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. 2004 Nov;63(11):1490–1495. doi: 10.1136/ard.2003.018226

Correlation and sex differences between ankle and knee cartilage morphology determined by quantitative magnetic resonance imaging

F Eckstein 1, V Siedek 1, C Glaser 1, D Al-Ali 1, K Englmeier 1, M Reiser 1, H Graichen 1
PMCID: PMC1754795  PMID: 15479900

Abstract

Objective: To study the correlation between ankle and knee cartilage morphology to test the hypothesis that knee joint cartilage loss in gonarthritis can be estimated retrospectively using quantitative MRI analysis of the knee and ankle and established regression equations; and to test the hypothesis that sex differences in joint surface area are larger in the knee than the ankle, which may explain the greater incidence of knee osteoarthritis in elderly women than in elderly men.

Methods: Sagittal MR images (3D FLASH WE) of the knee and hind foot were acquired in 29 healthy subjects (14 women, 15 men; mean (SD) age, 25 (3) years), with no signs joint disease. Cartilage volume, thickness, and joint surface area were determined in the knee, ankle, and subtalar joint.

Results: Knee cartilage volumes and joint surface areas showed only moderate correlations with those of the ankle and subtalar joint (r = 0.33 to 0.81). The correlations of cartilage thickness between the two joints were weaker still (r = –0.05 to 0.53). Sex differences in cartilage morphology at the knee and the ankle were similar, with surface areas being –17.5% to –23.5% lower in women than in men.

Conclusions: Only moderate correlations in cartilage morphology of healthy subjects were found between knee and ankle. It is therefore impractical to estimate knee joint cartilage loss a posteriori in cross sectional studies by measuring the hind foot and then applying a scaling factor. Sex differences in cartilage morphology do not explain differences in osteoarthritis incidence between men and women in the knee and ankle.

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Figure 1.

Figure 1

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 Scattergram showing the rationale for the study. If the hypothesis is correct that there is a strong linear relation between knee joint cartilage volume in the knee and ankle surfaces (for example, medial tibia and distal tibia) in healthy volunteers (empty circles), this relation can be exploited to estimate retrospectively the amount of tissue loss in the knee surface in a cross sectional study. In the 29 healthy volunteers examined in this study, the cartilage volume of the medial tibia (knee joint) varied from 1.1 to 3.2 ml (mean 2.3 ml), and that of the distal tibia (ankle joint) from 0.6 to 1.7 ml (mean 1.1 ml). The graph also shows the hypothetical measurement in a patient (filled circle). Assuming a strong linear relation in healthy volunteers (empty circles), one could accurately estimate the cartilage tissue loss in the medial tibia of the hypothetical patient to amount to 1.2 ml (50% cartilage loss), although the measurement at the knee of this patients falls within the normal range.

Figure 2.

Figure 2

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 Sagittal magnetic resonance images of the knee and ankle, acquired with a high resolution FLASH (fast low angle shot) wider excitation sequence. The figure also displays the surfaces that have been analysed in the current study.

Figure 3.

Figure 3

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 Bivariate scattergrams showing the correlation of cartilage volume in the knee, ankle, and subtalar joint. Women and men are identified in the graphs. Surface, joint surface area; thickness, mean cartilage thickness; volume, cartilage volume.

Selected References

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

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