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Osteoarthritis of Knee
B.J. Manaster, MD, PhD, FACR
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KEY FACTS

  • Terminology

    • Imaging

      • Diagnostic Checklist

        TERMINOLOGY

        • Abbreviations

          • Osteoarthritis (OA)
        • Synonyms

          • Degenerative joint disease (DJD)
        • Definitions

          • Arthritis developing secondary to cartilage degeneration
            • Results from imbalance between biosynthesis and degradation of cartilage constituents; degradative processes outpace repair
            • Presently defined as productive radiographic changes in combination with joint pain
            • Cartilage loss occurs for several years before OA seen on radiograph; definition may be refined in future
              • 55% of patients with tibiofemoral compartment cartilage degeneration at arthroscopy had no radiographic evidence of OA in 1 study

        IMAGING

        • General Features

          • Radiographic Findings

            • CT Findings

              • MR Findings

                • Imaging Recommendations

                  DIFFERENTIAL DIAGNOSIS

                    PATHOLOGY

                    • General Features

                      • Gross Pathologic & Surgical Features

                        CLINICAL ISSUES

                        • Presentation

                          • Demographics

                            • Natural History & Prognosis

                              • Treatment

                                DIAGNOSTIC CHECKLIST

                                • Image Interpretation Pearls

                                  • Reporting Tips

                                    Selected References

                                    1. Alizai H et al: Cartilage lesion score: comparison of a quantitative assessment score with established semiquantitative MR scoring systems. Radiology. 271(2):479-87, 2014
                                    2. Guermazi A et al: Medial posterior meniscal root tears are associated with development or worsening of medial tibiofemoral cartilage damage: the multicenter osteoarthritis study. Radiology. 268(3):814-21, 2013
                                    3. Kijowski R et al: Evaluation of the articular cartilage of the knee joint: value of adding a T2 mapping sequence to a routine MR imaging protocol. Radiology. 267(2):503-13, 2013
                                    4. Raya JG et al: Diffusion-tensor imaging of human articular cartilage specimens with early signs of cartilage damage. Radiology. 266(3):831-41, 2013
                                    5. Crema MD et al: Factors associated with meniscal extrusion in knees with or at risk for osteoarthritis: the Multicenter Osteoarthritis study. Radiology. 264(2):494-503, 2012
                                    6. Mosher TJ et al: Knee articular cartilage damage in osteoarthritis: analysis of MR image biomarker reproducibility in ACRIN-PA 4001 multicenter trial. Radiology. 258(3):832-42, 2011
                                    7. Pan J et al: Knee cartilage T2 characteristics and evolution in relation to morphologic abnormalities detected at 3-T MR imaging: a longitudinal study of the normal control cohort from the Osteoarthritis Initiative. Radiology. 261(2):507-15, 2011
                                    8. Stahl R et al: Assessment of cartilage-dedicated sequences at ultra-high-field MRI: comparison of imaging performance and diagnostic confidence between 3.0 and 7.0 T with respect to osteoarthritis-induced changes at the knee joint. Skeletal Radiol. 38(8):771-83, 2009
                                    9. Takahashi T et al: Reproducibility of joint space width and the intermargin distance measurements in patients with medial osteoarthritis of the knee in various degrees of flexion. Skeletal Radiol. 38(1):37-42, 2009
                                    10. Anandacoomarasamy A et al: Predictors of clinical response to intraarticular Hylan injections -- a prospective study using synovial fluid measures, clinical outcomes, and magnetic resonance imaging. J Rheumatol. 35(4):685-90, 2008
                                    11. Chan WP et al: Radiographic joint space narrowing in osteoarthritis of the knee: relationship to meniscal tears and duration of pain. Skeletal Radiol. 37(10):917-22, 2008
                                    12. Englund M et al: Incidental meniscal findings on knee MRI in middle-aged and elderly persons. N Engl J Med. 359(11):1108-15, 2008
                                    13. Hernández JL et al: Aromatase expression in osteoarthritic and osteoporotic bone. Arthritis Rheum. 58(6):1696-700, 2008
                                    14. Kessler MA et al: Recovery of the menisci and articular cartilage of runners after cessation of exercise: additional aspects of in vivo investigation based on 3-dimensional magnetic resonance imaging. Am J Sports Med. 36(5):966-70, 2008
                                    15. Krampla WW et al: Changes on magnetic resonance tomography in the knee joints of marathon runners: a 10-year longitudinal study. Skeletal Radiol. 37(7):619-26, 2008
                                    16. Owman H et al: Association between findings on delayed gadolinium-enhanced magnetic resonance imaging of cartilage and future knee osteoarthritis. Arthritis Rheum. 58(6):1727-30, 2008
                                    17. Pouders C et al: Prevalence and MRI-anatomic correlation of bone cysts in osteoarthritic knees. AJR Am J Roentgenol. 190(1):17-21, 2008
                                    18. Rauscher I et al: Meniscal measurements of T1rho and T2 at MR imaging in healthy subjects and patients with osteoarthritis. Radiology. 249(2):591-600, 2008
                                    19. Thomas E et al: Predicting the course of functional limitation among older adults with knee pain: do local signs, symptoms and radiographs add anything to general indicators? Ann Rheum Dis. 67(10):1390-8, 2008
                                    20. Felson DT et al: Correlation of the development of knee pain with enlarging bone marrow lesions on magnetic resonance imaging. Arthritis Rheum. 56(9):2986-92, 2007
                                    21. Kijowski R et al: Arthroscopic validation of radiographic grading scales of osteoarthritis of the tibiofemoral joint. AJR Am J Roentgenol. 187(3):794-9, 2006
                                    Related Anatomy
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                                    Related Differential Diagnoses
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                                    References
                                    Tables

                                    Tables

                                    KEY FACTS

                                    • Terminology

                                      • Imaging

                                        • Diagnostic Checklist

                                          TERMINOLOGY

                                          • Abbreviations

                                            • Osteoarthritis (OA)
                                          • Synonyms

                                            • Degenerative joint disease (DJD)
                                          • Definitions

                                            • Arthritis developing secondary to cartilage degeneration
                                              • Results from imbalance between biosynthesis and degradation of cartilage constituents; degradative processes outpace repair
                                              • Presently defined as productive radiographic changes in combination with joint pain
                                              • Cartilage loss occurs for several years before OA seen on radiograph; definition may be refined in future
                                                • 55% of patients with tibiofemoral compartment cartilage degeneration at arthroscopy had no radiographic evidence of OA in 1 study

                                          IMAGING

                                          • General Features

                                            • Radiographic Findings

                                              • CT Findings

                                                • MR Findings

                                                  • Imaging Recommendations

                                                    DIFFERENTIAL DIAGNOSIS

                                                      PATHOLOGY

                                                      • General Features

                                                        • Gross Pathologic & Surgical Features

                                                          CLINICAL ISSUES

                                                          • Presentation

                                                            • Demographics

                                                              • Natural History & Prognosis

                                                                • Treatment

                                                                  DIAGNOSTIC CHECKLIST

                                                                  • Image Interpretation Pearls

                                                                    • Reporting Tips

                                                                      Selected References

                                                                      1. Alizai H et al: Cartilage lesion score: comparison of a quantitative assessment score with established semiquantitative MR scoring systems. Radiology. 271(2):479-87, 2014
                                                                      2. Guermazi A et al: Medial posterior meniscal root tears are associated with development or worsening of medial tibiofemoral cartilage damage: the multicenter osteoarthritis study. Radiology. 268(3):814-21, 2013
                                                                      3. Kijowski R et al: Evaluation of the articular cartilage of the knee joint: value of adding a T2 mapping sequence to a routine MR imaging protocol. Radiology. 267(2):503-13, 2013
                                                                      4. Raya JG et al: Diffusion-tensor imaging of human articular cartilage specimens with early signs of cartilage damage. Radiology. 266(3):831-41, 2013
                                                                      5. Crema MD et al: Factors associated with meniscal extrusion in knees with or at risk for osteoarthritis: the Multicenter Osteoarthritis study. Radiology. 264(2):494-503, 2012
                                                                      6. Mosher TJ et al: Knee articular cartilage damage in osteoarthritis: analysis of MR image biomarker reproducibility in ACRIN-PA 4001 multicenter trial. Radiology. 258(3):832-42, 2011
                                                                      7. Pan J et al: Knee cartilage T2 characteristics and evolution in relation to morphologic abnormalities detected at 3-T MR imaging: a longitudinal study of the normal control cohort from the Osteoarthritis Initiative. Radiology. 261(2):507-15, 2011
                                                                      8. Stahl R et al: Assessment of cartilage-dedicated sequences at ultra-high-field MRI: comparison of imaging performance and diagnostic confidence between 3.0 and 7.0 T with respect to osteoarthritis-induced changes at the knee joint. Skeletal Radiol. 38(8):771-83, 2009
                                                                      9. Takahashi T et al: Reproducibility of joint space width and the intermargin distance measurements in patients with medial osteoarthritis of the knee in various degrees of flexion. Skeletal Radiol. 38(1):37-42, 2009
                                                                      10. Anandacoomarasamy A et al: Predictors of clinical response to intraarticular Hylan injections -- a prospective study using synovial fluid measures, clinical outcomes, and magnetic resonance imaging. J Rheumatol. 35(4):685-90, 2008
                                                                      11. Chan WP et al: Radiographic joint space narrowing in osteoarthritis of the knee: relationship to meniscal tears and duration of pain. Skeletal Radiol. 37(10):917-22, 2008
                                                                      12. Englund M et al: Incidental meniscal findings on knee MRI in middle-aged and elderly persons. N Engl J Med. 359(11):1108-15, 2008
                                                                      13. Hernández JL et al: Aromatase expression in osteoarthritic and osteoporotic bone. Arthritis Rheum. 58(6):1696-700, 2008
                                                                      14. Kessler MA et al: Recovery of the menisci and articular cartilage of runners after cessation of exercise: additional aspects of in vivo investigation based on 3-dimensional magnetic resonance imaging. Am J Sports Med. 36(5):966-70, 2008
                                                                      15. Krampla WW et al: Changes on magnetic resonance tomography in the knee joints of marathon runners: a 10-year longitudinal study. Skeletal Radiol. 37(7):619-26, 2008
                                                                      16. Owman H et al: Association between findings on delayed gadolinium-enhanced magnetic resonance imaging of cartilage and future knee osteoarthritis. Arthritis Rheum. 58(6):1727-30, 2008
                                                                      17. Pouders C et al: Prevalence and MRI-anatomic correlation of bone cysts in osteoarthritic knees. AJR Am J Roentgenol. 190(1):17-21, 2008
                                                                      18. Rauscher I et al: Meniscal measurements of T1rho and T2 at MR imaging in healthy subjects and patients with osteoarthritis. Radiology. 249(2):591-600, 2008
                                                                      19. Thomas E et al: Predicting the course of functional limitation among older adults with knee pain: do local signs, symptoms and radiographs add anything to general indicators? Ann Rheum Dis. 67(10):1390-8, 2008
                                                                      20. Felson DT et al: Correlation of the development of knee pain with enlarging bone marrow lesions on magnetic resonance imaging. Arthritis Rheum. 56(9):2986-92, 2007
                                                                      21. Kijowski R et al: Arthroscopic validation of radiographic grading scales of osteoarthritis of the tibiofemoral joint. AJR Am J Roentgenol. 187(3):794-9, 2006