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Sagittal 3D dual-echo in steady state (DESS) sequence images of the right knee at baseline (A) and 48-month follow-up (B) in a representative individual with weight gain (approximately 5.7% increase in BMI from 33.1 to 35) over 48 months. There is interval development of a full thickness focal cartilage defect at the patella > 1 cm (WORMS grade 5) and adjacent increased bone marrow edema pattern (WORMS grade 2) (white arrow).
