Quantitative magnetic resonance imaging assessment of lateral atlantoaxial joint meniscoid composition: a validation study

  • Scott F. FarrellEmail author
  • Peter Stanwell
  • Jon Cornwall
  • Peter G. Osmotherly
Original Article



Lateral atlantoaxial (LAA) joint meniscoid composition may have clinical significance in patients following neck trauma. However, the existing method of radiologically assessing meniscoid composition has an inherent element of subjectivity, which could contribute to measurement variability. The present study sought to investigate the accuracy of two-point Dixon fat/water separation MRI as a quantitative assessment of LAA joint meniscoid composition.


Sixteen LAA joint meniscoids were excised from four cadavers (mean [SD] age 79.5 [3.7] years; one female) following cervical spine MRI (two-point Dixon, T1-weighted VIBE and T2-weighted SPACE sequences). Composition of LAA joint meniscoids was undertaken by (1) histological examination by light microscopy, (2) calculation of fat fraction by Dixon MRI (both in-phase/opposed-phase and fat/water methods), and (3) the existing method of considering VIBE and SPACE signal intensities. Analysis was performed using the kappa statistic with linear weighting.


Microscopy revealed three, five, and eight meniscoids to be composed of adipose, fibroadipose, and fibrous tissues, respectively. Dixon sequence MRI classified 11 of these meniscoids correctly, with ‘substantial’ level of agreement (In-phase/Opp-phase kappa statistic = 0.78 [95% CI 0.38, 1.17]; fat/water kappa statistic = 0.72 [95% CI 0.32, 1.11]). Level of agreement between microscopy and the VIBE and SPACE method was ‘slight’ (kappa statistic = 0.02 [95% CI − 0.34, 0.38]).


Findings suggest that Dixon fat/water separation MRI may have superior utility in the assessment of LAA joint meniscoid composition than the existing method of considering VIBE and SPACE signal intensities.

Graphical abstract

These slides can be retrieved under Electronic Supplementary Material.


Meniscoids Synovial folds Atlantoaxial joint Magnetic resonance imaging Histology Cervical spine 


Compliance with ethical standards

Conflict of interest

The authors have no conflicts of interest to declare.

Supplementary material

586_2018_5868_MOESM1_ESM.pptx (142 kb)
Supplementary material 1 (PPTX 142 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Scott F. Farrell
    • 1
    • 2
    • 6
    Email author
  • Peter Stanwell
    • 3
  • Jon Cornwall
    • 4
    • 5
  • Peter G. Osmotherly
    • 3
  1. 1.RECOVER Injury Research Centre, NHMRC Centre for Research Excellence in Recovery Following Road Traffic InjuriesThe University of QueenslandBrisbaneAustralia
  2. 2.Menzies Health Institute QueenslandGriffith UniversityGold CoastAustralia
  3. 3.School of Health SciencesThe University of NewcastleNewcastleAustralia
  4. 4.Centre for Early Learning in Medicine, Otago Medical SchoolUniversity of OtagoDunedinNew Zealand
  5. 5.Institute for Health SciencesZurich University of Applied SciencesZurichSwitzerland
  6. 6.RECOVER Injury Research Centre, Level 7 Oral Health BuildingThe University of QueenslandHerstonAustralia

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