title: Accuracy of magnetic resonance imaging to detect cartilage loss in severe osteoarthritis of the first carpometacarpal joint: comparison with histological evaluation.
abstract: Magnetic resonance imaging (MRI) is increasingly used for research in hand osteoarthritis, but imaging the thin cartilage layers in the hand joints remains challenging. We therefore assessed the accuracy of MRI in detecting cartilage loss in patients with symptomatic osteoarthritis of the first carpometacarpal (CMC1) joint.
  
  
  
  Twelve patients scheduled for trapeziectomy to treat severe symptomatic osteoarthritis of the CMC1 joint underwent a preoperative high resolution 3D spoiled gradient (SPGR) MRI scan. Subsequently, the resected trapezium was evaluated histologically. The sections were scored for cartilage damage severity (Osteoarthritis Research Society International (OARSI) score), and extent of damage (percentage surface area). Each MRI scan was scored for the area of normal cartilage, partial cartilage loss and full cartilage loss. The percentages of the total surface area with any cartilage loss and full-thickness cartilage loss were calculated using MRI and histological evaluation.
  
  
  
  MRI and histological evaluation both identified large areas of overall cartilage loss. The median (IQR) surface area of any cartilage loss on MRI was 98% (82-100%), and on histological assessment 96% (87-98%). However, MRI underestimated the extent of full-thickness cartilage loss. The median (IQR) surface area of full-thickness cartilage loss on MRI was 43% (22-70%), and on histological evaluation 79% (67-85%). The difference was caused by a thin layer of high signal on the articulating surface, which was interpreted as damaged cartilage on MRI but which was not identified on histological evaluation.
  
  
  
  Three-dimensional SPGR MRI of the CMC1 joint demonstrates overall cartilage damage, but underestimates full-thickness cartilage loss in patients with advanced osteoarthritis.
authors.affiliation: Department of Radiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands. m.saltzherr@erasmusmc.nl.|Department of Plastic, Reconstructive and Hand Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands. m.saltzherr@erasmusmc.nl.|Department of Rheumatology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands. m.saltzherr@erasmusmc.nl.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Saltzherr
authors.affiliation: Department of Plastic, Reconstructive and Hand Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: J Henk
authors.initials: JH
authors.lastname: Coert
authors.affiliation: Department of Plastic, Reconstructive and Hand Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.|Department of Rehabilitation Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
authors.forename: Ruud W
authors.initials: RW
authors.lastname: Selles
authors.affiliation: Department of Plastic, Reconstructive and Hand Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
authors.forename: Johan W
authors.initials: JW
authors.lastname: van Neck
authors.affiliation: Department of Plastic, Reconstructive and Hand surgery, Maasstad Hospital, Rotterdam, The Netherlands.
authors.forename: Jean-Bart
authors.initials: JB
authors.lastname: Jaquet
authors.affiliation: Department of Orthopaedics and Department of Otorhinolaryngology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
authors.forename: Gerjo J V M
authors.initials: GJ
authors.lastname: van Osch
authors.affiliation: Department of Radiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
authors.forename: Edwin H G
authors.initials: EH
authors.lastname: Oei
authors.affiliation: Department of Rheumatology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
authors.forename: Jolanda J
authors.initials: JJ
authors.lastname: Luime
authors.affiliation: Department of Radiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
authors.forename: Galied S R
authors.initials: GS
authors.lastname: Muradin
mesh_terms: D000368:Aged; D052737:Carpometacarpal Joints / Q000000981:diagnostic imaging* / Q000473:pathology*; D002358:Cartilage, Articular / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D021621:Imaging, Three-Dimensional / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000000981:diagnostic imaging* / Q000473:pathology*
keywords: Cartilage; First carpometacarpal joint; Histology; Magnetic resonance imaging; Osteoarthritis