Pathophysiology 17 (2010) 1 8. Received 24 February 2009; received in revised form 16 March 2009; accepted 28 April 2009

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "Pathophysiology 17 (2010) 1 8. Received 24 February 2009; received in revised form 16 March 2009; accepted 28 April 2009"

Transcription

1 Pathophysiology 17 (2010) 1 8 Detection and evaluation of initial cartilage pathology in man: A comparison between MRT, arthroscopy and near-infrared spectroscopy (NIR) in their relation to initial knee pain Gunther O. Hofmann a,b,, Julia Marticke a, Ralph Grossstück b, M. Hoffmann d, Matthias Lange d, Holger K.W. Plettenberg d, Rainer Braunschweig c, Oliver Schilling c, Ingmar Kaden c, Gunter Spahn a,e a Department of Traumatology, Friedrich Schiller University of Jena, Germany b Department of Traumatology and Orthopaedic Surgery, Trauma Center Halle (Saale), Germany c Institute for Diagnostic and Interventional Radiology, Trauma Center Halle (Saale), Germany d Research Center for Medical Technology and Biotechnology, Bad Langensalza, Germany e Center of Trauma and Orthopaedic Surgery Eisenach, Germany Received 24 February 2009; received in revised form 16 March 2009; accepted 28 April 2009 Abstract Background and aims: MRI and arthroscopy are important methods in the evaluation of cartilage pathology. But frequently initial changes of cartilage in combination with chronic knee pain cannot be detected by employing these two methods. Better diagnostic tools for the detection of the early stages of osteoarthritis (OA) are required. The objective of this study was to show that near-infrared spectroscopy (NIRS) can be incorporated into routine arthroscopy to improve detection and assessment of the initial cartilage pathology. Furthermore correlations between findings in MRI, arthroscopy and NIRS in patients with initial symptoms of OA have studied. Methods: Patients (n = 21, 12 women, 9 men, age: years, mean years) with knee pain lasting for at least half a year without any trauma of the knee in their history were interviewed (body weight, smoking behaviour) and clinically evaluated using the Knee Injury and Osteoarthritis Outcome Score (KOOS). Also serum parameters (cholesterol, lipids) were analysed, conventional X-rays in three directions (evaluated according to Kellgren and Lawrence) and MRI (evaluation of cartilage damage according to the ICRS-score) were performed preoperatively in all patients. During subsequent arthroscopy cartilage damage was evaluated according to the ICRS-score. In addition the spectral reflection of cartilage was investigated in all knees using a special micro-glass-fiber probe in the near-infrared light region (spectral range between 1150 and 1475 nm). To characterize relations between the investigated parameters the Spearman s rank correlation coefficient was used. Inter-observer variance was calculated employing the Cohens Kappa-test. Results: MRI demonstrated a strong inter-observer variance with no significant correlations to other parameters. The same was observed for arthroscopic findings. Only NIRS showed significant correlations with three out of five KOOS subscores. Within the general parameters only smoking behaviour showed a significant correlation with two of the KOOS-scores. NIRS therefore seemed to be a sensitive diagnostic tool in detection of initial pathology in human cartilage. The additional necessary time for the spectroscopic investigation as part of the routine arthroscopy ranged between 3 and 7 min (mean: 4 min 18 s). Conclusion: Particularly for early-stage cartilage lesions (ICRS 0/I) MRI and arthroscopy have rather low predictive value. The inter-observer variance is very high (Cohens Kappa < 0.4). Correlations found between NIRS and KOOS suggest that NIRS potentially can be used for detection of initial cartilage Abbreviations: OA, osteoarthritis; MFT, medial femoral tibial; LFT, lateral femoral tibial; G, femoropatellar (groove); KOOS, Knee Injury and Osteoarthritis Outcome Score; ADL, activity of daily life; ICRS, International Cartilage Repair Society; KL, Kellgren Lawrence; MRI, magnetic resonance imaging; FFE, fast field echo; FOV, field of view; RFOV, rectangular field of view; TR, time of repetition; TE, time of echo; TSE, turbo spin echo; PD SPAIR, proton density (sequence with fat suppression); NIRS, near-infrared spectroscopy. Corresponding author at: Klinik für Unfall- und Wiederherstellungschirurgie, Berufsgenossenschaftliche Kliniken Bergmannstrost, D Halle (Saale), Merseburgerstrasse 165, Germany. Tel.: ; fax: address: (G.O. Hofmann) /$ see front matter 2009 Elsevier Ireland Ltd. All rights reserved. doi: /j.pathophys

2 2 G.O. Hofmann et al. / Pathophysiology 17 (2010) 1 8 pathology and may be helpful in the evaluation of the benefit of different medical or surgical interventions at early-stage of articular cartilage damage Elsevier Ireland Ltd. All rights reserved. Keywords: Knee pain; Cartilage; Osteoarthritis; Imaging; MRI; Arthroscopy; NIRS 1. Introduction Osteoarthritis (OA) is one of the most prevalent diseases of cartilage in large joints with painful burden for the patients and enormous social end economic impact for society. A non-destructive quantitative evaluation method for extent and localization of early cartilage pathology (stage ICRS-I) is not available up to now [1]. Arthroscopy is still the golden standard for in vivo cartilage diagnosis employing visual impression and the mechanical feedback by palpation [2 4]. The consistency of articular cartilage is evaluated using mechanical tools, especially different hooks for distinct indentation of the cartilage surface. OA chances the biochemical and biomechanical properties of articular cartilage [5]. These changes manifest themselves in a breakup of the collagen glucosamine matrix of cartilage [6] with consequent changes in water-binding properties and a shift in the ratio of the main cartilage components, collagen II and water. Infrared light interacts with vibrational modes in molecules through a change in the dipole moment, producing a useful frequency range for the study of molecular properties of matter. Water, water-binding, CH- and NH-groups can be detected by near-infrared light, suggesting that even early changes in cartilage on the way to OA can be detected with this method [7,8]. Intra-articular NIR-devices can be manufactured as reflection probes with optical fibers and may be employed similar in size, shape and utility compared to classical palpating hooks. sum of all compartments were included in this study. The exclusion criteria made certain that only patients with very early stages of OA were included in this study. A total of 21 patients were recruited between 03/2007 and 09/2007. The study was open-label, prospective and performed in one centre. The mean age of the patients (12 woman and 9 men) was years (ranging from 15 to 59 years, SD years). Informed consent was obtained from all patients after the nature of all examinations had been fully explained. All patients were interviewed (body weight, smoking behaviour) and examined clinically and by serum analysis (cholesterol, lipids). The Knee Injury and Osteoarthritis Outcome Score (KOOS) first described by Roos et al. [11,12] and modified by Kessler et al. [13] was determined. This score is a well-established clinical grading system which quantifies the degree of pain (9 items), symptoms (7 items), activity of daily life (ADL) function (17 items), sport and recreation function (5 items) and quality of life (4 items). The different areas of articular cartilage in the knee joint were divided into 15 defined areas of interest (AOI) (Fig. 1). Mapping of the articular areas in the knee joint makes it easier to describe lesion location and enables a direct comparison between clinical, radiological, MRI, arthroscopic and spectroscopic evaluation. MRI of all knee joints was performed with the 1.5T Achiva (Philips, Eindhoven) by using an 8 channels dual phasedarray coil (Philips, Eindhoven) for signal reception. The sequences employed were: 2. Patients and methods All patients reported in this paper were operated due to clinically relevant knee pain lasting for at least half a year. Patients with a history of trauma, previous surgery or inflammatory arthritis were excluded. Preoperative conventional X-rays were taken of all knees in three planes: a.p., lateral and tangential view of the patellofemoral joint. The a.p.-view was performed in standing and weight-bearing position. The degree of osteoarthrosis was classified due to a modified Kellgren Lawrence(KL)- knee score [9,10] (Table 1), estimating the degree of pathological changes (A: osteophytes, B: subchondral sclerosis, C: joint space narrowing, D: joint deformation) between 0 and 8 points. The three compartments (medial femorotibial (MFT), lateral femorotibial (LFT), femoropatellar (G: groove) of each knee joint were evaluated separately. Only patients with a maximum of 2 points or less in Table 1 Modified Kellgren Lawrence-score [25,26] of OA in conventional X-ray diagnosis. Osteophytes (A) 0 = none or beginning 1 = definitive Subchondral sclerosis (B) 0 = none 1 = slight 2 = significant 3 = significant with bone cysts in femur, tibia, patella Joint space (C) 0 = normal 1 = half of normal 2 = no joint space visible Joint deformation (D) 0 = no deformation 1 = femur condyles not spherical 2 = significant destruction and deformations Kellgren Lawrence-score 3 (0...8)= for each compartment separately (MFT: medial femorotibial; LFT: lateral femorotibial; FP: femoropatellar).

3 G.O. Hofmann et al. / Pathophysiology 17 (2010) Fig. 1. Regions of interest. 15 areas of interest: mapping of the articular cartilage in femur, tibia and patella of the knee joints for a defined and consistent localization and evaluation of the cartilage in MRI, arthroscopy and NIRS. Footnotes: F: femoral, M: medial, T: tibial, L: lateral, P: patellar, V: ventral, G: groove, D: dorsal, N: notch, C: central. T2 FFE sagittal and coronal (FOV 200, RFOV 80%, thickness 2 mm, TR 796 ms, TE 10 ms, 2:40 min). T1 TSE sagittal (FOV 200, RVOV 90%, thickness 3 mm, TR 420 ms, TE 8.6 ms, 2:24 min). PD SPAIR sagittal, coronal and axial (FOV 170, RFOV 90%, thickness 3 mm, TR 2051 ms, TE 7 ms, 3:08 min). During the preoperative MRI all 15 AOI were evaluated according to the ICRS recommended magnetic resonance imaging acquisition protocols for articular cartilage [14] by three experienced radiologists as independent readers (R.B., O.S., I.K.). To compare both arthroscopic and MRI-findings and to evaluate the inner structures of the knee joint cartilage the following graduation was used: normal surface lesions defects in less than 50% of the cartilage thickness defects in more than 50% of the cartilage thickness total defect All operations were carried out by only two surgeons (G.O.H., R.G.). Evaluation of cartilage followed a standardized protocol for the clinical ICRS-based and the NIRS application. During arthroscopy the grade of cartilage pathology within the 15 AOI was determined and classified as four stages according to the ICRS protocol [14] (Table 2). Stage 2, 3 and 4 defects are easily detectable by visualization with bare eyes. However, the differentiation between early-stage cartilage defects (stage 1) and intact cartilage (stage 0) is rather difficult. Depth and areal extension of any lesions were analyzed with use of a graduated hook. One AOI could not be explored by arthroscopy and 15 AOIs were not to investigate with the NIRS probe due to a very narrow joint space. For NIRS a fiber optic diode micro-spectrometer (microparts 1.7, Dortmund, Germany) with a spectral range Table 2 Arthroscopy evaluation of articular cartilage according to the ICRS-score [11]. Stage 0 Stage 1 Stage 2 Stage 3 Stage 4 Normal, macroscopically intact cartilage, no notable defects Softening of cartilage with intact surface, 1a: with fibrillation; 1b: with additional superficial lacerations and fissures Clefts within the superficial layer (less than 50% of cartilage thickness) Clefts down to the subchondral bone (more than 50% of cartilage thickness), 3a: depth not extending to the calcified layer, 3b: depth extending to the calcified layer, 3c: depth extending down to but not through the subchondral bone plate, 3d: with blisters Complete defects of nm and a spectral resolution of 10 mm was used. The NIRS probe has nearly the same geometry as a standard hook probe usually employed during arthroscopy (Fig. 2). Light from a stabilized light source (LQ2NIR, JETI Technische Instrumente GmbH, Jena, Germany) was coupled into six optical fibers (silica glass, diameter: 200 m). The collection fiber (silica glass, diameter: 200 m) was connected to the spectrometer. The fibers were combined in a reflection probe (Loptec, Berlin, Germany) with the light delivering fibers surrounding the collection fiber (Fig. 3). Fig. 2. Arthroscopic NIRS probe compared to a standard hook probe.

4 4 G.O. Hofmann et al. / Pathophysiology 17 (2010) 1 8 Table 3 Recorded parameters in knee pain patients, part 1. N Min Max Mean SD BMI Age Cholesterol Lipids Koos-symptoms Koos-pain Koos-ADL Koos-sports Koos-quality of life Kellgreen MRI range ICRS NIRS ADL: activity of daily life. Fig. 3. Tip of the NIRS-probe. The collection fiber is placed in the center with the six light delivering fibers surrounding it in the periphery Prior to each measurement the reflectance of Ringer solution was recorded as reference. Then the tip of the probe was directly placed on the surface of each AOI (Fig. 4) and approximately 10 reflection spectra were recorded with 10 ms integration time. The absorption spectra were calculated from the reference and measurement spectra (absorption [AU] = log 10(reflectance [counts]/reference [counts]). The spectra were mean-centred to compensate for baseline shifts. For analysis the ratio of the peak absorptions of two bands, the 1st OH and CH combination overtones ( nm) and the 2nd CH overtone ( nm) was calculated for statistical evaluation. The additional necessary time for the spectroscopy during the routine arthroscopy ranged between 3 and 7 min (mean: 4 min 18 s). Statistical analysis was performed on a personal computer using SPSS (SPSS 11.0, SPSS Inc., USA). Since all Fig. 4. NIRS-probe in situ. NIRS-probe directly placed on the surface of articular cartilage in the medial groove of a knee joint with ICRS I during arthroscopy parameters showed no normal or linear distribution, the Spearman s rank correlation coefficient ρ was used to characterize links between parameters. The significance level p was set at 0.01 and for multiple tests was corrected by the number of variables involved. This resulted in a significance level of for the six general parameters (age, sex, BMI, smoking behaviour, cholesterol, lipids) and the five KOOS subscores. The AOIs were analyzed in three groups (femur, tibia, patella). Each imaging technique (X-ray, MRI, arthroscopy) and NIRS was tested against the 5 KOOS subscores with a corrected significance level of p = Cohens Kappa was used to test for inter-observer reliability between the three MRI readers. The study and all employed devices have been approved by the Ethic Commission for Clinical Trials of the Friedrich Schiller-University of Jena ( /06). Informed consent of all patients to the procedure was obtained. 3. Results All 21 patients underwent arthroscopic surgery because of chronic knee pain without any trauma. Range and distribution of all recorded parameters are shown in Tables 3 and 4. No patient had diabetes. In accordance with the exclusion criteria (KL 2) the radiological X-ray score showed no significant correlations with any other parameters. The matrix of significant correlation of general parameters with KOOS subscores is shown in Table 5. Only smoking behaviour correlated with two KOOS-scores (symptoms and pain). Table 4 Recorded parameters in knee pain patients, part 2. N Sex 21 Female 11 Male 10 Smoker 21 Non-smoker 5 Smoker 16 Polyarticular 21 No 13 Yes 8 Diabetes 21 No 21 Yes 0

5 G.O. Hofmann et al. / Pathophysiology 17 (2010) Table 5 Significant correlation of general parameters with KOOS subscores of knee pain patients. Age BMI Smoker Polyarticular Cholesterine Lipids KOOSsymp. KOOSpain KOOS- ADL Age BMI n.s. Smoker n.s. n.s. Poly-articular n.s. n.s. n.s. Cholesterine 0.65 n.s. n.s. n.s. Lipids n.s. n.s. n.s. n.s KOOS-symptoms n.s. n.s n.s. n.s. n.s. KOOS-pain n.s. n.s n.s. n.s. n.s KOOS-ADL n.s. n.s. n.s. n.s. n.s. n.s KOOS-sports n.s. n.s. n.s. n.s. n.s. n.s. n.s. n.s KOOS-quality of life n.s. n.s. n.s. n.s. n.s. n.s. n.s. n.s. n.s Corrected significance level at ADL: activity of daily life. KOOSsports KOOS-quality of life Table 6 Significant correlations between MRI, arthroscopy and NIRS. MRI Arthroscopy NIRS MRI Arthroscopy NIRS n.s. n.s. Corrected significance level at There is no correlation between radiological and MRIfindings, but MRI matched significantly (p < 0.1) with arthroscopy with a correlation coefficient ρ = 0.6 (Table 6). Moreover we found strong inter-observer differences for the MRI with a Cohens Kappa not extending 0.36 (low agreement [15]). There is no predictive value for KOOS parameters using MRI-findings with a maximal ρ of 0.51 (Table 7). Also the arthroscopic score showed no significant correlation with any KOOS subscore with a maximum of ρ of 0.41 (Table 7). Significant (p > 0.007) correlations with three KOOS subscores (symptoms, sports, quality of life) only were found with the NIRS (Table 7). The correlation coefficients ρ ranged between 0.68 and Discussion The main functions of articular cartilage are smooth gliding of articular surfaces and the withstanding of high loads. Therefore structural integrity of the articular cartilage is the most essential requirement for the performance of load bearing and motion. Clinical evaluation of early cartilage pathology is very difficult. Pain, the restriction of movement, joint effusion or crepitation are rather unspecific symptoms and may also occur in other joint diseases. Sensitivity, specificity and interobserver variations in clinical evaluation of cartilage pathology are very bad. Based on the experiences with the WOMAC-score, Roos et al. [11,12] developed the KOOSscore in This specific score for osteoarthritis patients was adapted to German-speaking patients by Kessler et al. [13]. With this a multidimensional instrument is available to measure health status in patients with knee problems. Five patient relevant subscales are scored separately. In order to analyse and interpret the five dimensions separately an aggregated score of the subscales must not be calculated. Therefore all subscales were checked separately against all other parameters of radiography, MRI, arthroscopy and NIRS Conventional radiography and CT The radiological examination of a joint by radiography or CT still remains parts of a standardized evaluation procedure. Both techniques have axial resolutions in excess of 500 m, which is insufficient for the detection of most microstructural changes and is not capable of depicting articular cartilage. Chondral lesions are not visible, except in cases of chondrocalcinosis or significant osteoarthrosis [9,10,16]. In early stages of osteoarthrosis changes in conventional radiology are not visible. Initial visibility is possible in stage II according to Kellgren and Lawrence (KL) in only 30% of cases [10]. Our study did not show any correlation between the KL-score and any clinical parameters or any technical diagnostic devices (MRI, arthroscopy, NIRS). Table 7 Significant correlations of MRI, arthroscopy and NIRS with KOOS subscores of knee pain patients. KOOS-sympt. KOOS-pain KOOS-ADL KOOS-sports KOOS-quality of life MRI n.s. n.s. n.s. n.s. n.s. Arthroscopy n.s. n.s. n.s. n.s. n.s. NIRS n.s. n.s. 0,269 0,3 Corrected significance level at

6 6 G.O. Hofmann et al. / Pathophysiology 17 (2010) MRI Magnetic resonance imaging (MRI) is a non-invasive method. During the last years MRI has become the leading diagnostic tool for the detection of intra-articular joint pathologies such as ligament or meniscal injuries with optical resolutions better than 100 m. With appropriate pulse sequences it is now feasible to quantify the volume and thickness of the cartilage non-invasively. Recent MRI techniques are able to detect focal abnormities with a high sensitivity (0.95) [17 22]. Up to now it is in discussion what abnormalities are to be expected in MRI at different stages of cartilage disease and whether MRI may be useful as an additional diagnostic tool in specific grades of osteoarthritis. Recently no standardized MRI classification system for articular cartilage lesions has been accepted. Previous studies have shown only a very poor correlation between arthroscopic grading of cartilage lesions according to Outerbridge and lesions detected by MRI [18 20]. Especially low-grade cartilage lesions are hardly detected by MRI employing magnetic fields between 0.5 and 2 T. At least superficial fissuring, fibrillation or shallow ulceration must be present before a lesion is detectable. Johnson et al. [1] found, that geographic bone bruise found on magnetic resonance imaging indicates substantial damage to normal articular cartilage homeostasis. Only in one study employing fat-suppressed fast-spin-echo imaging, ICRS-1 areas were detected as regions of cartilage signal abnormality without visually detectable morphologic changes [17]. MRI sensitive to the concentration of glycosaminoglycans within the cartilage matrix may detect ICRS-1a lesions in future [23]. Nevertheless the differentiation of ICRS-1a, - 1b or -2 lesions remains difficult in the MRI. For low-grade cartilage lesions the contemporary MRI technique is insufficient to provide reliable predictive values. Using a better gray scale exploration and high resolution matrix there may be some improvement in the future. Furthermore objective measurements as far as T2 relaxation time is concerned are hopefully able to improve the predictive value too. Whether advanced MRI technology mentioned above will correlate with the findings of NIRS during arthroscopy will be topic of further investigations. Up to now it remains open whether MRI will become the non-invasive golden standard for the detection of low-grade cartilage lesions Arthroscopy Evaluation of cartilage defects or disease under direct visualisation during arthroscopy still is the most reliable diagnostic tool. The most common used arthroscopic cartilage lesion classification system was developed by Outerbridge [24]. Chondral lesions are subdivided into four grades. The classification is easy to handle with, but some aspects are not implemented adequately, e.g. depth of the lesion. Other arthroscopic classification systems are based on various variables (articular surface appearance, lesion depth, lesion diameter, location) but are not in general use [4,25,26]. The problem unsolved is still the classification of low-grade chondral lesions, the transmission corridor from intact cartilage to first-degree lesions. In this field the classification is very subjective, based on the individual experience of the investigator and sometimes hardly reproducible [2,3,25 29]. Also in our study the two surgeons had difficulties to discern intact cartilage (ICRS-0) from early stages of chondral pathology (ICRS-1) in a reproducible manner without inter-observer differences NIRS Electromagnetic radiation (e.g. visible light or NIR-light) interacts with material in form of scattering, reflexion, absorption and transmission. These interactions depend on the physical and chemical properties of the specific material and the necessary energy level for these interactions, determined by the defined wavelength of the radiation. Some years ago another applications of IR light have been introduced with the intention of assessment of osteoarthritic articular cartilage microstructure. In optical coherence tomography (OCT), a high resolution micron scale imaging technology, the intensity of backreflected infrared light is measured [30 32]. The microstructural material resolution ranges between 4 and 30 m and the imaging penetration is limited to roughly 4 mm. OCT defined microstructural abnormalities in cartilage as fibrillation, fibrosis and abnormalities in the subchondral bone plate and therefore was thought to be a promising new technology for early diagnosis of cartilage abnormalities and osteoarthritis. In addition, the polarization sensitivity of imaging suggested a diagnostic role of polarization spectroscopy [30,31]. Normal cartilage yielded polarization sensitive imaging (birefringence), while osteoarthritic cartilage did not (loss of birefringence). Up to now only in vitro studies or those with relative small and inconsistent patient groups have been performed [7,8]. The detection of the intensity of reflected light at different wavelengths is called spectroscopy. Different methods of spectroscopy are available for different regions of electromagnetic radiation. In the infrared region (λ = ,000 nm) the underlying effect of absorption is the stimulation of interatomic bond vibrations. This is used, e.g. in biochemistry, to analyse the type of bonds present in a sample. In the NIR region (λ = nm) mostly the overtones of vibrations (especially of water and CH-, NH- SH- and OH-groups) can be observed. Therefore organic substances show a strong signal, which led to multiple applications of NIRS in many fields during the last decades [33 53]. Due to its relative high penetrations depth of 1 10 mm into organic samples it gives a good insight into the composition of material. NIRS is used in many clinical applications today. It is possible to measure water content, oxygen hemoglobin [38,47], glucose [42,46,49,53], lipids [41] and proteins and other substances in tissues, diet, blood or urine [40,50,52].

7 G.O. Hofmann et al. / Pathophysiology 17 (2010) Usually, NIRS is performed in the determination of brain [33,44,45,48], liver[33,43,51], skin [37] and muscle oxygenation [35,36]. In oncology the method is used for the differentiation of normal and pathological tissues in breast [39] and prostate cancer patients [34]. It is also possible to determine blood glucose levels percutaneously [42,46,49,53]. Further applications have been described in pharmacology and toxicology [41]. Arthritis diagnosis based upon the near-infrared spectrum of synovial fluid was first introduced by Shaw et al. [52]. Normal hyaline cartilage contains about 70 80% water, which is mainly bound to proteoglycans. During the initial stage of degeneration cartilage undergoes complex changes in matrix composition (water, proteoglycans, collagens) [54]. ICRS grade 1 cartilage shows significantly lower mechanical stiffness and more plastic deformation than ICRS grade 0 cartilage [5] and most interestingly these complex alterations within the matrix composition and the biomechanical sequelae correlate with its optical properties in the NIR region. The findings in NIRS significantly correlate with loss of mechanical hardness, increased water content and an increased Mankin-score in cartilage [8]. There are significant biochemical differences between weight-bearing and non-weight-bearing cartilage. Weightbearing regions of articular cartilage show a significantly higher concentration of glycosaminoglycans compared with non-weight-bearing areas [6]. Therefore intrapatient and interpatient variation of NIRS- and MRT-results and their correlation have to be discussed before the background of the specific articular region they have been evaluated. NIRS may be helpful for diagnosis and monitoring the progress of osteoarthritis in the future. Detection of low-grade cartilage lesions is of tremendous importance for different therapeutic approaches. The progression of articular damage may be modified at early stages either by medical or surgical interventions, when intervention is likely to have the greatest benefit. NIRS potentially can be used for the evaluation of successful cartilage repair or regeneration employing different therapeutical approaches like abrasion, drilling, microfracturing, OATS and autologous chondrocyte transplantation. Further challenge is to find out specific wavelength to receive better correlation between NIR findings and water, glycosaminoglycans and collagen content of the cartilage. Also a possible combination with polarization spectroscopy may provide more detailed biochemical and structural information to be obtained from the tissue. NIRS systems are optical fiber-based and therefore may be integrated into all kinds of arthroscopes, even very small ones. The spectroscopy as part of routine arthroscopy burdens no risk to the patient and leads to an only very low prolongation of the surgical procedure with the prospect of real-time analysis in the near future. We hope that NIRS probably will provide such a diagnostic tool to patients, therapist and scientist in the future. Acknowledgement This work has been supported by parts of the German Working Compensation (Berufsgenossenschaft für Bauwirtschaft) in Berlin. References [1] D.L. Johnson, W.P. Urban Jr., D.N. Caborn, W.J. Vanarthos, C.S. Carlson, Articular cartilage changes seen with magnetic resonance imaging-detected bone bruises associated with acute anterior cruciate ligament rupture, Am. J. Sports Med. 26 (1998) [2] A. Javed, M. Siddique, M. Vaghela, A.C. Hui, Interobserver variations in intra-articular evaluation during arthroscopy of the knee, J. Bone Joint Surg. Br. 84 (2002) [3] J. Jerosch, W.H. Castro, M.C. de Waal Malefijt, M. Busch, A. van Kampen, Interobserver variation in diagnostic arthroscopy of the knee joint. How really objective are arthroscopic findings?, Unfallchirurg 100 (1997) [4] F.R. Noyes, C.L. Stabler, A system for grading articular cartilage lesions at arthroscopy, Am. J. Sports Med. 17 (1989) [5] G. Spahn, E. Kahl, H.M. Klinger, T. Muckley, M. Gunther, G.O. Hofmann, Mechanical behavior of intact and low-grade degenerated cartilage, Biomed. Tech. (Berl.) 52 (2007) [6] B. Rogers, C. Murphy, S. Cannon, T. Briggs, Topographical glycosaminoglycan variation in human articular cartilage, in: AAOS Annual Meeting 2007, San Diego, [7] G. Spahn, H. Plettenberg, E. Kahl, H.M. Klinger, T. Mückley, G.O. Hofmann, Near-infrared (NIR) spectroscopy. A new method for arthroscopic evaluation of low grade degenerated cartilage lesions. Results of a pilot study, BMC Musculoskelet. Disord. 8 (2007) [8] G. Spahn, H. Plettenberg, H. Nagel, E. Kahl, H.M. Klinger, T. Mückley, M. Gunther, G.O. Hofmann, J.A. Mollenhauer, Evaluation of cartilage defects with near-infrared spectroscopy (NIR): an ex vivo study, Med. Eng. Phys. 30 (2008) [9] J.H. Kellgren, J.S. Lawrence, Atlas of Standard Radiographs of Arthritis, [10] J.H. Kellgren, J.S. Lawrence, Radiological assessment of osteoarthritis, Ann. Rheum. Dis. 16 (1963) [11] E.M. Roos, L.S. Lohmander, The Knee injury and Osteoarthritis Outcome Score (KOOS): from joint injury to osteoarthritis, Health Qual. Life Outcomes. 1 (2003) [12] E.M. Roos, H.P. Roos, L.S. Lohmander, C. Ekdahl, B.D. Beynnon, Knee Injury, Osteoarthritis Outcome Score (KOOS) development of a self-administered outcome measure, J. Orthop. Sports Phys. Ther. 28 (1998) [13] S. Kessler, S. Lang, W. Puhl, J. Stove, The Knee Injury and Osteoarthritis Outcome Score a multifunctional questionnaire to measure outcome in knee arthroplasty, Z. Orthop. Ihre Grenzgeb. 141 (2003) [14] M. Brittberg, C.S. Winalski, Evaluation of cartilage injuries and repair, J. Bone Joint Surg. Am. 85 (A Suppl. 2) (2003) [15] J.R. Landis, G.G. Koch, The measurement of observer agreement for categorical data, Biometrics 33 (1977) [16] T. Boegard, O. Rudling, I.F. Petersson, K. Jonsson, Correlation between radiographically diagnosed osteophytes and magnetic resonance detected cartilage defects in the tibiofemoral joint, Ann. Rheum. Dis. 57 (1998) [17] M.A. Bredella, P.F. Tirman, C.G. Peterfy, M. Zarlingo, J.F. Feller, F.W. Bost, J.P. Belzer, T.K. Wischer, H.K. Genant, Accuracy of T2-weighted fast spin-echo MR imaging with fat saturation in detecting cartilage defects in the knee: comparison with arthroscopy in 130 patients, AJR Am. J. Roentgenol. 172 (1999) [18] D.G. Disler, T.R. McCauley, C.G. Kelman, M.D. Fuchs, L.M. Ratner, C.R. Wirth, P.P. Hospodar, Fat-suppressed three-dimensional spoiled

8 8 G.O. Hofmann et al. / Pathophysiology 17 (2010) 1 8 gradient-echo MR imaging of hyaline cartilage defects in the knee: comparison with standard MR imaging and arthroscopy, AJR Am. J. Roentgenol. 167 (1996) [19] J.A. Gagliardi, E.M. Chung, V.P. Chandnani, K.L. Kesling, K.P. Christensen, R.N. Null, M.G. Radvany, M.F. Hansen, Detection and staging of chondromalacia patellae: relative efficacies of conventional MR imaging, MR arthrography, and CT arthrography, AJR Am. J. Roentgenol. 163 (1994) [20] Y. Kawahara, M. Uetani, N. Nakahara, Y. Doiguchi, M. Nishiguchi, S. Futagawa, Y. Kinoshita, K. Hayashi, Fast spin-echo MR of the articular cartilage in the osteoarthrotic knee. Correlation of MR and arthroscopic findings, Acta Radiol. 39 (1998) [21] H.G. Potter, J.M. Linklater, A.A. Allen, J.A. Hannafin, S.B. Haas, Magnetic resonance imaging of articular cartilage in the knee. An evaluation with use of fast-spin-echo imaging, J. Bone Joint Surg. Am. 80 (1998) [22] M.P. Recht, J. Kramer, S. Marcelis, M.N. Pathria, D. Trudell, P. Haghighi, D.J. Sartoris, D. Resnick, Abnormalities of articular cartilage in the knee: analysis of available MR techniques, Radiology 187 (1993) [23] A. Bashir, M.L. Gray, R.D. Boutin, D. Burstein, Glycosamninoglycan in articular cartilage: in vivo assessment with delayed GD (DTPA)(2-) enhanced MR imaging, Radiology 205 (2005) [24] R.E. Outerbridge, The etiology of chondromalacia patellae, J. Bone Joint Surg. Br. 43b (2008) [25] X. Ayral, M. Dougados, V. Listrat, J.P. Bonvarlet, J. Simonnet, S. Poiraudeau, B. Amor, Chondroscopy: a new method for scoring chondropathy, Semin. Arthritis Rheum. 22 (1993) [26] X. Ayral, A. Gueguen, R.W. Ike, J.P. Bonvarlet, L. Frizziero, K. Kalunian, L.W. Moreland, S. Myers, K.S. O Rourke, H. Roos, R. Altman, M. Dougados, Inter-observer reliability of the arthroscopic quantification of chondropathy of the knee, Osteoarthritis. Cartilage. 6 (1998) [27] B.H. Brismar, T. Wredmark, T. Movin, J. Leandersson, O. Svensson, Observer reliability in the arthroscopic classification of osteoarthritis of the knee, J. Bone Joint Surg. Br. 84 (2002) [28] N. Hunt, J. Sanchez-Ballester, R. Pandit, R. Thomas, R. Strachan, Chondral lesions of the knee: a new localization method and correlation with associated pathology, Arthroscopy 17 (2001) [29] S.P. Oakley, I. Portek, Z. Szomor, A. Turnbull, G.A. Murrell, B.W. Kirkham, M.N. Lassere, Poor accuracy and interobserver reliability of knee arthroscopy measurements are improved by the use of variable angle elongated probes, Ann. Rheum. Dis. 61 (2002) [30] W. Drexler, D. Stamper, C. Jesser, X. Li., C. Pitris, K. Saunders, S. Martin, M.B. Lodge, J.G. Fujimoto, M.E. Brezinski, Correlation of collagen organization with polarization sensitive imaging of in vitro cartilage: implications for osteoarthritis, J. Rheumatol. 28 (2001) [31] J.M. Herrmann, C. Pitris, B.E. Bouma, S.A. Boppart, C.A. Jesser, D.L. Stamper, J.G. Fujimoto, M.E. Brezinski, High resolution imaging of normal and osteoarthritic cartilage with optical coherence tomography, J. Rheumatol. 26 (1999) [32] X. Li, S. Martin, C. Pitris, R. Ghanta, D.L. Stamper, M. Harman, J.G. Fujimoto, M.E. Brezinski, High-resolution optical coherence tomographic imaging of osteoarthritic cartilage during open knee surgery, Arthritis Res. Ther. 7 (2005) R318 R323. [33] P.G. Al-Rawi, P. Lombardi, S. Schultz, A. Galindo, E. Coscarella, A. Vasquez, A. Vasquez, E. Rosenkranz, Rosenkranz Near infrared spectroscopy to monitor cerebral oxygen saturation in singleventricle physiology, J. Thorac. Cardiovasc. 131 (2006) [34] J.H. Ali, W.B. Wang, M. Zevallos, R.R. Alfano, Near infrared spectroscopy and imaging to probe differences in water content in normal and cancer human prostate tissues, Technol. Cancer Res. Treat. 3 (2004) [35] Y.N. Bhambhani, Muscle oxygenation trends during dynamic exercise measured by near infrared spectroscopy, Can. J Appl. Physiol. 29 (2004) [36] R. Boushel, C.A. Piantadosi, Near-infrared spectroscopy for monitoring muscle oxygenation, Acta Physiol. Scand. 168 (2000) [37] S.L. Davis, P.J. Fadel, J. Cui, G.D. Thomas, C.G. Crandall, Skin blood flow influences near-infrared spectroscopy-derived measurements of tissue oxygenation during heat stress, J. Appl. Physiol. 100 (2006) [38] M. Ferrari, D.A. Wilson, D.F. Hanley, J.F. Hartmann, R.J. Traystman, Determination of cerebral venous hemoglobin saturation by derivative near infrared spectroscopy, Adv. Exp. Med. Biol. 248 (1989) [39] Y. Gu, W.R. Chen, M. Xia, S.W. Jeong, H. Liu, Effect of photothermal therapy on breast tumor vascular contents: noninvasive monitoring by near-infrared spectroscopy, Photochem. Photobiol. 81 (2005) [40] T.P. Lin, C.C. Hsu., Determination of residual moisture in lyophilized protein pharmaceuticals using rapid and non-invasive method: near infrared spectroscopy, Pharm. Sci. Technol. 56 (2002) [41] P.R. Moreno, R.A. Lodder, K.R. Purushothaman, W.E. Charash, W.N. O Connor, J.E. Muller, Detection of lipid pool, thin fibrous cap, and inflammatory cells in human aortic atherosclerotic plaques by nearinfrared spectroscopy, Circulation 105 (2002) [42] U.A. Müller, B. Mertes, C. Fischbacher, K.U. Jageman, K. Danzer, Non-invasive blood glucose monitoring by means of near infrared spectroscopy: methods for improving the reliability of the calibration models, Int. J. Artif. Organs 20 (1997) [43] G. Naulaers, B. Meyns, M. Miserez, V. Leunens, S. Van Huffel, P. Casaer, H. Devlieger, Measurement of the liver tissue oxygenation by near-infrared spectroscopy, Intensive Care Med. 31 (2005) [44] C. Olsson, S. Thelin, Regional cerebral saturation monitoring with near-infrared spectroscopy during selective antegrade cerebral perfusion: diagnostic performance and relationship to postoperative stroke, J. Thorac. Cardiovasc. Surg. 131 (2006) [45] H. Owen-Reece, M. Smith, C.E. Elwell, J.C. Goldstone, Near infrared spectroscopy, Br. J. Anaesth. 82 (1999) [46] C. Petibois, A.M. Melin, A. Perromat, G. Cazorla, G. Deleris, Glucose and lactate concentration determination on single microsamples by Fourier-transform infrared spectroscopy, J. Lab. Clin. Med. 135 (2000) [47] M. Rendell, E. Anderson, W. Schlueter, J. Mailliard, D. Honigs, R. Rosenthal, Determination of hemoglobin levels in the finger using near infrared spectroscopy, Clin. Lab. Haematol. 25 (2003) [48] M. Ricci, P. Lombardi, S. Schultz, A. Galindo, E. Coscarella, A. Vasquez, E. Rosenkranz, Near-infrared spectroscopy to monitor cerebral oxygen saturation in single-ventricle physiology, J. Thorac. Cardiovasc. Surg. 131 (2006) [49] A. Samann, C.H. Fischbacher, K.U. Jagemann, K. Danzer, J. Schuler, L. Papenkordt, U.A. Muller, Non-invasive blood glucose monitoring by means of near infrared spectroscopy: investigation of long-term accuracy and stability, Exp. Clin. Endocrinol. Diabetes 108 (2000) [50] S. Sasic, Y. Ozaki, Short-wave near-infrared spectroscopy of biological fluids. 1. Quantitative analysis of fat, protein, and lactose in raw milk by partial least-squares regression and band assignment, Anal. Chem. (2001) 64 71, [51] G. Schulz, M. Weiss, U. Bauersfeld, J. Teller, D. Haensse, H.U. Bucher, O. Baenziger, Liver tissue oxygenation as measured by near-infrared spectroscopy in the critically ill child in correlation with central venous oxygen saturation, Intensive Care Med. 28 (2002) [52] R.A. Shaw, S. Kotowich, H.H. Eysel, M. Jackson, G.T. Thomson, H.H. Mantsch, Arthritis diagnosis based upon the near-infrared spectrum of synovial fluid, Rheumatol. Int. 15 (1995) [53] H. Zeller, P. Novak, R. Landgraf, Blood glucose measurement by infrared spectroscopy, Int. J. Artif. Organs 12 (1989) [54] K. Gelse, S. Soder, W. Eger, T. Dietmar, T. Aigner, Osteophyte development molecular characterization of differentiation stages, Osteoarthritis. Cartilage. 11 (2003)

RECENT ADVANCES IN CLINICAL MR OF ARTICULAR CARTILAGE

RECENT ADVANCES IN CLINICAL MR OF ARTICULAR CARTILAGE In Practice RECENT ADVANCES IN CLINICAL MR OF ARTICULAR CARTILAGE By Atsuya Watanabe, MD, PhD, Director, Advanced Diagnostic Imaging Center and Associate Professor, Department of Orthopedic Surgery, Teikyo

More information

Imaging of Articular Cartilage

Imaging of Articular Cartilage Clinical Imaging of Articular Cartilage Imaging of Articular Cartilage Prof. Dr. K. Verstraete Ghent University Introduction : Articular Cartilage Histology and biochemical composition Review of Imaging

More information

Cartilage Repair Options

Cartilage Repair Options Imaging of Cartilage Repair Carl S. Winalski, MD Imaging Institute Department of Biomedical Engineering Cleveland Clinic Cartilage Repair Options Direct repair Marrow stimulation Autologous transplantation

More information

Intraosseous Bio Filler. Surgical Technique

Intraosseous Bio Filler. Surgical Technique Intraosseous Bio Filler Surgical Technique Intraosseous Bio Filler Surgical Technique Introduction The Intraosseous Bio Filler technique is the treatment of bone pathologies resulting from acute or chronic

More information

Quantitative Comparison of 2D and 3D MRI Techniques for the Evaluation of Chondromalacia Patellae in 3.0T MR Imaging of the Knee

Quantitative Comparison of 2D and 3D MRI Techniques for the Evaluation of Chondromalacia Patellae in 3.0T MR Imaging of the Knee doi: 10.5505/actamedica.2016.81905 Acta Medica Anatolia Volume 4 Issue 3 2016 Quantitative Comparison of 2D and 3D MRI Techniques for the Evaluation of Chondromalacia Patellae in 3.0T MR Imaging of the

More information

Classification of Acetabular Cartilage Lesions. Claudio Mella, MD

Classification of Acetabular Cartilage Lesions. Claudio Mella, MD Classification of Acetabular Cartilage Lesions Claudio Mella, MD Acetabular cartilage lesions are frequently found during hip arthroscopy. The arthroscopic view offers an exceptional perspective to assess

More information

Distribution of MR-detected cartilage defects of the patellofemoral joint in chronic knee pain

Distribution of MR-detected cartilage defects of the patellofemoral joint in chronic knee pain OsteoArthritis and Cartilage (2003) 11, 494 498 Crown Copyright 2003 Published by Elsevier Science Ltd on behalf of OsteoArthritis Research Society International. All rights reserved. doi:10.1016/s1063-4584(03)00084-0

More information

Bone&JointAppraisal Vol

Bone&JointAppraisal Vol Bone&JointAppraisal Vol 01 No 03 December 2016 COBLATION Chondroplasty Versus Mechanical Debridement: Randomized Controlled Trial with 10-Year Outcomes -Year Four-Year Ten-Year Group A COBLATION technology

More information

MR imaging of the knee in marathon runners before and after competition

MR imaging of the knee in marathon runners before and after competition Skeletal Radiol (2001) 30:72 76 International Skeletal Society 2001 ARTICLE W. Krampla R. Mayrhofer J. Malcher K.H. Kristen M. Urban W. Hruby MR imaging of the knee in marathon runners before and after

More information

International Cartilage Repair Society

International Cartilage Repair Society OsteoArthritis and Cartilage (2005) 13, 1029e1036 ª 2005 OsteoArthritis Research Society International. Published by Elsevier Ltd. All rights reserved. doi:10.1016/j.joca.2005.07.004 Brief report Second-look

More information

Why the dog? Analogy of the anatomy

Why the dog? Analogy of the anatomy Why the dog? Analogy of the anatomy Surgically Induced canine OA models: Anterior (cranial) cruciate ligament transection model Pond MJ, Nuki G. Ann Rheum Dis 1973 (and > 100 others) Meniscal disruption

More information

Optimal Differentiation of Tissue Types Using Combined Mid and Near Infrared Spectroscopy

Optimal Differentiation of Tissue Types Using Combined Mid and Near Infrared Spectroscopy Optimal Differentiation of Tissue Types Using Combined Mid and Near Infrared Spectroscopy Mugdha V. Padalkar, M.S. 1, Cushla M. McGoverin, Ph.D. 1, Uday P. Palukuru, M.S. 1, Nicholas J. Caccese 1, Padraig

More information

Stability of Post Traumatic Osteochondritis Dissecans of the Knee: MR Imaging Findings

Stability of Post Traumatic Osteochondritis Dissecans of the Knee: MR Imaging Findings Chin J Radiol 2005; 30: 199-204 199 Stability of Post Traumatic Osteochondritis Dissecans of the Knee: MR Imaging Findings YU-CHUNG HUNG 1 JON-KWAY HUANG 1,2 Department of Radiology 1, Mackay Memorial

More information

Meniscus T2 Relaxation Time at Various Stages of Knee Joint Degeneration

Meniscus T2 Relaxation Time at Various Stages of Knee Joint Degeneration Meniscus T2 Relaxation Time at Various Stages of Knee Joint Degeneration Richard Kijowski, Michael Fazio, Benjamin Beduhn, and Fang Liu Department of Radiology University of Wisconsin School of Medicine

More information

DIAGNOSIS OF ARTICULAR CARTILAGE DAMAGE BY POLARIZATION SENSITIVE OPTICAL COHERENCE TOMOGRAPHY AND THE EXTRACTED OPTICAL PROPERTIES

DIAGNOSIS OF ARTICULAR CARTILAGE DAMAGE BY POLARIZATION SENSITIVE OPTICAL COHERENCE TOMOGRAPHY AND THE EXTRACTED OPTICAL PROPERTIES Progress In Electromagnetics Research, PIER 91, 365 376, 2009 DIAGNOSIS OF ARTICULAR CARTILAGE DAMAGE BY POLARIZATION SENSITIVE OPTICAL COHERENCE TOMOGRAPHY AND THE EXTRACTED OPTICAL PROPERTIES J.-J. Shyu

More information

Medial Knee Osteoarthritis Precedes Medial Meniscal Posterior Root Tear with an Event of Painful Popping

Medial Knee Osteoarthritis Precedes Medial Meniscal Posterior Root Tear with an Event of Painful Popping Medial Knee Osteoarthritis Precedes Medial Meniscal Posterior Root Tear with an Event of Painful Popping Dhong Won Lee, M.D, Ji Nam Kim, M.D., Jin Goo Kim, M.D., Ph.D. KonKuk University Medical Center

More information

Osteoarthritis. Dr Anthony Feher. With special thanks to Dr. Tim Williams and Dr. Bhatia for allowing me to use some of their slides

Osteoarthritis. Dr Anthony Feher. With special thanks to Dr. Tim Williams and Dr. Bhatia for allowing me to use some of their slides Osteoarthritis Dr Anthony Feher With special thanks to Dr. Tim Williams and Dr. Bhatia for allowing me to use some of their slides No Financial Disclosures Number one chronic disability in the United States

More information

What is the most effective MRI specific findings for lateral meniscus posterior root tear in ACL injuries

What is the most effective MRI specific findings for lateral meniscus posterior root tear in ACL injuries What is the most effective MRI specific findings for lateral meniscus posterior root tear in ACL injuries Kazuki Asai 1), Junsuke Nakase 1), Kengo Shimozaki 1), Kazu Toyooka 1), Hiroyuki Tsuchiya 1) 1)

More information

MRI of Cartilage. D. BENDAHAN (PhD)

MRI of Cartilage. D. BENDAHAN (PhD) MRI of Cartilage D. BENDAHAN (PhD) Centre de Résonance Magnétique Biologique et Médicale UMR CNRS 7339 Faculté de Médecine de la Timone 27, Bd J. Moulin 13005 Marseille France david.bendahan@univ-amu.fr

More information

Are radiographs needed when MR imaging is performed for non-acute knee symptoms in patients younger than 45 years of age?

Are radiographs needed when MR imaging is performed for non-acute knee symptoms in patients younger than 45 years of age? Skeletal Radiol (2007) 36:1129 1139 DOI 10.1007/s00256-007-0384-5 SCIENTIFIC ARTICLE Are radiographs needed when MR imaging is performed for non-acute knee symptoms in patients younger than 45 years of

More information

Prevalence of Meniscal Radial Tears of the Knee Revealed by MRI After Surgery

Prevalence of Meniscal Radial Tears of the Knee Revealed by MRI After Surgery Downloaded from www.ajronline.org by 46.3.207.114 on 12/22/17 from IP address 46.3.207.114. Copyright RRS. For personal use only; all rights reserved Thomas Magee 1 Marc Shapiro David Williams Received

More information

Arthrographic study of the rheumatoid knee.

Arthrographic study of the rheumatoid knee. Annals of the Rheumatic Diseases, 1981, 40, 344-349 Arthrographic study of the rheumatoid knee. Part 2. Articular cartilage and menisci KYOSUKE FUJIKAWA, YOSHINORI TANAKA, TSUNEYO MATSUBAYASHI, AND FUJIO

More information

Key words: arthroscopy, orthopaedic examination, magnetic resonance imaging, knee injury.

Key words: arthroscopy, orthopaedic examination, magnetic resonance imaging, knee injury. Original paper Videosurgery Arthroscopic verification of objectivity of the orthopaedic examination and magnetic resonance imaging in intra-articular knee injury. Retrospective study Julian Dutka, Michał

More information

FAI syndrome with or without labral tear.

FAI syndrome with or without labral tear. Case This 16-year-old female, soccer athlete was treated for pain in the right groin previously. Now has acute onset of pain in the left hip. The pain was in the groin that was worse with activities. Diagnosis

More information

dgemric Effectively Predicts Cartilage Damage Associated with Femoroacetabular Impingement

dgemric Effectively Predicts Cartilage Damage Associated with Femoroacetabular Impingement Riccardo Lattanzi 1,2 Catherine Petchprapa 2 Daniele Ascani 1 Roy I. Davidovitch 3 Thomas Youm 3 Robert J. Meislin 3 Michael. Recht 2 1 The Bernard and Irene Schwartz Center for Biomedical Imaging, New

More information

This presentation is the intellectual property of the author. Contact them for permission to reprint and/or distribute.

This presentation is the intellectual property of the author. Contact them for permission to reprint and/or distribute. MRI of the Knee Jennifer Swart, M.D. Musculoskeletal Radiology South Texas Radiology Group Outline Coils, Patient Positioning Acquisition Parameters, Planes and Pulse Sequences Knee Arthrography Normal

More information

T2 Values of Femoral Cartilage of the Knee Joint: Comparison between Pre-Contrast and Post-Contrast Images

T2 Values of Femoral Cartilage of the Knee Joint: Comparison between Pre-Contrast and Post-Contrast Images Original Article Musculoskeletal Imaging http://dx.doi.org/.3348/kjr.14.15.1.123 pissn 1229-6929 eissn 05-83 Korean J Radiol 14;15(1):123-129 T2 Values of Femoral Cartilage of the Knee Joint: Comparison

More information

MY PATIENT HAS KNEE PAIN. David Levi, MD Chief, Division of Musculoskeletal l limaging Atlantic Medical Imaging

MY PATIENT HAS KNEE PAIN. David Levi, MD Chief, Division of Musculoskeletal l limaging Atlantic Medical Imaging MY PATIENT HAS KNEE PAIN David Levi, MD Chief, Division of Musculoskeletal l limaging Atlantic Medical Imaging Causes of knee pain Non traumatic Trauma Osteoarthritis Patellofemoral pain Menisci or ligaments

More information

Effects of body mass index, infrapatellar fat pad volume and age on patellar cartilage defect

Effects of body mass index, infrapatellar fat pad volume and age on patellar cartilage defect Acta Orthop. Belg., 2015, 81, 41-46 ORIGINAL STUDY Effects of body mass index, infrapatellar fat pad volume and age on patellar cartilage defect Semra Duran, Ertugrul Aksahin, Onur Kocadal, Cem Nuri Aktekin,

More information

When (How) MRI Became the Gold Standard Hollis G. Potter, MD

When (How) MRI Became the Gold Standard Hollis G. Potter, MD When (How) MRI Became the Gold Standard Hollis G. Potter, MD potterh@hss.edu Target audience: Radiologists and imaging scientists interested in assessing MRI of cartilage Outcome/Objectives: 1. To become

More information

BIOMECHANICAL MECHANISMS FOR DAMAGE: RETRIEVAL ANALYSIS AND COMPUTATIONAL WEAR PREDICTIONS IN TOTAL KNEE REPLACEMENTS

BIOMECHANICAL MECHANISMS FOR DAMAGE: RETRIEVAL ANALYSIS AND COMPUTATIONAL WEAR PREDICTIONS IN TOTAL KNEE REPLACEMENTS Journal of Mechanics in Medicine and Biology Vol. 5, No. 3 (2005) 469 475 c World Scientific Publishing Company BIOMECHANICAL MECHANISMS FOR DAMAGE: RETRIEVAL ANALYSIS AND COMPUTATIONAL WEAR PREDICTIONS

More information

This presentation is the intellectual property of the author. Contact them at for permission to reprint and/or distribute.

This presentation is the intellectual property of the author. Contact them at for permission to reprint and/or distribute. MRI of the Knee Jennifer Swart, M.D. Musculoskeletal Radiology South Texas Radiology Group Financial Disclosure Dr. Jennifer Swart has no relevant financial relationships with commercial interests to disclose.

More information

Medical Practice for Sports Injuries and Disorders of the Knee

Medical Practice for Sports Injuries and Disorders of the Knee Sports-Related Injuries and Disorders Medical Practice for Sports Injuries and Disorders of the Knee JMAJ 48(1): 20 24, 2005 Hirotsugu MURATSU*, Masahiro KUROSAKA**, Tetsuji YAMAMOTO***, and Shinichi YOSHIDA****

More information

ORIGINAL ARTICLE. ROLE OF MRI IN EVALUATION OF TRAUMATIC KNEE INJURIES Saurabh Chaudhuri, Priscilla Joshi, Mohit Goel

ORIGINAL ARTICLE. ROLE OF MRI IN EVALUATION OF TRAUMATIC KNEE INJURIES Saurabh Chaudhuri, Priscilla Joshi, Mohit Goel ROLE OF MRI IN EVALUATION OF TRAUMATIC KNEE INJURIES Saurabh Chaudhuri, Priscilla Joshi, Mohit Goel 1. Associate Professor, Department of Radiodiagnosis & imaging, Bharati Vidyapeeth Medical College and

More information

Life. Uncompromised. The KineSpring Knee Implant System Surgeon Handout

Life. Uncompromised. The KineSpring Knee Implant System Surgeon Handout Life Uncompromised The KineSpring Knee Implant System Surgeon Handout 2 Patient Selection Criteria Patient Selection Criteria Medial compartment degeneration must be confirmed radiographically or arthroscopically

More information

2 A B Fig. 1. Lateral tibial condyle fracture with joint effusion in a 35-year-old man. Sagittal T2-weighted MRI shows a large amount of effusion

2 A B Fig. 1. Lateral tibial condyle fracture with joint effusion in a 35-year-old man. Sagittal T2-weighted MRI shows a large amount of effusion 1 2 1 1 1 2 A B Fig. 1. Lateral tibial condyle fracture with joint effusion in a 35-year-old man. Sagittal T2-weighted MRI shows a large amount of effusion (between arrowheads) in the suprapatellar pouch,

More information

Oak foundation for donating the 3T Siemens Verio scanner. Board of directors BBH and Frh Hospitals for supporting the

Oak foundation for donating the 3T Siemens Verio scanner. Board of directors BBH and Frh Hospitals for supporting the Knee pain and inflammation in the infrapatellar fat pad estimated by conventional and dynamic contrast-enhanced magnetic resonance imaging in obese patients with osteoarthritis: a crosssectional study

More information

Tissue-engineered medical products Evaluation of anisotropic structure of articular cartilage using DT (Diffusion Tensor)-MR Imaging

Tissue-engineered medical products Evaluation of anisotropic structure of articular cartilage using DT (Diffusion Tensor)-MR Imaging Provläsningsexemplar / Preview TECHNICAL REPORT ISO/TR 16379 First edition 2014-03-01 Tissue-engineered medical products Evaluation of anisotropic structure of articular cartilage using DT (Diffusion Tensor)-MR

More information

Traumatic Patellar Dislocation and Cartilage Injury A Follow- Up Study of Long-Term Cartilage Deterioration

Traumatic Patellar Dislocation and Cartilage Injury A Follow- Up Study of Long-Term Cartilage Deterioration Traumatic Patellar Dislocation and Cartilage Injury A Follow- Up Study of Long-Term Cartilage Deterioration Salonen EE 1 M.D., Magga T 2 M.D., Sillanpää PJ 3 M.D. Ph.D., Kiekara T 2 M.D., Ph.D., Mäenpää

More information

of the lumbar facet joints there

of the lumbar facet joints there Skeletal Radiol (1999) 28:215±219 International Skeletal Society 1999 A R T I C L E Dominik Weishaupt Marco Zanetti Norbert Boos Juerg Hodler MR imaging and CT in osteoarthritis of the lumbar facet joints

More information

Cristal Castellanos 1, Abelardo Camacho 2, Klaus Mieth 3, Gamal Zayed 3, German Carrillo 3, Oscar Rivero 4, Rafael Gómez 4, Sara Jaimes 4

Cristal Castellanos 1, Abelardo Camacho 2, Klaus Mieth 3, Gamal Zayed 3, German Carrillo 3, Oscar Rivero 4, Rafael Gómez 4, Sara Jaimes 4 Inter- And Intra-Observer Concordance Of The Modified Kellgren And Lawrence Scale For Knee Osteoarthritis By Compartments In Patients Of The University Hospital Fundación Santa Fe De Bogotá, Colombia.

More information

Viviane Khoury, MD. Assistant Professor Department of Radiology University of Pennsylvania

Viviane Khoury, MD. Assistant Professor Department of Radiology University of Pennsylvania U Penn Diagnostic Imaging: On the Cape Chatham, MA July 11-15, 2016 Viviane Khoury, MD Assistant Professor Department of Radiology University of Pennsylvania Hip imaging has changed in recent years: new

More information

Sasaki E 1,2, Otsuka H 2, Sasaki N 2, and Ishibashi Y 1

Sasaki E 1,2, Otsuka H 2, Sasaki N 2, and Ishibashi Y 1 Influence of osteophyte resection of the posterior femoral condyle on extension range of motion and gap balance in cruciate retaining type total knee arthroplasty. - Intraoperative evaluation using navigation

More information

Case Report Arthroscopic Microfracture Technique for Cartilage Damage to the Lateral Condyle of the Tibia

Case Report Arthroscopic Microfracture Technique for Cartilage Damage to the Lateral Condyle of the Tibia Case Reports in Orthopedics Volume 2015, Article ID 795759, 5 pages http://dx.doi.org/10.1155/2015/795759 Case Report Arthroscopic Microfracture Technique for Cartilage Damage to the Lateral Condyle of

More information

In vivo diffusion tensor imaging (DTI) of articular cartilage as a biomarker for osteoarthritis

In vivo diffusion tensor imaging (DTI) of articular cartilage as a biomarker for osteoarthritis In vivo diffusion tensor imaging (DTI) of articular cartilage as a biomarker for osteoarthritis Jose G. Raya 1, Annie Horng 2, Olaf Dietrich 2, Svetlana Krasnokutsky 3, Luis S. Beltran 1, Maximilian F.

More information

JMSCR Vol 05 Issue 01 Page January

JMSCR Vol 05 Issue 01 Page January www.jmscr.igmpublication.org Impact Factor 5.244 Index Copernicus Value: 83.27 ISSN (e)-2347-176x ISSN (p) 2455-0450 DOI: https://dx.doi.org/10.18535/jmscr/v5i1.28 Diagnostic Accuracy of Magnetic Resonance

More information

Save the meniscus Mais pourquoi?

Save the meniscus Mais pourquoi? Save the meniscus Mais pourquoi? #$%&' ()"*+!," Philippe Neyret E Servien S Lustig P Verdonk One or more of the authors of the next presentation have identified no potential conflicts of interest 2 Consequences

More information

SCALENE ASIA PACIFIC SDN BHD ROTATIONAL FIELD QUANTUM NUCLEAR MAGNETIC RESONANCE (RFQMR) IN TREATMENT OF OSTEOARTHRITIS OF THE KNEE JOINT

SCALENE ASIA PACIFIC SDN BHD ROTATIONAL FIELD QUANTUM NUCLEAR MAGNETIC RESONANCE (RFQMR) IN TREATMENT OF OSTEOARTHRITIS OF THE KNEE JOINT SCALENE ASIA PACIFIC SDN BHD ROTATIONAL FIELD QUANTUM NUCLEAR MAGNETIC RESONANCE (RFQMR) IN TREATMENT OF OSTEOARTHRITIS OF THE KNEE JOINT ROTATIONAL FIELD QUANTUM NUCLEAR MAGNETIC RESONANCE (RFQMR) IN

More information

Keywords Osteoarthritis; Knee; Pathology; Biopsy

Keywords Osteoarthritis; Knee; Pathology; Biopsy Carlos Antônio Garrido 1, Tania Clarete Fonseca Vieira Sales Sampaio 2, Frederico de Souza Ferreira 3 Objectives: To compare the modified Ahlbäck radiological classification with macroscopic analysis of

More information

Department of Orthopaedic Surgery, Tampere University Hospital, Tampere, Finland 3

Department of Orthopaedic Surgery, Tampere University Hospital, Tampere, Finland 3 Scandinavian Journal of Surgery 101: 56 61, 2012 Sensitivity of MRI for articular cartilage lesions of the patellae V. M. Mattila 1, 2, M. Weckström 1, V. Leppänen 1, M. Kiuru 1, H. Pihlajamäki 1, 3 1

More information

Rakesh Patel, MD 4/9/09

Rakesh Patel, MD 4/9/09 Rakesh Patel, MD 4/9/09 Chondral Injuries Very common Present in 63-66% patients undergoing arthroscopy 11-19% full-thickness lesions Up to 79% patients with ACL deficient knee have some form of chondral

More information

Summary. Introduction

Summary. Introduction Osteoarthritis and Cartilage (1999) 7, 526 532 1999 OsteoArthritis Research Society International 1063 4584/99/060526+07 $12.00/0 Article No. joca.1999.0256, available online at http://www.idealibrary.com

More information

Comparative study of sensitivity and specificity of MRI versus GNRB to detect ACL complete and partial tears

Comparative study of sensitivity and specificity of MRI versus GNRB to detect ACL complete and partial tears Comparative study of sensitivity and specificity of MRI versus GNRB to detect ACL complete and partial tears Anterior cruciate ligament (ACL) tears are difficult to diagnose and treat (DeFranco). The preoperative

More information

AUTOLOGOUS CHONDROCYTE IMPLANTATION FOR CHONDRAL KNEE DAMAGE B.A. Jalba 1, C.S. Jalba 2, F. Gherghina 3, M. Cruce 3

AUTOLOGOUS CHONDROCYTE IMPLANTATION FOR CHONDRAL KNEE DAMAGE B.A. Jalba 1, C.S. Jalba 2, F. Gherghina 3, M. Cruce 3 AUTOLOGOUS CHONDROCYTE IMPLANTATION FOR CHONDRAL KNEE DAMAGE B.A. Jalba 1, C.S. Jalba 2, F. Gherghina 3, M. Cruce 3 1-EMERGENCY CLINICAL HOSPITAL FLOREASCA BUCHAREST 2-EMERGENCY CLINICAL HOSPITAL SFANTUL

More information

the new accurate analysis and classification system of knee joint osteoarthritis

the new accurate analysis and classification system of knee joint osteoarthritis the new accurate analysis and classification system of knee joint osteoarthritis i3a Soft- and Hardware Components created and assembled in Austria Due to the rapidly increasing fraction of aging people

More information

Patella position in the trochlea groove: comparison between supine and standing radiographs

Patella position in the trochlea groove: comparison between supine and standing radiographs Patella position in the trochlea groove: comparison between supine and standing radiographs Award: Winner Poster No.: P-0098 Congress: ESSR 2014 Type: Authors: Keywords: DOI: Scientific Poster N. Skou,

More information

Case Report: Knee MR Imaging of Haemarthrosis in a Case of Haemophilia A

Case Report: Knee MR Imaging of Haemarthrosis in a Case of Haemophilia A Clinical > Pediatric Imaging Case Report: Knee MR Imaging of Haemarthrosis in a Case of Haemophilia A M. A. Weber, J. K. Kloth University Hospital Heidelberg, Department of Diagnostic and Interventional

More information

CLINICAL PRESENTATION AND RADIOLOGY QUIZ QUESTION

CLINICAL PRESENTATION AND RADIOLOGY QUIZ QUESTION Donald L. Renfrew, MD Radiology Associates of the Fox Valley, 333 N. Commercial Street, Suite 100, Neenah, WI 54956 12/01/2012 Radiology Quiz of the Week # 101 Page 1 CLINICAL PRESENTATION AND RADIOLOGY

More information

SSSR. 1. Nov Ankle. Postoperative Imaging of Cartilage Repair. and Lateral Ligament Reconstruction

SSSR. 1. Nov Ankle. Postoperative Imaging of Cartilage Repair. and Lateral Ligament Reconstruction Ankle Postoperative Imaging of Cartilage Repair and Lateral Ligament Reconstruction Andrea B. Rosskopf, MD University Hospital Balgrist Imaging of Cartilage Repair Why? To assess the technical success

More information

Why Talk About Technique? MRI of the Knee:

Why Talk About Technique? MRI of the Knee: Why Talk About Technique? MRI of the Knee: Part 1 - Imaging Techniques Mark Anderson, M.D. University of Virginia Health Sciences Center Charlottesville, Virginia Always had an interest teach our fellows

More information

Post-injury painful and locked knee

Post-injury painful and locked knee H R J Post-injury painful and locked knee, p. 54-59 Clinical Case - Test Yourself Musculoskeletal Imaging Post-injury painful and locked knee Ioannis I. Daskalakis 1, 2, Apostolos H. Karantanas 1, 2 1

More information

MR Imaging of a Posterior Root Tear of the Medial Meniscus: Diagnostic Accuracy of Various Tear Configurations and

MR Imaging of a Posterior Root Tear of the Medial Meniscus: Diagnostic Accuracy of Various Tear Configurations and MR Imaging of a Posterior Root Tear of the Medial Meniscus: Diagnostic Accuracy of Various Tear Configurations and Associated Knee Abnormalities 1 Hyang Mi Lee, M.D., Jae Chan Shim, M.D., Jin Goo Kim,

More information

Meniscal Tears: Role of Axial MRI Alone and in Combination with Other Imaging Planes

Meniscal Tears: Role of Axial MRI Alone and in Combination with Other Imaging Planes Nefise Cagla Tarhan 1,2 Christine. Chung 1 urea Valeria Rosa Mohana-orges 1 Tudor Hughes 1 Donald Resnick 1 Received September 30, 2003; accepted after revision February 2, 2004. 1 Department of Radiology,

More information

Correlation between radiographically diagnosed osteophytes and magnetic resonance detected cartilage defects in the patellofemoral joint

Correlation between radiographically diagnosed osteophytes and magnetic resonance detected cartilage defects in the patellofemoral joint Ann Rheum Dis 1998;57:395 400 395 EXTENDED REPORTS Department of Diagnostic Radiology, County Hospital, Helsingborg, Sweden T Boegård O Rudling Department of Diagnostic Radiology, University Hospital,

More information

Role of magnetic resonance imaging in the evaluation of traumatic knee joint injuries

Role of magnetic resonance imaging in the evaluation of traumatic knee joint injuries Original Research Article Role of magnetic resonance imaging in the evaluation of traumatic knee joint injuries Dudhe Mahesh 1*, Rathi Varsha 2 1 Resident, 2 Professor, Department of Radio-Diagnosis, Grant

More information

LATERAL MENISCUS SLOPE AND ITS CLINICAL RELEVANCE IN PATIENTS WITH A COMBINED ACL TEAR AND POSTERIOR TIBIA COMPRESSION

LATERAL MENISCUS SLOPE AND ITS CLINICAL RELEVANCE IN PATIENTS WITH A COMBINED ACL TEAR AND POSTERIOR TIBIA COMPRESSION LATERAL MENISCUS SLOPE AND ITS CLINICAL RELEVANCE IN PATIENTS WITH A COMBINED ACL TEAR AND POSTERIOR TIBIA COMPRESSION R. ŚMIGIELSKI, B. DOMINIK, U, ZDANOWICZ, Z. GAJEWSKI, K. SKIERBISZEWSKA, K. SIEWRUK,

More information

MRI versus clinical examination for the diagnosis of meniscal and ligamentous injuries of kneee

MRI versus clinical examination for the diagnosis of meniscal and ligamentous injuries of kneee Original Research Article MRI versus clinical examination for the diagnosis of meniscal and ligamentous injuries of kneee Rakesh Gujjar *, R. P. Bansal, L. K. Gotecha, Raja Kollu Department of Radio-diagnosis

More information

TREATMENT OF CARTILAGE LESIONS

TREATMENT OF CARTILAGE LESIONS TREATMENT OF CARTILAGE LESIONS Angelo J. Colosimo, MD -Head Orthopaedic Surgeon University of Cincinnati Athletics -Director of Sports Medicine University of Cincinnati Medical Center -Associate Professor

More information

BRIEF REPORT. KENNETH D. BRANDT, ROSE S. FIFE, ETHAN M. BRAUNSTEIN, and BARRY KATZ. From the Department of Medicine, the Department of

BRIEF REPORT. KENNETH D. BRANDT, ROSE S. FIFE, ETHAN M. BRAUNSTEIN, and BARRY KATZ. From the Department of Medicine, the Department of 1381 BRIEF REPORT RADIOGRAPHIC GRADING OF THE SEVERITY OF KNEE OSTEOARTHRITIS: RELATION OF THE KELLGREN AND LAWRENCE GRADE TO A GRADE BASED ON JOINT SPACE NARROWING, AND CORRELATION WITH ARTHROSCOPIC EVIDENCE

More information

Non-invasive blood glucose measurement by near infrared spectroscopy: Machine drift, time drift and physiological effect

Non-invasive blood glucose measurement by near infrared spectroscopy: Machine drift, time drift and physiological effect Spectroscopy 24 (2010) 629 639 629 DOI 10.3233/SPE-2010-0485 IOS Press Non-invasive blood glucose measurement by near infrared spectroscopy: Machine drift, time drift and physiological effect Simon C.H.

More information

TOTAL KNEE ARTHROPLASTY (TKA)

TOTAL KNEE ARTHROPLASTY (TKA) TOTAL KNEE ARTHROPLASTY (TKA) 1 Anatomy, Biomechanics, and Design 2 Femur Medial and lateral condyles Convex, asymmetric Medial larger than lateral 3 Tibia Tibial plateau Medial tibial condyle: concave

More information

New Directions in Osteoarthritis Research

New Directions in Osteoarthritis Research New Directions in Osteoarthritis Research Kananaskis October 22, 2015 Nick Mohtadi MD MSc FRCSC No conflicts of interest related to this presentation 1 Osteoarthritis: Disease? Fact of Life? Strong family

More information

MRI of Osteochondral Defects of the Lateral Femoral Condyle: Incidence and Pattern of Injury After Transient Lateral Dislocation of the Patella

MRI of Osteochondral Defects of the Lateral Femoral Condyle: Incidence and Pattern of Injury After Transient Lateral Dislocation of the Patella Sanders et al. MRI of Osteochond ral Defects of the Lateral Femoral Condyle Musculoskeletal Imaging Clinical Observations A C M E D E N T U R I C A L I M A G I N G AJR 2006; 187:1332 1337 0361 803X/06/1875

More information

Knee Articular Cartilage in an Asymptomatic Population : Comparison of T1rho and T2 Mapping

Knee Articular Cartilage in an Asymptomatic Population : Comparison of T1rho and T2 Mapping TR_002 Technical Reports Knee Articular Cartilage in an Asymptomatic Population : Comparison of T1rho and T2 Mapping Min A Yoon 1,*, Suk-Joo Hong 1, Chang Ho Kang 2, Baek Hyun Kim 3 1 Korea University

More information

Priorities Forum Statement GUIDANCE

Priorities Forum Statement GUIDANCE Priorities Forum Statement Number 21 Subject Knee Arthroscopy including arthroscopic knee washouts Date of decision November 2016 Date refreshed March 2017 Date of review November 2018 Osteoarthritis of

More information

Concentrations of serum cartilage oligomeric matrix protein after anterior cruciate ligament injury.

Concentrations of serum cartilage oligomeric matrix protein after anterior cruciate ligament injury. Concentrations of serum cartilage oligomeric matrix protein after anterior cruciate ligament injury. -Comparing with MRI T2 mapping technique- Yohei Nishida, M.D. 1) Yusuke Hashimoto, M.D. Ph.D. 1), Shinya

More information

OSTEOCHONDRAL ALLOGRAFTS AND AUTOGRAFTS IN THE TREATMENT OF FOCAL ARTICULAR CARTILAGE LESIONS

OSTEOCHONDRAL ALLOGRAFTS AND AUTOGRAFTS IN THE TREATMENT OF FOCAL ARTICULAR CARTILAGE LESIONS Status Active Medical and Behavioral Health Policy Section: Surgery Policy Number: IV-115 Effective Date: 10/22/2014 Blue Cross and Blue Shield of Minnesota medical policies do not imply that members should

More information

Acute Injury of the Articular Cartilage and Subchondral Bone: A Common but Unrecognized Lesion in the Immature Knee

Acute Injury of the Articular Cartilage and Subchondral Bone: A Common but Unrecognized Lesion in the Immature Knee Rachel S. Oeppen 1,2 Susan. Connolly 3 Jenny T. encardino 4 Diego Jaramillo 1 Received May 19, 2003; accepted after revision July 28, 2003. 1 Department of Pediatric Radiology, Massachusetts General Hospital,

More information

Histologic change of cartilage layer of osteochondritis dissecans before and after fixation in the knee

Histologic change of cartilage layer of osteochondritis dissecans before and after fixation in the knee 1 Histologic change of cartilage layer of osteochondritis dissecans before and after fixation in the knee Mitsuo Ochi, M.D. PhD Professor and chairman Department of Orthopaedic Surgery Graduate School

More information

2003 OsteoArthritis Research Society International. Published by Elsevier Science Ltd. All rights reserved. International Cartilage Repair Society

2003 OsteoArthritis Research Society International. Published by Elsevier Science Ltd. All rights reserved. International Cartilage Repair Society OsteoArthritis and Cartilage (2003) 11, 361 369 2003 OsteoArthritis Research Society International. Published by Elsevier Science Ltd. All rights reserved. doi:10.1016/s1063-4584(03)00049-9 Assessment

More information

Mmmmmm Mmmmmm mmmmmmmmmmmmm mmmmmmm mmmmmmm MRI of Equine Stifle Injuries: A Review of the first 100 clinical cases Martin Waselau, Dr.med.vet., MS Diplomate ACVS, Diplomate ECVS Equine Hospital Aschheim,

More information

Original Research Article

Original Research Article Original Research Article Intermediate Weighted Fast Spin Echo (IW FSE) MR Imaging of Hyaline Cartilage Defects of the Knee: Comparison with the Fat Suppressed Three Dimensional Gradient Echo (3D SPGR)

More information

Original Research Article

Original Research Article Original Research Article Intermediate Weighted Fast Spin Echo (IW FSE) MR Imaging of Hyaline Cartilage Defects of the Knee: Comparison with the Fat Suppressed Three Dimensional Gradient Echo (3D SPGR)

More information

Analysis of the Osteoarthritis Initiative Incidence Cohort: Patellar Cartilage T2 and Focal Knee Pathology

Analysis of the Osteoarthritis Initiative Incidence Cohort: Patellar Cartilage T2 and Focal Knee Pathology TECHNISCHE UNIVERSITÄT MÜNCHEN Klinikum rechts der Isar Institut für Röntgendiagnostik (Direktor: Univ.-Prof. Dr. E. J. Rummeny) Analysis of the Osteoarthritis Initiative Incidence Cohort: Patellar Cartilage

More information

The Relationship Between Cartilage Loss on Magnetic Resonance Imaging and Radiographic Progression in Men and Women With Knee Osteoarthritis

The Relationship Between Cartilage Loss on Magnetic Resonance Imaging and Radiographic Progression in Men and Women With Knee Osteoarthritis ARTHRITIS & RHEUMATISM Vol. 52, No. 10, October 2005, pp 3152 3159 DOI 10.1002/art.21296 2005, American College of Rheumatology The Relationship Between Cartilage Loss on Magnetic Resonance Imaging and

More information

PRE & POST OPERATIVE RADIOLOGICAL ASSESSMENT IN TOTAL KNEE REPLACEMENT. Dr. Divya Rani K 2 nd Year Resident Dept. of Radiology

PRE & POST OPERATIVE RADIOLOGICAL ASSESSMENT IN TOTAL KNEE REPLACEMENT. Dr. Divya Rani K 2 nd Year Resident Dept. of Radiology PRE & POST OPERATIVE RADIOLOGICAL ASSESSMENT IN TOTAL KNEE REPLACEMENT Dr. Divya Rani K 2 nd Year Resident Dept. of Radiology PRE OPERATIVE ASSESSMENT RADIOGRAPHS Radiographs are used for assessment and

More information

ChondroMimetic Osteochondral Cartilage Repair Clinical Study. Results of Eight-Year Follow Up February 21, 2018

ChondroMimetic Osteochondral Cartilage Repair Clinical Study. Results of Eight-Year Follow Up February 21, 2018 ChondroMimetic Osteochondral Cartilage Repair Clinical Study Results of Eight-Year Follow Up February 21, 2018 ChondroMimetic Osteochondral Scaffold ChondroMimetic is an all arthroscopic, single-surgery,

More information

Evaluation and Treatment of Knee Arthritis Classification of Knee Arthritis Osteoarthritis Osteoarthritis Osteoarthritis of Knee

Evaluation and Treatment of Knee Arthritis Classification of Knee Arthritis Osteoarthritis Osteoarthritis Osteoarthritis of Knee 1 2 Evaluation and Treatment of Knee Arthritis John Zebrack, MD Reno Orthopaedic Clinic Classification of Knee Arthritis Non-inflammatory Osteoarthritis Primary Secondary Post-traumatic, dysplasia, neuropathic,

More information

Assessment of primary hip osteoarthritis: comparison of radiographic methods using colon radiographs

Assessment of primary hip osteoarthritis: comparison of radiographic methods using colon radiographs Assessment of primary hip osteoarthritis: comparison of radiographic methods using colon radiographs comparison of radiographic methods using colon radiographs Ingvarsson, T; Hägglund, Gunnar; Lindberg,

More information

Pre-operative clinical and radiological

Pre-operative clinical and radiological Pre-operative clinical and radiological assessment of the patellofemoral joint in unicompartmental knee replacement and its influence on outcome D. J. Beard, H. Pandit, S. Ostlere, C. Jenkins, C. A. F.

More information

B one contusion is a finding substantiated by magnetic

B one contusion is a finding substantiated by magnetic 592 ORIGINAL ARTICLE The appearance of kissing contusion in the acutely injured knee in the athletes I P Terzidis, A G Christodoulou, A L Ploumis, S R Metsovitis, M Koimtzis, P Givissis... See end of article

More information

A Comparative Study of Ultrasonographic Findings with Clinical and Radiological Findings of Painful Osteoarthritis of the Knee Joint

A Comparative Study of Ultrasonographic Findings with Clinical and Radiological Findings of Painful Osteoarthritis of the Knee Joint Med. J. Cairo Univ., Vol. 84, No. 3, December: 97-, www.medicaljournalofcairouniversity.net A Comparative Study of Ultrasonographic Findings with Clinical and Radiological Findings of Painful Osteoarthritis

More information

Original Research JOURNAL OF MAGNETIC RESONANCE IMAGING 22: (2005)

Original Research JOURNAL OF MAGNETIC RESONANCE IMAGING 22: (2005) JOURNAL OF MAGNETIC RESONANCE IMAGING 22:788 793 (2005) Original Research STIR vs. T1-Weighted Fat-Suppressed Gadolinium- Enhanced MRI of Bone Marrow Edema of the Knee: Computer-Assisted Quantitative Comparison

More information

Osteoarthritis. RA Hughes

Osteoarthritis. RA Hughes Osteoarthritis RA Hughes Osteoarthritis (OA) OA is the most common form of arthritis and the most common joint disease Most of the people who have OA are older than age 45, and women are more commonly

More information

MRI EVALUATION OF KNEE CARTILAGE

MRI EVALUATION OF KNEE CARTILAGE UPDATING ARTICLE MRI EVALUATION OF KNEE CARTILAGE Marcelo Bordalo Rodrigues 1, Gilberto Luís Camanho 2 ABSTRACT Through the ability of magnetic resonance imaging (MRI) to characterize soft tissue noninvasively,

More information

Thanks. As something to help remember. Thanks 07/02/14. Arthroscopy TKR V Uni. Arthroscopy TKR V Uni. Role of arthroscopy to choose operation

Thanks. As something to help remember. Thanks 07/02/14. Arthroscopy TKR V Uni. Arthroscopy TKR V Uni. Role of arthroscopy to choose operation 07/02/14 Thanks Role of arthroscopy to choose operation TKR Versus Uni Francois and Philippe Faculty Audience Audiovisual Pierre and Vincent Myles Coolican Val d Isere 2014 Thanks Francois and Philippe

More information

Table 2. Mean Scores of Articular Cartilage by Qualitative E v a l u a t i o n

Table 2. Mean Scores of Articular Cartilage by Qualitative E v a l u a t i o n 5 7 7 Table 2. Mean Scores of Articular Cartilage by Qualitative E v a l u a t i o n S e q u e n c e s without MTC (scores, 04 ) with MTC (scores, 04 ) E f f e c t s (scores, 03 ) PDWSE 1.2 1.6 0. 8 T2WSE

More information

Arthritis & Rheumatism

Arthritis & Rheumatism ~ Arthritis & Rheumatism Official Journal of the American College of Rheumatology RELATIONSHIP BETWEEN ARTHROSCOPIC EVIDENCE OF CARTILAGE DAMAGE AND RADIOGRAPHIC EVIDENCE OF JOINT SPACE NARROWING IN EARLY

More information

JMSCR Vol 05 Issue 07 Page July 2017

JMSCR Vol 05 Issue 07 Page July 2017 www.jmscr.igmpublication.org Impact Factor 5.84 Index Copernicus Value: 83.27 ISSN (e)-2347-176x ISSN (p) 2455-0450 DOI: https://dx.doi.org/10.18535/jmscr/v5i7.84 Anatomical Differences Between T2 WI FSE

More information