title: Osteoarthritis of the knee at 3.0 T: comparison of a quantitative and a semi-quantitative score for the assessment of the extent of cartilage lesion and bone marrow edema pattern in a 24-month longitudinal study.
abstract: OBJECTIVE
  To compare a semi-quantitative and a quantitative morphological score for assessment of early osteoarthritis (OA) evolution.
  
  
  METHODS
  3.0 T MRI of the knee was performed in 60 women, 30 with early OA (each 15 with Kellgren-Lawrence grade 2 and 3) and 30 age-matched controls at baseline and at 12 and 24 months. Pathological condition was assessed with the whole-organ magnetic resonance imaging score (WORMS). Cartilage abnormalities and bone marrow edema pattern (BMEP) were also quantified using a previously introduced morphological quantitative score. These data were correlated with changes in clinical parameters and joint space width using generalized estimation equations (GEE).
  
  
  RESULTS
  At baseline, OA patients had significantly (p < 0.05) more and larger cartilage lesions and BMEP. During follow-up, cartilage lesions increased significantly (p < 0.05) in the patients compared with controls: WORMS showed progression only at the lateral patella, whereas the quantitative score revealed progression additionally at the trochlea and at the medial compartment. Both scores showed a significant (p < 0.05) increase in BMEP at the lateral femur in OA patients. In addition, quantitative scores of BMEP of the whole knee decreased significantly (p < 0.05) after 12 months and increased after 24 months in the patients, but showed an increase in controls at all follow-up examinations. Only weak correlations between structural imaging findings and clinical parameters were observed.
  
  
  CONCLUSIONS
  Quantitative assessment of cartilage lesions and BMEP is more sensitive to changes during the course of the disease than semi-quantitative scoring. However, structural imaging findings do not correlate well with the clinical progression of OA.
authors.affiliation: Department of Radiology, University of California, San Francisco, 185 Berry Street, Suite 350, San Francisco, CA 94107-0946, USA. Robert.Stahl@med.uni-muenchen.de
authors.forename: Robert
authors.initials: R
authors.lastname: Stahl
authors.forename: Sapna K
authors.initials: SK
authors.lastname: Jain
authors.forename: Jürgen
authors.initials: J
authors.lastname: Lutz
authors.forename: Bradley T
authors.initials: BT
authors.lastname: Wyman
authors.forename: Marie-Pierre Hellio
authors.initials: MP
authors.lastname: Le Graverand-Gastineau
authors.forename: Eric
authors.initials: E
authors.lastname: Vignon
authors.forename: Sharmila
authors.initials: S
authors.lastname: Majumdar
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Link
mesh_terms: D001853:Bone Marrow / Q000473:pathology*; D002358:Cartilage, Articular / Q000473:pathology; D018450:Disease Progression; D004487:Edema / Q000473:pathology; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000473:pathology*; D015203:Reproducibility of Results