Osteoarthritis (OA) is a leading cause of disability worldwide. Magnetic resonance imaging (MRI), with its unique ability to image and characterize soft tissue non-invasively, has proven valuable in assessing cartilage in OA. The development of new, fast imaging methods with high contrast show promise to improve the magnetic resonance (MR) evaluation of this disease. In addition to morphologic MRI methods, MRI contrast mechanisms under development may reveal detailed information about the physiology of cartilage. It is anticipated that these and other MRI techniques will play an increasingly important role in assessing the success or failure of therapies for OA. On December 5 and 6, 2002, OMERACT (Outcome Measures in Rheumatology Clinical Trials) and OARSI (Osteoarthritis Research Society International) held a workshop in Bethesda, MD aiming at providing a state-of-the-art review of imaging outcome measures for OA of the knee to help guide scientists and pharmaceutical companies in the use of MRI in multi-site studies of OA. Applications of MRI were initially reviewed by a multidisciplinary, international panel of expert scientists and physicians from academia, the pharmaceutical industry and regulatory agencies. The findings of the panel were then presented to a wider group of participants for open discussion. The following report summarizes the results of these discussions with respect to novel MRI pulse sequences for evaluating articular cartilage of the knee in OA and notes any additional advances that have been made since.
measurements are obtained by applying multiple diffusion-sensitizing gradient
MRI pulses to generate magnetization in water molecules. When
diffusion-sensitizing gradients are applied, unrestricted water gains a random
amount of phase and does not refocus, which results in signal loss of the
tissue undergoing diffusion . The diffusion of water in articular cartilage reflects the
biochemical structure and architecture of the tissue. "
[Show abstract][Hide abstract] ABSTRACT: Current musculoskeletal imaging techniques usually target the macro-morphology of
articular cartilage or use histological analysis. These techniques are able to reveal
advanced osteoarthritic changes in articular cartilage but fail to give detailed
information to distinguish early osteoarthritis from healthy cartilage, and this
necessitates high-resolution imaging techniques measuring cells and the extracellular
matrix within the multilayer structure of articular cartilage. This review provides a
comprehensive exploration of the cellular components and extracellular matrix of
articular cartilage as well as high-resolution imaging techniques, including magnetic
resonance image, electron microscopy, confocal laser scanning microscopy, second
harmonic generation microscopy, and laser scanning confocal arthroscopy, in the
measurement of multilayer ultra-structures of articular cartilage. This review also
provides an overview for micro-structural analysis of the main components of normal
or osteoarthritic cartilage and discusses the potential and challenges associated
with developing non-invasive high-resolution imaging techniques for both research and
clinical diagnosis of early to late osteoarthritis.
"An X-ray indicates a cartilage lesion in the minority of the cases and Magnetic Resonance Imaging (MRI) is the best noninvasive technique available for diagnosis of cartilage lesions. Important developments are new protocols such as delayed Gadolinium Enhanced MRI of Cartilage (dGEMRIC) and sodium MRI which can visualize cartilage on the Collagen and GAG content level (Gold, Burstein et al. 2006). Overall the MRI is expected to diagnose cartilage lesions in an early stage and will become more important in evaluation of progression of cartilage degeneration and cartilage repair techniques. "
"Please cite this article as: Braun HJ, Gold GE, Diagnosis of osteoarthritis: Imaging, Bone (2011), doi:10.1016/j.bone.2011.11.019 weighting, expressed as the b-value, depends on the amplitude and timing of these gradients. In response to these gradients, water accrues a random amount of phase and does not refocus, resulting in signal loss in tissues where diffusion occurs . In healthy cartilage, the apparent diffusion coefficient (ADC) is low and diffusion times are long because intact cartilage components restrict the motion of water. "
[Show abstract][Hide abstract] ABSTRACT: Osteoarthritis (OA) is a chronic, debilitating joint disease characterized by degenerative changes to the bones, cartilage, menisci, ligaments, and synovial tissue. Imaging modalities such as radiography, magnetic resonance imaging (MRI), optical coherence tomography (OCT), and ultrasound (US) permit visualization of these structures and can evaluate disease onset and progression. Radiography is primarily useful for the assessment of bony structures, while OCT is used for evaluation of articular cartilage and US for ligaments and the synovium. MRI permits visualization of all intraarticular structures and pathologies, though US or OCT may be preferential in some circumstances. As OA is a disease of the whole joint, a combination of imaging techniques may be necessary in order to gain the most comprehensive picture of the disease state. This article is part of a Special Issue entitled "Osteoarthritis".
Bone 12/2011; 51(2):278-88. DOI:10.1016/j.bone.2011.11.019 · 3.97 Impact Factor
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