Accuracy of magnetic resonance imaging to detect cartilage loss in severe osteoarthritis of the first carpometacarpal joint: comparison with histological evaluation

Michael S Saltzherr,Johan W Van Neck,Jolanda J Luime,Edwin H G Oei,Gerjo J V M Van Osch,J Henk Coert,Jean-Bart Jaquet,Ruud W Selles,Galied S R Muradin

doi:10.1186/s13075-017-1262-8

Michael S Saltzherr, Johan W Van Neck + Show 7 more

Open Access

https://doi.org/10.1186/s13075-017-1262-8

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Abstract

BackgroundMagnetic 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.MethodsTwelve 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.ResultsMRI 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.ConclusionsThree-dimensional SPGR MRI of the CMC1 joint demonstrates overall cartilage damage, but underestimates full-thickness cartilage loss in patients with advanced osteoarthritis.

Highlights

Magnetic resonance imaging (MRI) is increasingly used for research in hand osteoarthritis, but imaging the thin cartilage layers in the hand joints remains challenging
MRI has given us new insights into hand OA, such as the involvement of collateral ligaments [6, 7], the high prevalence of synovitis [8] and significant associations of joint pain with bone marrow lesions (BML) and synovitis [9, 10]
MRI of cartilage in hand OA has been less wellexplored, yet accurate cartilage assessment would be a valuable addition to other pathological change detected by MRI in the assessment and follow up monitoring of the whole joint in hand OA

Summary

Introduction

Magnetic resonance imaging (MRI) is increasingly used for research in hand osteoarthritis, but imaging the thin cartilage layers in the hand joints remains challenging. Osteoarthritis (OA) of the hand is the most prevalent disease of the hand joint, which can lead to pain and functional impairment. Magnetic resonance imaging (MRI) is gaining popularity in studies of hand OA [4, 5] as it depicts bone, cartilage, and soft tissue changes, and images the complete joint in multiple planes. Previous studies have reported that reliable quantitative evaluation of the cartilage layer in the small joints of the hand can be performed using conventional MRI and small dedicated coils [11, 12]

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