Magnetic resonance imaging in osteoarthritis of the knee: correlation with radiographic and scintigraphic findings.

Abstract

Twelve knees with a range of severity of knee osteoarthritis were assessed by magnetic resonance imaging (MRI) and technetium-99m labelled hydroxymethylene diphosphonate scintigraphy. Five magnetic resonance pulse sequences were evaluated. Proton density (TR= 1000, TE=26 ms) The knee with exertional pain at the time of the study was examined for tenderness, swelling, crepitus, and deformity. Plasma viscosity and rheumatoid factor were also measured. RADIOGRAPHYRecent anteroposterior weightbearing, and lateral knee radiographs were available in all cases. The presence of joint space narrowing, sclerosis, remodelling, cysts, and effusion was recorded in each compartment of the knee joint and graded on a 0-3 severity scale. These scores were then summated to provide an overall severity score relating to each compartment.

Osteoarthritis revisited—again!

“…Quite clearly, the bone scan is demonstrating bony pathology prior to radiographic change. Bone scans in knee OA also suggested subsets, one which seems to correlate with osteophyte formation, the other extending away from the joint surfaces correlated with bone marrow lesions subsequently identified on knee magnetic resonance imaging (MRI) [11]. Two processes, one perhaps bone forming, non-progressive OA, the other indicating significant pathology in subchondral bone supportive of the texture changes already described?…”

Knee adduction moment and development of chronic knee pain in elders

“…One possible hypothesis is that higher knee adduction moments may mediate knee pain by excessively loading subchondral bone of the medial compartment. There is growing evidence that subchondral bone and its turnover may play a causal role in the pathogenesis of osteoarthritis as well as its related symptoms, especially at the knee (23)(24)(25)(26). We speculate that high adduction moments, particularly with certain activities such as descending stairs, could lead to increased loading on the medial compartment of the knee, producing trauma and contusion to the subchondral bone, with subsequent pain.…”

Magnetic resonance imaging of bone destruction in rheumatoid arthritis: comparison with radiography

“…The unique high soft tissue contrast on MR images can be further improved using gadolinium-based contrast agents to delineate inflamed synovial tissue and its relationship to joint effusion and neighbouring cartilage and bony structures [3,8,12]. Although MRI is considered to be inferior to X-radiography and/or CT in the detection of cortical destruction and endosteal/ periosteal reactions [11], it still may demonstrate bone changes not readily detectable by standard radiographic techniques [2,[5][6][7]10].The ability to detect early destructive proliferative synovitis in RA is crucial for both prognosis and treatment strategy. Previous MRI investigations have focused mainly on the wrists [6,7], since involvement of these joints in patients with RA occurs more regularly than in the knee.…”