Pelletier, J.P., Cooper, C., Peterfy, C., Reginster, J.Y., Brandi, M.L., Bruyere, O., Chapurlat, R., Cicuttini, F., Conaghan, P.G., Doherty, M., Genant, H., Giacovelli, G., Hochberg, M.C., Hunter, D.J., Kanis, J.A., Kloppenburg, M., Laredo, J.D., McAlindon, T., Nevitt, M., Raynauld, J.P., Rizzoli, R., Zilkens, C., Roemer, F.W., Martel-Pelletier, J. and Guermazi, A. (2013) What is the predictive value of MRI for the occurrence of knee replacement surgery in knee osteoarthritis? Annals of the Rheumatic Diseases, 72 (10), 1594-1604. (doi:10.1136/annrheumdis-2013-203631). (PMID:23887285)
Abstract
Knee osteoarthritis is associated with structural changes in the joint. Despite its many drawbacks, radiography is the current standard for evaluating joint structure in trials of potential disease-modifying osteoarthritis drugs. MRI is a non-invasive alternative that provides comprehensive imaging of the whole joint. Frequently used MRI measurements in knee osteoarthritis are cartilage volume and thickness; others include synovitis, synovial fluid effusions, bone marrow lesions (BML) and meniscal damage. Joint replacement is considered a clinically relevant outcome in knee osteoarthritis; however, its utility in clinical trials is limited. An alternative is virtual knee replacement on the basis of symptoms and structural damage. MRI may prove to be a good alternative to radiography in definitions of knee replacement. One of the MRI parameters that predicts knee replacement is medial compartment cartilage volume/thickness, which correlates with radiographic joint space width, is sensitive to change, and predicts outcomes in a continuous manner. Other MRI parameters include BML and meniscal lesions. MRI appears to be a viable alternative to radiography for the evaluation of structural changes in knee osteoarthritis and prediction of joint replacement.
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