title: No Difference on Quantitative Magnetic Resonance Imaging in Patellofemoral Cartilage Composition Between Patients With Patellofemoral Pain and Healthy Controls.
abstract: Retropatellar cartilage damage has been suggested as an etiological factor for patellofemoral pain (PFP), a common knee condition among young and physically active individuals. To date, there is no conclusive evidence for an association between cartilage defects and PFP. Nowadays, advanced quantitative magnetic resonance imaging (MRI) techniques enable estimation of cartilage composition.
  
  
  
  To investigate differences in patellofemoral cartilage composition between patients with PFP and healthy control subjects using quantitative MRI.
  
  
  
  Cross-sectional study; Level of evidence, 3.
  
  
  
  Patients with PFP and healthy control subjects underwent 3.0-T MRI including delayed gadolinium-enhanced MRI of cartilage and T1ρ and T2 mapping. Differences in relaxation times of patellofemoral cartilage were compared between groups by linear regression analyses, adjusted for age, body mass index, sex, sports participation, and time of image acquisition.
  
  
  
  This case-control study included 64 patients and 70 controls. The mean (±SD) age was 23.2 ± 6.4 years and the mean body mass index was 22.9 ± 3.4 kg/m(2); 56.7% were female. For delayed gadolinium-enhanced MRI of cartilage, the mean T1GD relaxation times of patellar (657.8 vs 669.4 ms) and femoral cartilage (661.6 vs 659.8 ms) did not significantly differ between patients and controls. In addition, no significant difference was found in mean T1ρ relaxation times of patellar (46.9 vs 46.0 ms) and femoral cartilage (50.8 vs 50.2 ms) and mean T2 relaxation times of patellar (33.2 vs 32.9 ms) and femoral cartilage (36.7 vs 36.6 ms) between patients and controls. Analysis of prespecified medial and lateral subregions within the patellofemoral cartilage also revealed no significant differences.
  
  
  
  There was no difference in composition of the patellofemoral cartilage, estimated with multiple quantitative MRI techniques, between patients with PFP and healthy control subjects. However, clinically relevant differences could not be ruled out for T1ρ in the adolescent population. Retropatellar cartilage damage has long been hypothesized as an important factor in the pathogenesis of PFP, but study findings suggest that diminished patellofemoral cartilage composition is not associated with PFP.
authors.affiliation: Department of General Practice, Erasmus MC, University Medical Center, Rotterdam, the Netherlands Department of Radiology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.
authors.forename: Rianne A
authors.initials: RA
authors.lastname: van der Heijden
authors.affiliation: Department of Radiology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.
authors.forename: Edwin H G
authors.initials: EH
authors.lastname: Oei
authors.affiliation: Biomedical Imaging Group Rotterdam, Departments of Radiology and Medical Informatics, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.
authors.forename: Esther E
authors.initials: EE
authors.lastname: Bron
authors.affiliation: Department of Radiology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands Department of Orthopedic Surgery, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.
authors.forename: Jasper
authors.initials: J
authors.lastname: van Tiel
authors.affiliation: Department of Sports Medicine, Medical Center Haaglanden, Leidschendam, the Netherlands.
authors.forename: Peter L J
authors.initials: PL
authors.lastname: van Veldhoven
authors.affiliation: Biomedical Imaging Group Rotterdam, Departments of Radiology and Medical Informatics, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.
authors.forename: Stefan
authors.initials: S
authors.lastname: Klein
authors.affiliation: Department of Orthopedic Surgery, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.
authors.forename: Jan A N
authors.initials: JA
authors.lastname: Verhaar
authors.affiliation: Department of Radiology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.
authors.forename: Gabriel P
authors.initials: GP
authors.lastname: Krestin
authors.affiliation: Department of General Practice, Erasmus MC, University Medical Center, Rotterdam, the Netherlands Department of Orthopedic Surgery, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.
authors.forename: Sita M A
authors.initials: SM
authors.lastname: Bierma-Zeinstra
authors.affiliation: Department of General Practice, Erasmus MC, University Medical Center, Rotterdam, the Netherlands m.vanmiddelkoop@erasmusmc.nl.
authors.forename: Marienke
authors.initials: M
authors.lastname: van Middelkoop
mesh_terms: D000293:Adolescent; D000328:Adult; D002356:Cartilage / Q000000981:diagnostic imaging* / Q000473:pathology; D002357:Cartilage Diseases / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology*; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D057071:Patellofemoral Joint / Q000000981:diagnostic imaging* / Q000473:pathology; D046788:Patellofemoral Pain Syndrome / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology*; D055815:Young Adult
keywords: cartilage; knee; magnetic resonance imaging; patella; patellofemoral pain syndrome