Advanced cartilage imaging for detection of cartilage injuries and osteochondral lesions

Abstract

Osteochondral defects represent amain risk factor for osteoarthritis of the ankle. The aim of this article is to provide an overview of current optimal clinical cartilage imaging techniques of the foot and ankle and to show typical osteochondral injuries on imaging. A thorough literature search was performed and was supported by personal experience. Cartilage imaging of the foot and ankle remains challenging. However, advanced morphological and quantitative magnetic resonance (MR) imaging techniques may provide useful clinical information, for example, concerning cartilage repair surgery. Compared to MRI, MR arthrography (MR-A) and CT arthrography (CT-A) have higher sensitivity with respect to detection of osteochondral defects. Regarding smaller joints of the foot, mainly advanced osteoarthritic changes are detected on conventional radiography; only in rare cases, MR and CT imaging of these smaller joints is of relevance. While at the smaller joints of the foot cartilage imaging only plays a minor role, at the ankle joint cross-sectional cartilage imaging using CT and MRI becomes more and more important for clinicians due to emerging therapeutic options, such as different osteochondral repair techniques.