging.

[56]  C C Glüer,et al.  Quantification of articular cartilage in the knee with pulsed saturation transfer subtraction and fat-suppressed MR imaging: optimization and validation. , 1994, Radiology.

[57]  E. Vignon,et al.  Radiographic assessment of hip and knee osteoarthritis. Recommendations: recommended guidelines. , 1999, Osteoarthritis and cartilage.

[58]  K. Rauber,et al.  Degenerative joint disease on MRI and physical activity: a clinical study of the knee joint in 320 patients , 1999, European Radiology.

[59]  F. Cicuttini,et al.  Gender differences in knee cartilage volume as measured by magnetic resonance imaging. , 1999, Osteoarthritis and cartilage.

[60]  J. B. Kneeland,et al.  Quantification of the volume of articular cartilage in the metacarpophalangeal joints of the hand: accuracy and precision of three-dimensional MR imaging. , 1995, AJR. American journal of roentgenology.

[61]  F. Cicuttini,et al.  The determinants of change in tibial cartilage volume in osteoarthritic knees. , 2002, Arthritis and rheumatism.

[62]  T. Stammberger,et al.  Determination of 3D cartilage thickness data from MR imaging: Computational method and reproducibility in the living , 1999, Magnetic resonance in medicine.