Cartilage imaging simplified
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Articular cartilage is a specialized connective tissue that facilitates joint movement and load transmission but has limited healing capacity. MRI is an effective tool for assessing cartilage condition, measuring both loss and matrix composition, but cannot entirely replace arthroscopy, which remains the gold standard in cartilage evaluation. Newer MRI techniques aim to improve sensitivity for cartilage injuries, with established grading systems for conditions like chondromalacia patella.
Cartilage imaging simplified
- 3. What is articular cartilage..?
- 4. A highly specialized connective tissue in joints. Provides smooth lubrication and load transmission . Limited capacity for healing and repair Normal cartilage on arthroscopy
- 5. Why MR imaging of cartilage…?
- 6. MRI directly assesses cartilage. Reliable assessment of cartilage loss and volume. Assessment of cartilage matrix composition.
- 7. How do MRI and plain radiographs compare ..?
- 8. Plain radiographs are insensitive to early cartilage loss and focal cartilage defects. Widely available does not require much expertise. Sensitive to cartilage loss and defects. Not widely available and requires expert technique.
- 9. How does normal cartilage look On MRI.?
- 10. Cartilage is best assessed in fat suppressed sequences .
- 12. When I read through cartilage imaging , so many terms I encounter , what are they..? 2D imaging. 3D imaging. DESS SPACE. T2 mapping deGMRIC technique Sodium MRI Composition of cartilage Size and cartilage signal
- 13. What is T2 mapping..? A technique to assess quality of cartilage , red color denoting increased degeneration of cartilage.
- 14. MRI versus arthroscopy in cartilage assessment.
- 15. MRI can not replace arthroscopy . MRI techniques showed a sensitivity of 38 % and specificity of 98%. Newer cartilage specific techniques are expected to improve sensitivity.
- 16. Cases Case 1 20 year old lady with knee pain , mainly complains of pain anteriorly. Normal plain radiographs.
- 19. How do you grade chondromalacia patella on MRI..? Grade 1– focal hyperintensity. Arthroscopically corresponds to swelling or softening Grade 2- blister or fraying of articular cartilage. Arthroscoplically – fissuring of articular cartilage
- 20. Grading of chondromalacia..contd Grade 3- partial thickness cartilage loss Arthroscopy– crabmeat appearance. Grade 4- full thickness cartilage loss with bone reactive changes. Arthroscopy– destroyed cartilage with exposed bone.
- 21. Case 2 20 years old male complains of knee pain and swelling.
- 23. Osteochondral fragment in osteochondritis dissecans. MRI can assess stability of fragment and overlying cartilage.
- 24. How does cartilage loss look on MRI…?
- 27. Case 4 20 year old female with knee pain.
- 28. Slide taken from radiographics journal Jan- Feb 2011 Large osteochondral fragment medial femoral condyle
- 29. Slide taken from radiographics journal Jan-Feb 2011 Follow up MRI 18 months after autologous chondrocyte implantation. It shows heterogenous tissue at site of surgery
- 30. Cartilage MRI shows normal layering of cartilage absent at operated site. Slide taken from radiographics journal Jan-Feb 2011
- 31. In short , what I want to say.. MRI is an exciting tool for cartilage assessment. One can assess volume of cartilage , quality of cartilage , focal defects on MRI today At present arthroscopy remains gold standard for cartilage evaluation , MRI is not yet sensitive enough.