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Interpretation of Cartilage Damage at Routine Clinical MRI: How to Match Arthroscopic Findings
B Keegan Markhardt1, Brady K Huang1, Andrea M Spiker1
1From the Department of Radiology, Division of Musculoskeletal Imaging and Intervention (B.K.M.), and Department of Orthopedic Surgery (A.M.S.), University of Wisconsin-Madison, Clinical Science Center, 600 Highland Ave, E3/311, Madison, WI 53792; Department of Radiology, Division of Musculoskeletal Imaging, University of California, San Diego, La Jolla, Calif (B.K.H., E.Y.C.); and Radiology Services, Veterans Affairs San Diego Healthcare System (E.Y.C.).
This review explains how to interpret articular cartilage damage on MRI scans for better clinical management. Understanding MRI physics and artifacts is crucial for accurate cartilage lesion depth assessment.
Area of Science:
- Radiology
- Orthopedics
- Biomedical Imaging
Background:
- Articular cartilage damage assessment relies on Magnetic Resonance Imaging (MRI).
- Accurate interpretation requires understanding cartilage histology, biochemistry, and MRI physics.
- Challenges in MRI interpretation include anisotropic fibrous organization and artifacts like the magic angle effect.
Purpose of the Study:
- To aid in the interpretation of articular cartilage damage using routine clinical MRI.
- To improve the clinical management of cartilage injuries.
- To discuss the role of MRI physics and artifacts in cartilage lesion characterization.
Main Methods:
- Review of histologic and biochemical characteristics of cartilage.
- Discussion of clinical management strategies for cartilage damage.
- Analysis of MRI physics and artifact influences on cartilage imaging.
Main Results:
- Understanding the osteochondral unit's appearance on MRI is key for characterizing cartilage damage.
- Subchondral bone plate location is critical for determining cartilage lesion depth.
- Artifacts can lead to overestimation of cartilage lesion depth.
Conclusions:
- Accurate MRI interpretation of articular cartilage damage requires knowledge of normal and abnormal appearances, sequence parameters, and artifact mitigation.
- Subchondral bone marrow changes and secondary features like osteophytes are important indicators of cartilage damage.
- Improved MRI interpretation enhances clinical management of articular cartilage injuries.
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