Document Detail


Delayed gadolinium-enhanced magnetic resonance imaging of cartilage in knee osteoarthritis: findings at different radiographic stages of disease and relationship to malalignment.
MedLine Citation:
PMID:  16255024     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Delayed gadolinium-enhanced magnetic resonance imaging (MRI) of cartilage (dGEMRIC) is used to examine the distribution of glycosaminoglycan in cartilage. This study sought to characterize dGEMRIC in the evaluation of knee osteoarthritis (OA) according to various radiographically determined disease parameters, and to examine the relationship between alignment of the knee joint and the lateral:medial dGEMRIC ratio. METHODS: Thirty-one patients with knee OA underwent MRI with a dGEMRIC protocol at 1.5T. Semiflexed knee radiographs and full-limb radiographs were also obtained for assessment of alignment. RESULTS: Compartments of the knee joint without joint space narrowing had a higher dGEMRIC index than those with any level of narrowing (mean 408 msec versus 365 msec; P = 0.001). In knees with 1 unnarrowed (spared) and 1 narrowed (diseased) compartment, the dGEMRIC index was greater in the spared versus the diseased compartment (mean 395 msec versus 369 msec; P = 0.001). In spared compartments, there was a trend toward a lower dGEMRIC index with increasing Kellgren/Lawrence (K/L) radiographic severity grade; the spared compartments of knees with a K/L grade 2 had a higher dGEMRIC index than those of knees with a K/L grade 4 (mean 425 msec versus 371 msec; P < 0.05). There was a range of dGEMRIC values in the spared compartments within a given K/L grade, demonstrating biochemical differentiation of disease in radiographically comparable compartments. Almost all compartments with narrowing had dGEMRIC indices of <400 msec. Valgus-aligned knees tended to have lower dGEMRIC values laterally, and varus-aligned knees tended to have lower dGEMRIC values medially; as a continuous variable, alignment correlated with the lateral:medial dGEMRIC ratio (Pearson's R = 0.43, P = 0.02). CONCLUSION: The biochemical information provided by dGEMRIC scans may augment radiography by improving the differentiation of disease status within a given radiographic grade, especially in early OA.
Authors:
Ashley Williams; Leena Sharma; Charles A McKenzie; Pottumarthi V Prasad; Deborah Burstein
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Arthritis and rheumatism     Volume:  52     ISSN:  0004-3591     ISO Abbreviation:  Arthritis Rheum.     Publication Date:  2005 Nov 
Date Detail:
Created Date:  2005-11-03     Completed Date:  2005-12-09     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0370605     Medline TA:  Arthritis Rheum     Country:  United States    
Other Details:
Languages:  eng     Pagination:  3528-35     Citation Subset:  AIM; IM    
Affiliation:
Beth Israel Deaconess Medical Center and Harvard Medical School, #4 Blackfan Circle, Boston, MA 02115, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Bone Malalignment / diagnosis*,  physiopathology
Cartilage, Articular / metabolism,  pathology*,  radiography
Contrast Media*
Female
Gadolinium DTPA / diagnostic use*
Glycosaminoglycans / metabolism
Humans
Knee Joint / metabolism,  radiography
Magnetic Resonance Imaging / methods*
Male
Middle Aged
Osteoarthritis, Knee / diagnosis*,  metabolism
Chemical
Reg. No./Substance:
0/Contrast Media; 0/Glycosaminoglycans; 80529-93-7/Gadolinium DTPA

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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