Osteosynthesis and Trauma Care 2006; 14(3): 195-202
DOI: 10.1055/s-2006-942230
Original Article

© Georg Thieme Verlag Stuttgart · New York

Radiological Evaluation of Cartilage Disorders

S. Trattnig1
  • 1Centre of Excellence for High-Field MR, Department of Radiology, Medical University of Vienna, Vienna, Austria
Further Information

Publication History

Publication Date:
02 November 2006 (online)

Abstract

MR imaging is the method of choice in the evaluation of cartilage and in the follow-up of cartilage repair procedures. The use of cartilage-sensitive sequences and high spatial resolution technique allows accurate evaluation of cartilage morphology even in the earlier stages of disease as well as analysis of cartilage repair tissue in the follow-up. In addition to morphology, new MR techniques give insight into biochemical composition of cartilage and cartilage repair, which allow an earlier diagnosis of cartilage degeneration and help to objectively monitor different conservative and surgical therapies. MR visualization of the biomechanical properties and contact areas in kinematic MR studies are in development.

References

  • 1 Akesson K. Bone and joint diseases around the world. Sweden: a brief update on burden and priority.  J Rheumatol Suppl. 2003;  67 38-40
  • 2 Alparslan L, Minas T, Winalski C S. Magnetic resonance imaging of autologous chondrocyte implantation.  Seminars in Ultrasound, CT and MRI. 2001;  22 341-351
  • 3 Ateshian G A, Kwak S D, Soslowsky L J, Mow V C. A stereophotogrammetric method for determining in situ contact areas in diarthrodial joints and a comparison with other methods.  J Biomechanics. 1994;  27 111-124
  • 4 Bashir A, Gray M L, Burstein D. Gd-DTPA2- as a measure of cartilage degradation.  Magn Reson Med. 1996;  36 665-673
  • 5 Bashir A, Gray M L, Hartke J, Burstein D. Nondestructive imaging of human cartilage glycosaminoglycan concentration by MRI.  Magn Reson Med. 1999;  41 857-865
  • 6 Ba-Ssalamah A, Schnibany N, Puig S, Herneth A M, Noebauer-Huhmann I M, Trattnig S. Imaging articular cartilage defects in the ankle joint with 3D fat suppressed echo planar imaging: comparison with conventional 3D fat suppressed gradient echo imaging.  J Magn Reson Imaging. 2002;  16 209-216
  • 7 Black J D, Matejczyk M B, Greenwald S. Reversible cartilage staining technique for defining articular weight-bearing surfaces.  Clin Orthop Rel Res. 1981;  159 265-267
  • 8 Bobic V. ICRS articular cartilage imaging committee, IRCS MR imaging protocol for knee articular cartilage. Newsletter 2000; III: 12
  • 9 Borthakur A, Shapiro E M, Akella S V, Gougoutas A, Kneeland J B, Reddy R. Quantifying sodium in the human wrist in vivo by using MR imaging.  Radiology. 2002;  224 598-602
  • 10 Bredella M A, Tirman P FJ, Peterfy C G. et al . Accuracy of T2-weighted fast spin-echo MR imaging with fat saturation in detecting cartilage defects in the knee. Comparison with arthroscopy in 130 patients.  AJR Am J Roentgenol. 1999;  172 1073-1080
  • 11 Buckwalter J A, Mankin H J. Articular cartilage. Part II: Degeneration and osteoarthritis repair, regeneration and transplantation.  J Bone Joint Surg [Am]. 1997;  79 612-663
  • 12 Burstein D, Velyvis J, Scott K T. et al . Protocol issues for delayed Gd(DTPA)2- enhanced MRI (dGEMRIC) for clinical evaluation of articular cartilage.  Magn Reson Med. 2001;  45 36-41
  • 13 Calhoun J H, Ledbetter B R, Viegas S F. A comprehensive study of pressure distribution in the ankle joint with inversion and eversion.  Foot and Ankle. 1994;  15 125-133
  • 14 Cherunbino P, Ronga M, Grassi F A, Bulgheroni P. Autologous chondrocyte implantation with a collagen membrane. Springer, Italy 2002
  • 15 Christensen J C, Driscoll H L, Tencer A F. Contact characteristics of the ankle joint. Part 2. The effects of talar dome cartilage defects.  J Am Paediatr Med Assoc. 1994;  84 537-547
  • 16 Cohen Z A, McCarthy D M, Kwak D S, Legrand P, Fogarasi F, Ciaccio E J, Ateshian G A. Knee cartilage topography, thickness and contact areas from MRI: In-vitro calibration and in-vivo measurement.  Osteoarthritis and Cartilage. 1999;  7 95-109
  • 17 Constable R T, Anderson A W, Zhong J, Gore J C. Factors influencing contrast in fast spin-echo MR imaging.  Magn Reson Imaging. 1992;  10 497-511
  • 18 Curl W W, Krome J, Gordon E S, Rushing J, Smith B P, Poehling G G. Cartilage injuries: a review of 31 516 knee arthroscopies.  Arthroscopy. 1997;  13 456-460
  • 19 Dardzinski B J, Mosher T J, Li S, Van Slyke M A, Smith M B. Spatial variation of T2 in human articular cartilage.  Radiology. 1997;  205 546-550
  • 20 Disler D G, McCauley T R, Kelman C G, Fuchs M D, Ratner L M, Wirth C R, Hospodar P P. Fat-suppressed three-dimensional spoiled gradient-echo FLASH MR imaging of hyaline cartilage defects in the knee: comparison with standard MR imaging and arthroscopy.  AJR Am J Roentgenol. 1996;  167 127-132
  • 21 Eckstein F, Sittek H, Milz S, Putz R, Reiser M. The morphology of articular cartilage assessed by magnetic resonance imaging (MRI). Reproducibility and anatomical correlation.  Surg Radiol Anat. 1994;  16 429-438
  • 22 Eckstein F, Sittek H, Milz S, Schulte E, Kiefer B, Reiser M. The potential of magnetic resonance imaging (MRI) for quantifying articular cartilage thickness - a methodological study.  Clin Biomech. 1995;  10 434-440
  • 23 Ehlers E M, Fuß J, Rohwedel J, Russlies M, Kühnel W, Behrens P. Development of a biocomposit to fill out articular cartilage lesions. Light, scanning and transmission electron microscopy of sheep chondrocytes cultured on a collagen I/III sponge.  Ann Anat. 1999;  181 513-518
  • 24 Elders M J. The increasing impact of arthritis on public health.  Rheumatology Suppl. 2000;  60 6-8
  • 25 Faber S C, Eckstein F, Lukasz S, Muhlbauer R, Hohe J, Englmeier K H, Reiser M. Gender differences in knee joint cartilage thickness, volume and articular surface areas: assessment with quantitative three-dimensional MR imaging.  Skeletal Radiol. 2001;  30 144-150
  • 26 Fragonas E, Mlynarik V, Toffanin R, Rizzo R, Vittur F. Correlation between biochemical composition and megnetic resonance appearance of articular cartilage.  Osteoarthritis Cartilage. 1998;  6 24-32
  • 27 Frank L R, Wong E C, Luh W M, Ahn J M, Resnick D. Articular cartilage in the knee: mapping of the physiologic parameters at MR imaging with a local gradient coil - preliminary results.  Radiology. 1999;  210 241-246
  • 28 Gagliardi J A, Chung E M, Chandnani V P. et al . Detection and staging of chondromalacia patellae: Relative efficacies of conventional MR imaging, MR arthrography and CT arthrography.  AJR Am J Roentgenol. 1994;  163 629-636
  • 29 Gilbert J E. Current treatment options in the restoration of articular cartilage.  Am J Knee Surg. 1998;  11 42-46
  • 30 Glaser C, Faber S, Eckstein F, Fischer H, Springer V, Heudorfer L, Stammberger T, Englmeier K H, Reiser M. Optimization and validation of a rapid high-resolution T1-w 3D FLASH water excitation MRI sequence for the quantitative assessment of articular cartilage volume and thickness.  Magn Reson Imaging. 2001;  19 177-185
  • 31 Graichen H, Springer V, Flaman T, Stammberger T, Glaser C, Englmeier K H, Reiser M, Eckstein F. Validation of high-resolution water-excitation magnetic resonance imaging for quantitative assessment of thin cartilage layers.  Osteoarthritis Cartilage. 2000;  8 106-114
  • 32 Hayes W C, Mockros L F. Viscoelastic properties of human articular cartilage.  J Appl Physiol. 1971;  31 562-568
  • 33 Jackson D W, Simon T M, Aberman H M. Symptomic articular cartilage degeneration: the impact in the new millennium.  Clin Orthop. 2001;  391 14-25
  • 34 Kaufman J H, Regatte R R, Bolinger L, Kneeland J B, Reddy R, Leigh J S. A novel approach to observing articular cartilage deformation in vitro via magnetic resonance imaging.  J Magn Reson Imaging. 1999;  9 653-662
  • 35 Kawahara Y, Uetani M, Nakahara N. et al . Fast spin-echo MR of the articular cartilage in the osteoarthrotic knee. Correlation of MR and arthroscopic findings.  Acta Radiol. 1998;  39 120-125
  • 36 Kempson G E, Freeman M AR, Swanson S AV. The determination of a creep modulus for the articular cartilage from indentation tests on the human femoral head.  J Biomechanics. 1971;  4 239-250
  • 37 Kimelman T, Vu A, Li B, Storey P, Williams A, McKenzie C A, Burstein D, Prasad P V. Preliminary experience with dGEMRIC at 3.0 T. Proc Int Soc Magn Reson Med Twelfth Sci Meeting, Kyoto 2004; 823
  • 38 Kimizuka M, Kurosawa H, Fukubayashi T. Load-bearing pattern of the ankle joint. Contact area and pressure distribution.  Arch Orthop Traum Surg. 1980;  96 45-49
  • 39 Kingsley P B. Signal intensities and T1 calculations in multiecho sequences with imperfect pulses.  Con Magn Reson. 1999;  11 29-49
  • 40 Lukasz S, Muhlbauer R, Faber S, Englmeier K H, Reiser M, Eckstein F. [Sex-specific analysis of cartilage volume in the knee joint - a quantitative MRI-based study].  Anat Anz. 1998;  180 487-493 ,  [in German]
  • 41 Mak A F, Mow V C. Biphasic indentation of articular cartilage - I. Theoretical analysis.  J Biomechanics. 1987;  20 703-714
  • 42 March L M, Bachmeier C J. Economics of osteoarthritis: a global perspective.  Baillieres Clin Rheumatol. 1997;  11 817-834
  • 43 Menezes N M, Gray M L, Hartke J R, Burstein D. T2 and T1ρ in articular cartilage systems.  Magn Reson Med. 2004;  51 503-509
  • 44 Miller K L, Hargreaves B A, Gold G E, Pauly J M. Steady-state diffusion-weighted imaging of in vivo knee cartilage.  Magn Reson Med. 2004;  51 394-398
  • 45 Minas T. A practical algorithm for cartilage repair.  Op Tech Sports Med. 2000;  8 141-143
  • 46 Minas T, Nehrer S. Current concepts in the treatment of articular cartilage defects.  Orthopedics. 1997;  20 525-538
  • 47 Mosher T J, Dardzinski B J, Smith M B. Human articular cartilage: Influence of aging and early symptomatic degeneration on the spatial variation of T2 - preliminary findings at 3 T.  Radiology. 2000;  214 259-266
  • 48 Mosher T J, Liu Y, Smith M B. Run while you're young: Age dependent differences in cartilage T2 response to running in trained marathoners. Proc Int Soc Magn Reson Med Twelfth Sci Meeting, Kyoto 2004; 208
  • 49 Mow V, Gibbs M C, Lai W M, Zhu W B, Athanasiou K A. Biphasic indentation of articular cartilage II. A numerical algorithm and an experimental study.  J Biomechanics. 1989;  22 853-861
  • 50 Mow V C, Fithian D C, Kelly M A. Fundamentals of articular cartilage and meniscus biomechanics. In: Ewing JW (ed). Articular cartilage and knee joint function: basic science and arthroscopy. Raven Press Ltd., New York 1990; 1-18
  • 51 Nakagawa S, Kadoya Y, Kobayashi A. et al . Kinematics of the patella in deep flexion. Analysis with magnetic resonance imaging.  J Bone Joint Surg [Am]. 2003;  85 1238-1242
  • 52 Nieminen M T, Rieppo J, Töryäs J, Hakumäki J M, Silvennoinen J, Hyttinen M M, Helminen H J, Jurvelin J S. T2 relaxation reveals spatial collagen architecture in articular cartilage: A comparative quantitative MRI and polarized light microscopic study.  Magn Reson Med. 2001;  46 487-493
  • 53 Nieminen M T, Toyras J, Laasanen M S. et al .MRI quantitation of proteoglycans predicts cartilage stiffness in bovine humeral head. Orthopaedic Research Society. San Francisco CA, February 25-28, 2001
  • 54 Nieminen M T, Toyras J, Rieppo J. et al . Quantitative MR microscopy of enzymatically degraded articular cartilage.  Magn Reson Med. 2000;  43 676-681
  • 55 Nieminen M T, Winalski C S, Rieppo J, Lammi M, Lechpammer S, Johnson K, Minas T, Kiviranta I. Multi-parametric MRI assessment of cartilage repair with correlation to histology. Proc Int Soc Magn Reson Med Twelfth Sci Meeting, Kyoto 2004; 2399
  • 56 Patel V V, Hall K, Ries M. et al . A three-dimensional MRI analysis of knee kinematics.  J Orthop Res. 2004;  22 283-292
  • 57 Patel V V, Hall K, Ries M. et al . Magnetic resonance imaging of patellofemoral kinematics with weight-bearing.  J Bone Joint Surg [Am]. 2003;  85 2419-2424
  • 58 Peterfy C G, Majumdar S, Lang P, van-Dijke C F, Sack K, Genant H K. MR imaging of the arthritic knee: Improved discrimination of cartilage, synovium and effusion with pulsed saturation transfer and fat-suppressed T1-weighted sequences.  Radiology. 1994;  191 413-419
  • 59 Peterfy C G, van Dijke C F, Janzen D L, Gluer C C, Namba R, Majumdar S, Lang P, Genant H K. Quantification of articular cartilage in the knee with pulsed saturation transfer subtraction and fat-suppressed MR imaging: optimization and validation.  Radiology. 1994;  192 485-491
  • 60 Peterfy C G, van Dijke C F, Lu Y. et al . Quantification of the volume of articular cartilage in the metacarpophalangeal joints of the hand: Accuracy and precision of three-dimensional MR imaging.  AJR Am J Roentgenol. 1998;  165 371-375
  • 61 Peterson L, Minas T, Brittberg M, Nilsson A, Sjogren-Jansson E, Lindahl A. Two- to 9-year outcome after autologous chondrocyte transplantation of the knee.  Clin Orthop Rel Res. 2000;  374 212-234
  • 62 Pilch L, Stewart C, Gordon D, Inman R, Parsons K, Pataki I, Stevens J. Assessment of cartilage volume in the femorotibial joint with magnetic resonance imaging and 3D computer reconstruction.  J Rheumatol. 1994;  21 2307-2321
  • 63 Potter H G, Linklater J M, Allen A A, Hannafin J A, Haas S B. Magnetic resonance imaging of articular cartilage in the knee. An evaluation with the use of fast-spin-echo imaging.  J Bone Joint Surg [Am]. 1998;  80 1276-1284
  • 64 Recht M, Bobic V, Burstein D, Disler D, Gold G, Gray M, Kramer J, Lang P, McCauley T, Winalski C. Magnetic resonance imaging of articular cartilage.  Clin Orthop Rel Res. 2001;  1 (391 Suppl) s379-s396
  • 65 Recht M P, Piraino D W, Paletta G A. et al . Accuracy of fat-suppressed three-dimensional spoiled gradient-echo FLASH MR imaging in the detection of patellofemoral articular cartilage abnormalities.  Radiology. 1996;  198 209-212
  • 66 Reginster J Y. The prevalence and burden of arthritis.  Rheumatology (Oxford). 2002;  1 3-6
  • 67 Roberts S, McCall I W, Darby A J, Menage J, Evans H, Harriso P E, Richardson J B. Autologous chondrocyte implantation cartilage repair: monitoring its success by magnetic resonance imaging and histology.  Arthritis Res Ther. 2003;  5 (1) R60-R73
  • 68 Robson M D, Hodgson R J, Herrod N J, Tyler J A, Hall L D. A combined analysis and magnetic resonance imaging technique for computerised automatic measurement of cartilage thickness in the distal interphalangeal joint.  Magn Reson Imaging. 1995;  13 709-718
  • 69 Rubenstein J D, Li J G, Majumdar S, Henkelmann R M. Image resolution and signal-to-noise ratio requirements for MR imaging of degenerative cartilage.  Radiology. 1997;  169 1039-1096
  • 70 Scarvell J M, Smith P N, Refshauge K M, Galloway H R, Woods K R. Evaluation of a method to map tibiofemoral contact points in the normal knee using MRI.  J Orthop Res. 2004;  22 788-793
  • 71 Shapiro E M, Borthakur A, Gougoutas A, Reddy R. 23Na MRI accurately measures fixed charge density in articular cartilage.  Magn Reson Med. 2002;  47 284-291
  • 72 Smith H E, Mosher T J, Dardzinski B J, Collins B G, Collins C M, Yang Q X, Schmithorst V J, Smith M B. Spatial variation in cartilage T2 of the knee.  J Magn Reson Imaging. 2001;  14 50-55
  • 73 Solloway S, Hutchinson C E, Waterton J C, Taylor C J. The use of active shape models for making thickness measurements of articular cartilage from MR images.  Magn Reson Med. 1997;  37 943-952
  • 74 Stammberger T, Eckstein F, Michaelis M, Englmeier K H, Reiser M. Interobserver reproducibility of quantitative cartilage measurement: comparison between B-spline snakes and manual segmentation.  Magn Reson Imaging. 1999;  17 1033-1042
  • 75 Sussman M S, White L M, Roberts T P. High-resolution diffusion-weighted imaging of cartilage using PROPELLER. Proc Int Soc Magn Reson Med Twelfth Sci Meeting, Kyoto 2004; 211
  • 76 Trattnig S, Huber M, Breitenseher M J, Trnka H-J, Rand T, Kaider A, Helbich T, Imhof H, Resnick D. Imaging articular cartilage defects with 3D fat-suppressed echo planer imaging: comparison with conventional 3D suppressed gradient echo sequence and correlation with histology.  J Comput Assist Tomogr. 1998;  22 8-14
  • 77 Vasara A, Nieminen M T. In vivo assessment of autologous chondrocyte transplantation using arthroscopy stiffness measurement and quantitative MRI of proteoglycans. In: Orthopaedic Research Society 2002
  • 78 von Eichenhart-Rothe R, Siebert M, Bringmann C. et al . A new in vivo technique for determination of 3D kinematics and contact areas of the patello-femoral and tibio-femoral joint.  J Biomech. 2004;  37 927-934
  • 79 Wheaton A J, Borthakur A, Dodge G R, Kneeland J B, Schumacher H R, Reddy R. Sodium magnetic resonance imaging of proteoglycan depletion in an in vivo model of osteoarthritis.  Acad Radiol. 2004;  11 21-28
  • 80 Wheaton A J, Borthakur A, Shapiro E M, Regatte R R, Akella S V, Kneeland J B, Reddy R. Proteoglycan loss in human knee cartilage: quantitation with sodium MR imaging - feasibility study.  Radiology. 2004;  231 900-905
  • 81 Williams A, Sharma L, McKenzie C, Afridi M, Li W, Pottumarthi P, Burstein D. dGEMRIC in osteoarthritis: Comparison with radiography. Proc Int Soc Magn Reson Med Twelfth Sci Meeting, Kyoto 2004; 215
  • 82 Wilson M G, Michet Jr  C J, Ilstrup D M, Melton 3rd  L J. Idiopathic symptomatic osteoarthritis of the hip and knee: a population-based incidence study.  Mayo Clin Proc. 1990;  65 1214-1221
  • 83 Winalski C S, Minas T. Evaluation of chondral injuries by magnetic resonance imaging: repair assessments.  Op Tech in Sports Med. 2000;  8 108-119
  • 84 Wretenberg P, Ramsey D K, Nemeth G. Tibifemoral contact points relative to flexion angle measured with MRI.  Clin Biomech (Bristol, Avon). 2002;  17 477-485
  • 85 Xia Y, Moody J B, Alhadlaq H. Orientational dependence of T2 relaxation in articular cartilage: a microscopic MRI (microMRI) study.  Magn Reson Med. 2002;  48 460-464
  • 86 Yao J Q, Seedhom B B. A new technique for measuring contact areas in human joints -the ‘3S technique’.  Proc Inst Mech Engin. 1991;  205H 69-72
  • 87 Yao L, Gentili A, Thomas A. Incidental magnetization transfer contrast in fast spin-echo imaging of cartilage.  J Magn Reson Imaging. 1996;  1 180-184

S. TrattnigMD 

Center of Excellence for High-Field MR · Department of Radiology · Medical University of Vienna

Lazarettgasse 14

1090 Vienna

Austria

Phone: +43/1/4 04 00 17 73

Fax: +43/1/40 40 07 76 31

Email: siegfried.trattnig@meduniwien.ac.at