Abstract

BackgroundIn patients with osteoarthritis, a detailed assessment of degenerative cartilage disease is important to recommend adequate treatment. Using a representative sample of patients, this study investigated whether MRI is reliable for a detailed cartilage assessment in patients with osteoarthritis of the knee.MethodsIn a cross sectional-study as a part of a retrospective case-control study, 36 patients (mean age 53.1 years) with clinically relevant osteoarthritis received standardized MRI (sag. T1-TSE, cor. STIR-TSE, trans. fat-suppressed PD-TSE, sag. fat-suppressed PD-TSE, Siemens Magnetom Avanto syngo MR B 15) on a 1.5 Tesla unit. Within a maximum of three months later, arthroscopic grading of the articular surfaces was performed. MRI grading by two blinded observers was compared to arthroscopic findings. Diagnostic values as well as intra- and inter-observer values were assessed.ResultsInter-observer agreement between readers 1 and 2 was good (kappa = 0.65) within all compartments. Intra-observer agreement comparing MRI grading to arthroscopic grading showed moderate to good values for readers 1 and 2 (kappa = 0.50 and 0.62, respectively), the poorest being within the patellofemoral joint (kappa = 0.32 and 0.52). Sensitivities were relatively low at all grades, particularly for grade 3 cartilage lesions. A tendency to underestimate cartilage disorders on MR images was not noticed.ConclusionsAccording to our results, the use of MRI for precise grading of the cartilage in osteoarthritis is limited. Even if the practical benefit of MRI in pretreatment diagnostics is unequivocal, a diagnostic arthroscopy is of outstanding value when a grading of the cartilage is crucial for a definitive decision regarding therapeutic options in patients with osteoarthritis.

Highlights

  • IntroductionA detailed assessment of degenerative cartilage disease is important to recommend adequate treatment

  • In patients with osteoarthritis, a detailed assessment of degenerative cartilage disease is important to recommend adequate treatment

  • The diagnostic values reported in clinical studies and cadaver studies present a wide range, with sensitivities ranging from 31% to 100% [16,20,22]

Read more

Summary

Introduction

A detailed assessment of degenerative cartilage disease is important to recommend adequate treatment. Von Engelhardt et al BMC Musculoskeletal Disorders 2010, 11:75 http://www.biomedcentral.com/1471-2474/11/75 clinical studies have focused on degenerative cartilage diseases [16,17,18,19,20,21,22] These studies, which compare MRI grading and arthroscopic grading of the cartilage in patients with knee osteoarthritis, used different statistical methods and demonstrated various results [16,17,18,19,20,21,22]. The aim of this study was to determine whether MRI is a reliable method for a detailed assessment of the articular cartilage in patients with advanced and clinically relevant osteoarthritis or not For this purpose, MR images and intra-operative findings in a representative sample of patients were evaluated

Objectives
Methods
Results
Discussion
Conclusion
Full Text
Published version (Free)

Talk to us

Join us for a 30 min session where you can share your feedback and ask us any queries you have

Schedule a call