Osteoarthritis of the knee: Comparison of MR imaging findings with radiographic severity measurements and clinical features in middle-aged women

Abstract

To assess the value of MRI in detection of osteoarthritic changes of the knee and to correlate MRI findings and radiographic severity grading with the severity of patient’s clinical complaints. It is a proposed study observed at Institute of Orthopedics and Traumatology, Rajiv Gandhi Government General Hospital, Madras Medical College, Chennai from May 2018-Jan 2019.Thirty knees of 30 female patients and their average age is 47.13 years attending Orthopedics outpatient were clinically assessed and examined by conventional radiographs prior to the patients undergoing knee MRI. Patients with knee pain for more than three months with varying grades of pain severity were included. Patients with a past history of knee surgery, knee infection, or knee trauma in the preceding three months of study and males were excluded. Patients were classified based on pain severity by VRS scale for pain. All the cases having pain in knee were subjected to standard radiograph of knee joint both antero-posterior and lateral views and classified based on Kellgren- Lawrence grading of osteoarthritic changes in knee joint. They were further subjected to MR imaging. The following parameters like defects of cartilage, subchondral bone marrow edema (BME), osteophytes, subchondral cysts, sclerosis, meniscal abnormalities, anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial and lateral collateral ligament abnormalities, joint effusion, synovial cysts and joint effusions were analyzed. Nineteen patients, representing 19 cases of knee pain (63.33%) classified as mild. Ten cases (33.33%) classified as moderate and one case (3.33%) under severe pain grade rays were classified based on KL criteria. They showed four knees (13.33%) with grade 0, thirteen knees (43.33%) under grade 1, eleven knees (36.66%) under grade 2 and two knees (6.66%) under grade 3 and no cases under grade 4. Increasing Kellgren-Lawrence severity grading and longer the duration of symptoms is associated with more severe defects of cartilage, meniscal tears, subchondral cysts, bone marrow edema and joint effusion. From this study, it is observed that among the middle-aged females there is proportionate co-relation between the pain duration, MRI parameters and radiologic screening of knees with osteoarthritis.