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. 1998 Jul;57(7):395–400. doi: 10.1136/ard.57.7.395

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

T Boegard 1, O Rudling 1, I Petersson 1, K Jonsson 1
PMCID: PMC1752672  PMID: 9797565

Abstract

OBJECTIVE—To assess the correlation between radiographically diagnosed osteophytes in the axial and lateral view of the patellofemoral joint (PFJ) and (1) magnetic resonance (MR) detected cartilage defects in the same joint and (2) knee pain.
METHODS—Fifty seven pepole with chronic knee pain, (aged 41-58 years, mean 50 years) were examined with axial and lateral radiograms when standing of the right and the left PFJ. The presence and grade of osteophytes was assessed. On the same day, a MR examination was performed of the signal knee with proton density and T2 weighted turbo spin-echo sequences in the sagittal and axial view on a 1.0 T imager. Cartilage defects in the PFJ were noted. The subjects were questioned for current knee pain for each knee.
RESULTS—Osteophytes at the PFJ had a specificity varying between 59 and 100% and a positive predictive value between 74 and 100% for MR detected cartilage defects. The corresponding values for osteophytes at the lateral aspect of the femoral trochlea were both 100%. In PFJ with narrowing (<5 mm) osteophytes had a sensitivity and a positive predictive value of 90 and 95% respectively for MR detected cartilage defects, while in PFJ with non-narrowing (⩾5 mm) the corresponding values were 75 and 65% and the specificity was 50%. A correlation (p<0.05) between osteophytes at the inferior pole of the patella and knee pain was found.
CONCLUSIONS—Osteophytes at the PFJ are associated with MR detected cartilage defects in the same joint. The relation was strong for osteophytes at the lateral femoral trochlea and in the PFJ with narrowing (<5 mm), but weak in the PFJ with non-narrowing (⩾5 mm). 

 Keywords: knee; radiograms; osteoarthritis; osteophyte

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Figure 1  .

Figure 1  

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(A) The axial radiogram of the right patellofemoral joint in a 55 year old man with an osteophyte of grade 2 at the medial aspect of the patella (arrow), as well as at the medial and lateral aspects of the femoral trochlea. The minimal joint space width in this view was 9 mm medially and 7 mm laterally. The corresponding (B) axial Pd weighted MR image is demonstrating a cartilage defect grade 2 in the medial facet of the patella (arrow).

Figure 2  .

Figure 2  

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(A) The axial radiogram of the left patellofemoral joint in a 58 year old woman with osteophytes of grade 1 at all joint margins. The joint space width in the this view was 8 mm medially and 6 mm laterally. The corresponding axial (B) Pd and (C) T2 weighted MR images show a cartilage defect of grade 1 at the lateral facet of the femoral trochlea (arrow).

Figure 3  .

Figure 3  

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(A) The lateral radiogram of the right patellofemoral joint in a 57 year old woman with an osteophyte at the inferior and superior pole of the patella (arrows). The joint space width in the axial view of the same joint was 6 mm medially and >5 mm laterally. The corresponding (B) axial Pd weighted MR image shows a cartilage defect of grade 2 at the medial facet of the patella (arrow).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Altman R. D., Hochberg M., Murphy W. A., Jr, Wolfe F., Lequesne M. Atlas of individual radiographic features in osteoarthritis. Osteoarthritis Cartilage. 1995 Sep;3 (Suppl A):3–70. [PubMed] [Google Scholar]
  2. Boegård T., Rudling O., Petersson I. F., Sanfridsson J., Saxne T., Svensson B., Jonsson K. Joint-space width in the axial view of the patello-femoral joint. Definitions and comparison with MR imaging. Acta Radiol. 1998 Jan;39(1):24–31. doi: 10.1080/02841859809172144. [DOI] [PubMed] [Google Scholar]
  3. Broderick L. S., Turner D. A., Renfrew D. L., Schnitzer T. J., Huff J. P., Harris C. Severity of articular cartilage abnormality in patients with osteoarthritis: evaluation with fast spin-echo MR vs arthroscopy. AJR Am J Roentgenol. 1994 Jan;162(1):99–103. doi: 10.2214/ajr.162.1.8273700. [DOI] [PubMed] [Google Scholar]
  4. Brown T. R., Quinn S. F. Evaluation of chondromalacia of the patellofemoral compartment with axial magnetic resonance imaging. Skeletal Radiol. 1993;22(5):325–328. doi: 10.1007/BF00198391. [DOI] [PubMed] [Google Scholar]
  5. Buckland-Wright C. Protocols for precise radio-anatomical positioning of the tibiofemoral and patellofemoral compartments of the knee. Osteoarthritis Cartilage. 1995 Sep;3 (Suppl A):71–80. [PubMed] [Google Scholar]
  6. Cicuttini F. M., Baker J., Hart D. J., Spector T. D. Association of pain with radiological changes in different compartments and views of the knee joint. Osteoarthritis Cartilage. 1996 Jun;4(2):143–147. doi: 10.1016/s1063-4584(05)80323-1. [DOI] [PubMed] [Google Scholar]
  7. Cicuttini F. M., Baker J., Hart D. J., Spector T. D. Choosing the best method for radiological assessment of patellofemoral osteoarthritis. Ann Rheum Dis. 1996 Feb;55(2):134–136. doi: 10.1136/ard.55.2.134. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Disler D. G. Fat-suppressed three-dimensional spoiled gradient-recalled MR imaging: assessment of articular and physeal hyaline cartilage. AJR Am J Roentgenol. 1997 Oct;169(4):1117–1123. doi: 10.2214/ajr.169.4.9308475. [DOI] [PubMed] [Google Scholar]
  9. Gilbertson E. M. Development of periarticular osteophytes in experimentally induced osteoarthritis in the dog. A study using microradiographic, microangiographic, and fluorescent bone-labelling techniques. Ann Rheum Dis. 1975 Feb;34(1):12–25. doi: 10.1136/ard.34.1.12. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Hayes C. W., Sawyer R. W., Conway W. F. Patellar cartilage lesions: in vitro detection and staging with MR imaging and pathologic correlation. Radiology. 1990 Aug;176(2):479–483. doi: 10.1148/radiology.176.2.2367664. [DOI] [PubMed] [Google Scholar]
  11. Heron C. W., Calvert P. T. Three-dimensional gradient-echo MR imaging of the knee: comparison with arthroscopy in 100 patients. Radiology. 1992 Jun;183(3):839–844. doi: 10.1148/radiology.183.3.1584944. [DOI] [PubMed] [Google Scholar]
  12. Jones A. C., Ledingham J., McAlindon T., Regan M., Hart D., MacMillan P. J., Doherty M. Radiographic assessment of patellofemoral osteoarthritis. Ann Rheum Dis. 1993 Sep;52(9):655–658. doi: 10.1136/ard.52.9.655. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. KELLGREN J. H., LAWRENCE J. S. Radiological assessment of osteo-arthrosis. Ann Rheum Dis. 1957 Dec;16(4):494–502. doi: 10.1136/ard.16.4.494. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Lanyon P., Jones A., Doherty M. Assessing progression of patellofemoral osteoarthritis: a comparison between two radiographic methods. Ann Rheum Dis. 1996 Dec;55(12):875–879. doi: 10.1136/ard.55.12.875. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Marshall J. L. Periarticular osteophytes. Initiation and formation in the knee of the dog. Clin Orthop Relat Res. 1969 Jan-Feb;62:37–47. [PubMed] [Google Scholar]
  16. McAlindon T. E., Snow S., Cooper C., Dieppe P. A. Radiographic patterns of osteoarthritis of the knee joint in the community: the importance of the patellofemoral joint. Ann Rheum Dis. 1992 Jul;51(7):844–849. doi: 10.1136/ard.51.7.844. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. McDevitt C., Gilbertson E., Muir H. An experimental model of osteoarthritis; early morphological and biochemical changes. J Bone Joint Surg Br. 1977 Feb;59(1):24–35. doi: 10.1302/0301-620X.59B1.576611. [DOI] [PubMed] [Google Scholar]
  18. Peterfy C. G. MR imaging. Baillieres Clin Rheumatol. 1996 Nov;10(4):635–678. doi: 10.1016/s0950-3579(96)80055-0. [DOI] [PubMed] [Google Scholar]
  19. Peterfy C. G., van Dijke C. F., Janzen D. L., Glüer C. C., Namba R., Majumdar S., Lang P., Genant H. K. Quantification of articular cartilage in the knee with pulsed saturation transfer subtraction and fat-suppressed MR imaging: optimization and validation. Radiology. 1994 Aug;192(2):485–491. doi: 10.1148/radiology.192.2.8029420. [DOI] [PubMed] [Google Scholar]
  20. Petersson I. F., Boegård T., Saxne T., Silman A. J., Svensson B. Radiographic osteoarthritis of the knee classified by the Ahlbäck and Kellgren & Lawrence systems for the tibiofemoral joint in people aged 35-54 years with chronic knee pain. Ann Rheum Dis. 1997 Aug;56(8):493–496. doi: 10.1136/ard.56.8.493. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Recht M. P., Piraino D. W., Paletta G. A., Schils J. P., Belhobek G. H. Accuracy of fat-suppressed three-dimensional spoiled gradient-echo FLASH MR imaging in the detection of patellofemoral articular cartilage abnormalities. Radiology. 1996 Jan;198(1):209–212. doi: 10.1148/radiology.198.1.8539380. [DOI] [PubMed] [Google Scholar]
  22. Spector T. D., Hart D. J., Byrne J., Harris P. A., Dacre J. E., Doyle D. V. Definition of osteoarthritis of the knee for epidemiological studies. Ann Rheum Dis. 1993 Nov;52(11):790–794. doi: 10.1136/ard.52.11.790. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Tervonen O., Dietz M. J., Carmichael S. W., Ehman R. L. MR imaging of knee hyaline cartilage: evaluation of two- and three-dimensional sequences. J Magn Reson Imaging. 1993 Jul-Aug;3(4):663–668. doi: 10.1002/jmri.1880030417. [DOI] [PubMed] [Google Scholar]

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