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


CONCLUSIONS
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.
Phan
Catherine M
CM
Department of Radiology, University of California San Francisco, 185 Berry Street, Suite 350, Box 0628, San Francisco, CA 94143-0946, USA. catherine.phan@radiology.ucsf.edu
Link
Thomas M
TM
Blumenkrantz
Gabrielle
G
Dunn
Timothy C
TC
Ries
Michael D
MD
Steinbach
Lynne S
LS
Majumdar
Sharmila
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001853:Bone Marrow / Q000473:pathology; D002358:Cartilage, Articular / Q000473:pathology; D018450:Disease Progression; D004487:Edema / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000473:pathology*; D011446:Prospective Studies