Evaluation of Chondrocalcinosis and Associated Knee Joint Degeneration Using MR Imaging: Data from the Osteoarthritis Initiative
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To evaluate the ability of different MRI sequences to detect chondrocalcinosis within knee cartilage and menisci, and to analyze the association with joint degeneration.
Subjects with radiographic knee chondrocalcinosis (n = 90, age 67.7 ± 7.3 years, 50 women) were selected from the Osteoarthritis Initiative and matched to controls without radiographic chondrocalcinosis (n = 90). Visualization of calcium-containing crystals (CaC) was compared between 3D T1-weighted gradient-echo (T1GE), 3D dual echo steady-state (DESS), 2D intermediate-weighted (IW), and proton density (PD)-weighted fast spin-echo (FSE) sequences obtained with 3T MRI and correlated with a semiquantitative CaC score obtained from radiographs. Structural abnormalities were assessed using Whole-Organ MRI Score (WORMS) and logistic regression models were used to compare cartilage compartments with and without CaC.
Correlations between CaC counts of MRI sequences and degree of radiographic calcifications were highest for GE (rT1GE = 0.73, P < 0.001; rDESS = 0.68, P < 0.001) compared to other sequences (P > 0.05). Meniscus WORMS was significantly higher in subjects with chondrocalcinosis compared to controls (P = 0.005). Cartilage defects were significantly more frequent in compartments with CaC than without (patella: P = 0.006; lateral tibia: P < 0.001; lateral femur condyle: P = 0.017).
Gradient-echo sequences were most useful for the detection of chondrocalcinosis and presence of CaC was associated with higher prevalence of cartilage and meniscal damage.
• Magnetic resonance imaging is useful for assessing burden of calcium-containing crystals (CaC).
• Gradient-echo sequences are superior to fast spin echo sequences for CaC imaging.
• Presence of CaC is associated with meniscus and cartilage degradation.
KeywordsChondrocalcinosis Osteoarthritis Magnetic resonance imaging Musculoskeletal imaging Cartilage imaging
Bone marrow edema pattern
Basic calcium phosphate
Calcium pyrophosphate deposition
Dual echo steady-state
Fast spin echo
Intra-class correlation coefficients
Whole-Organ Magnetic Resonance Imaging Score
The scientific guarantor of this publication is Dr. Thomas M. Link, MD, PhD, Department of Radiology and Biomedical Imaging, University of California, San Francisco. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. The OAI is a public-private partnership comprised of five contracts (N01-AR-2-2258; N01-AR-2-2259; N01-AR-2-2260; N01-AR-2-2261; N01-AR-2-2262) funded by the National Institutes of Health, a branch of the Department of Health and Human Services, and conducted by the OAI Study Investigators. Private funding partners include Merck Research Laboratories; Novartis Pharmaceuticals Corporation, GlaxoSmithKline; and Pfizer, Inc. Private sector funding for the OAI is managed by the Foundation for the National Institutes of Health. Written informed consent was obtained from all subjects in this study. Institutional Review Board approval was obtained. This manuscript was prepared using an OAI public use data set and has received the approval of the OAI Publications Committee based on a review of its scientific content and data interpretation. The analyses in this study were funded through the NIH (National Institute of Arthritis and Musculoskeletal and Skin Diseases grants R01AR064771 and P50-AR060752).
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