Osteoarthritis of the knee: comparison of radiography, CT, and MR imaging to assess extent and severity.

Chan, Wing P.; Lang, Philipp; Stevens, Martijn; Sack, K; Majumdar, Sharmila; Stoller, David W.; Basch, C.; Genant, Harry K.

doi:10.2214/ajr.157.4.1892040

Cited by 232 publications

(143 citation statements)

References 17 publications

Supporting

Mentioning

132

Contrasting

Unclassified

Order By: Relevance

“…Neither included asymptomatic controls. In 1 study of 20 patients with knee OA, 7 (35%) had complete and 3 (15%) had partial ACL tears, with 1 further patient having a complete PCL tear (16). In another study of 50 patients with knee OA, 14 (28%) had complete ACL tears, all with K/L grade Ն3 (17).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Cruciate ligament integrity in osteoarthritis of the knee

Hill¹,

Seo²,

Gale³

et al. 2005

Arthritis & Rheumatism

143

View full text Add to dashboard Cite

Objective. To evaluate, using magnetic resonance imaging (MRI), the prevalence of anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) rupture in knees with symptomatic osteoarthritis (OA) compared with those without OA, and the relationship to pain and recalled injury.Methods. MRI and plain radiography of the knee were performed in a group of 360 subjects with painful knee OA (cases; 66.7% male, mean age 67.1 years) and 73 without knee pain (controls; 57.5% male, mean age 66.1 years). MRIs were read for the presence or absence of complete or partial ACL or PCL tear. Subjects with knee pain were asked to quantify severity of pain on a visual analog scale and to report whether they could recall a significant knee injury (requiring use of a cane or crutches). We compared the prevalence of ACL and PCL rupture in those with and those without knee pain and also evaluated whether, in cases, there was any association with recalled knee injury.Results. The proportion of cases who had complete ACL rupture was 22.8%, compared with 2.7% of controls (P ‫؍‬ 0.0004). PCL rupture was rare both in cases (0.6%) and in controls (0%). Cases with ACL rupture had more severe radiologic OA (P < 0.0001) and were more likely to have medial joint space narrowing (P < 0.0001) than cases with intact ACLs, but did not have higher pain scores. Among cases, only 47.9% of those with complete ACL tears reported a previous knee injury, compared with 25.9% of those without complete ACL tears (P ‫؍‬ 0.003).Conclusion. ACL rupture is more common among those with symptomatic knee OA compared with those without knee OA. Fewer than half of subjects with ACL rupture recall a knee injury, suggesting that this risk factor for knee OA is underrecognized.

show abstract

Section: Discussionmentioning

confidence: 99%

“…Two small MRI studies of cruciate ligament integrity in knee OA have been published previously (16,17). Neither included asymptomatic controls.…”

Section: Discussionmentioning

confidence: 99%

Cruciate ligament integrity in osteoarthritis of the knee

Hill¹,

Seo²,

Gale³

et al. 2005

Arthritis & Rheumatism

143

View full text Add to dashboard Cite

show abstract

“…As such, component rotation could not be analyzed. It is likely that the MRI-based technique provides improved imaging of the cartilage surfaces [6,9,22,44,47]. Based on the cartilage surface estimated by the surgeon with CT-based patient-specific instrumentation, deviations from the real joint surface are possible, which can result in a poorer fit.…”

Section: Discussionmentioning

confidence: 99%

Small Improvements in Mechanical Axis Alignment Achieved With MRI versus CT-based Patient-specific Instruments in TKA: A Randomized Clinical Trial

Pfitzner

Abdel

Roth

et al. 2014

Clinical Orthopaedics &Amp; Related Research

101

View full text Add to dashboard Cite

Background Patient-specific instrumentation in TKA has the proposed benefits of improving coronal and sagittal alignment and rotation of the components. In contrast, the literature is inconsistent if the use of patient-specific instrumentation improves alignment in comparison to conventional instrumentation. Depending on the manufacturer, patient-specific instrumentation is based on either MRI or CT scans. However, it is unknown whether one patient-specific instrumentation approach is more accurate than the other and if there is a potential benefit in terms of reduction of duration of surgery. Questions/purposes We compared the accuracy of MRIand CT-based patient-specific instrumentation with conventional instrumentation and with each other in TKAs. The three approaches also were compared with respect to validated outcomes scores and duration of surgery. Methods A randomized clinical trial was conducted in which 90 patients were enrolled and divided into three groups: CT-based, MRI-based patient-specific instrumentation, and conventional instrumentation. The groups were not different regarding age, male/female sex distribution, and BMI. In all groups, coronal and sagittal alignments were measured on postoperative standing long-leg and lateral radiographs. Component rotation was measured on CT scans. Clinical outcomes (Knee Society and WOMAC scores) were evaluated preoperatively and at a mean of 3 months postoperatively and the duration of surgery was analyzed for each patient. MRI-and CT-based patientspecific instrumentation groups were first compared with conventional instrumentation, the patient-specific instrumentation groups were compared with each other, and all three approaches were compared for clinical outcome measures and duration of surgery. Results Compared with conventional instrumentation MRI-and CT-based patient-specific instrumentation showed higher accuracy regarding the coronal limb axis

show abstract

“…Magnetic resonance imaging (MRI) offers a distinct advantage over knee radiography, since cartilage can be assessed directly. Several studies have been performed evaluating MRI as an imaging tool for knee OA (4)(5)(6)(7)(8). Since MRI also provides 3-dimensional imaging of the knee, in contrast to the 2-dimensional radiographic images, cartilage morphology in multiple compartments of the knee can be better assessed.…”

mentioning

confidence: 99%

The relationship between cartilage loss on magnetic resonance imaging and radiographic progression in men and women with knee osteoarthritis

Amin¹,

LaValley²,

Guermazi³

et al. 2005

Arthritis & Rheumatism

202

160

View full text Add to dashboard Cite

Objective. To determine the relationship between radiographic progression of joint space narrowing and cartilage loss on magnetic resonance imaging (MRI) in patients with symptomatic knee osteoarthritis (OA), and to investigate the location of MRI-based cartilage loss in the knee and its relation to radiographic progression.Methods. Two hundred twenty-four men and women (mean age 66 years) were studied. Radiographs and MRI of the more symptomatic knee were obtained at baseline and at 15-and 30-month followup. Radiographs of the knee (with weight-bearing) were read for joint space narrowing (scale 0-3), with progression defined as any worsening in score. We used a semiquantitative method to score cartilage morphology in all 5 regions of the tibiofemoral joint, and defined cartilage loss as an increase in score (scale 0-4) at any region. We examined the relationship between progression of joint space narrowing on radiographic images and cartilage loss on MRI, using a generalized estimating equation proportional odds logistic regression, adjusted for baseline cartilage score, age, body mass index, and sex. The medial and lateral compartments were analyzed separately.Results. In the medial compartment, 104 knees (46%) had cartilage loss detected by MRI. The adjusted odds ratio was 3.7 (95% confidence interval 2.2-6.3) for radiographic progression being predictive of cartilage loss on MRI. However, there was still a substantial proportion of knees (80 of 189 [42%]) with cartilage loss visible on MRI when no radiographic progression was apparent. Cartilage loss occurred frequently in the central regions of the femur and tibia as well as the posterior femur region, but radiographic progression was less likely to be observed when posterior femur regions showed cartilage loss. Radiographic progression appeared specific (91%) but not sensitive (23%) for cartilage loss. Overall findings were similar for the lateral compartment.Conclusion. While our results provide longitudinal evidence that radiographic progression of joint space narrowing is predictive of cartilage loss assessed on MRI, radiography is not a sensitive measure, and if used alone, will miss a substantial proportion of knees with cartilage loss.

show abstract

Osteoarthritis of the knee: comparison of radiography, CT, and MR imaging to assess extent and severity.

Cited by 232 publications

References 17 publications

Cruciate ligament integrity in osteoarthritis of the knee

Cruciate ligament integrity in osteoarthritis of the knee

Small Improvements in Mechanical Axis Alignment Achieved With MRI versus CT-based Patient-specific Instruments in TKA: A Randomized Clinical Trial

The relationship between cartilage loss on magnetic resonance imaging and radiographic progression in men and women with knee osteoarthritis

Contact Info

Product

Resources

About