Download PDF
Semin Musculoskelet Radiol 2008; 12(4): 283-301
DOI: 10.1055/s-0028-1100637
© Thieme Medical Publishers

Imaging of Articular Cartilage Injuries of the Lower Extremity

Carl S. Winalski1 , Leyla Alparslan2
  • 1Imaging Institute, Cleveland Clinic, Cleveland, Ohio
  • 2Department of Radiology, Brigham & Women's Hospital, Harvard Medical School, Boston, Massachusetts
Further Information

Publication History

Publication Date:
18 November 2008 (online)

Also available at
    Permissions and Reprints

ABSTRACT

Imaging has become an important clinical tool in the evaluation of articular cartilage, both in the clinical and research setting. This article reviews the mechanisms of articular cartilage injury in the lower extremities and their implications. Specific examples of acute and chronic repetitive injuries in the hip, knee, and ankle are used to demonstrate the characteristics of articular cartilage lesions on magnetic resonance imaging and multidetector computed tomographic arthrography. Loss of meniscal function in the knee and femoroacetabular impingement in the hip represent sources of repetitive cartilage injury that predispose the joint to osteoarthritis. Acute cartilage injury is exemplified by osteochondral lesions of the talus, which may result in post-traumatic osteoarthritis. Recognition of early cartilage damage and associated lesions may help determine the proper treatment for the patient to delay or prevent progression to osteoarthritis.

KEYWORDS

Articular cartilage - magnetic resonance imaging - multidetector computed tomography - osteoarthritis - joint injury

REFERENCES

  • 1 Hjelle K, Solheim E, Strand T, Muri R, Brittberg M. Articular cartilage defects in 1,000 knee arthroscopies.  Arthroscopy. 2002;  18(7) 730-734
    CrossrefPubMedGoogle Scholar
  • 2 Johnson D L, Urban Jr W P, Caborn D N, Vanarthos W J, Carlson C S. Articular cartilage changes seen with magnetic resonance imaging-detected bone bruises associated with acute anterior cruciate ligament rupture.  Am J Sports Med. 1998;  26(3) 409-414
    PubMedGoogle Scholar
  • 3 Cobby M J, Schweitzer M E, Resnick D. The deep lateral femoral notch: an indirect sign of a torn anterior cruciate ligament.  Radiology. 1992;  184(3) 855-858
    PubMedGoogle Scholar
  • 4 Levy A S, Lohnes J, Sculley S, LeCroy M, Garrett W. Chondral delamination of the knee in soccer players.  Am J Sports Med. 1996;  24(5) 634-639
    CrossrefPubMedGoogle Scholar
  • 5 Buckwalter J A, Mankin H J. Articular cartilage: degeneration and osteoarthritis, repair, regeneration, and transplantation.  Instr Course Lect. 1998;  47 487-504
    PubMedGoogle Scholar
  • 6 Shelbourne K D, Jari S, Gray T. Outcome of untreated traumatic articular cartilage defects of the knee: a natural history study.  J Bone Joint Surg Am. 2003;  85-A(suppl 2) 8-16
    PubMedGoogle Scholar
  • 7 Biswal S, Hastie T, Andriacchi T P et al.. Risk factors for progressive cartilage loss in the knee: a longitudinal magnetic resonance imaging study in forty-three patients.  Arthritis Rheum. 2002;  46(11) 2884-2892
    CrossrefPubMedGoogle Scholar
  • 8 Phan C M, Link T M, Blumenkrantz G et al.. MR imaging findings in the follow-up of patients with different stages of knee osteoarthritis and the correlation with clinical symptoms.  Eur Radiol. 2006;  16(3) 608-618
    CrossrefPubMedGoogle Scholar
  • 9 Ding C, Cicuttini F, Scott F, Boon C, Jones G. Association of prevalent and incident knee cartilage defects with loss of tibial and patellar cartilage: a longitudinal study.  Arthritis Rheum. 2005;  52(12) 3918-3927
    CrossrefPubMedGoogle Scholar
  • 10 Wang Y, Ding C, Wluka A E et al.. Factors affecting progression of knee cartilage defects in normal subjects over 2 years.  Rheumatology (Oxford). 2006;  45(1) 79-84
    CrossrefPubMedGoogle Scholar
  • 11 Cicuttini F, Ding C, Wluka A et al.. Association of cartilage defects with loss of knee cartilage in healthy, middle-age adults: a prospective study.  Arthritis Rheum. 2005;  52(7) 2033-2039
    CrossrefPubMedGoogle Scholar
  • 12 Outerbridge R E. The etiology of chondromalacia patellae.  J Bone Joint Surg Br. 1961;  43-B 752-757
    CrossrefPubMedGoogle Scholar
  • 13 Wluka A E, Ding C, Jones G, Cicuttini F M. The clinical correlates of articular cartilage defects in symptomatic knee osteoarthritis: a prospective study.  Rheumatology (Oxford). 2005;  44(10) 1311-1316
    CrossrefPubMedGoogle Scholar
  • 14 Minas T, Nehrer S. Current concepts in the treatment of articular cartilage defects.  Orthopedics. 1997;  20(6) 525-538
    PubMedGoogle Scholar
  • 15 Lee S J, Aadalen K J, Malaviya P et al.. Tibiofemoral contact mechanics after serial medial meniscectomies in the human cadaveric knee.  Am J Sports Med. 2006;  34(8) 1334-1344
    CrossrefPubMedGoogle Scholar
  • 16 McDermott I D, Amis A A. The consequences of meniscectomy.  J Bone Joint Surg Br. 2006;  88(12) 1549-1556
    CrossrefPubMedGoogle Scholar
  • 17 Shrive N G, O'Connor J J, Goodfellow J W. Load-bearing in the knee joint.  Clin Orthop Relat Res. 1978;  (131) 279-287
    PubMedGoogle Scholar
  • 18 Roos E M, Ostenberg A, Roos H, Ekdahl C, Lohmander L S. Long-term outcome of meniscectomy: symptoms, function, and performance tests in patients with or without radiographic osteoarthritis compared to matched controls.  Osteoarthritis Cartilage. 2001;  9(4) 316-324
    PubMedGoogle Scholar
  • 19 McNicholas M J, Rowley D I, McGurty D et al.. Total meniscectomy in adolescence. A thirty-year follow-up.  J Bone Joint Surg Br. 2000;  82(2) 217-221
    PubMedGoogle Scholar
  • 20 Englund M, Roos E M, Roos H P, Lohmander L S. Patient-relevant outcomes fourteen years after meniscectomy: influence of type of meniscal tear and size of resection.  Rheumatology (Oxford). 2001;  40(6) 631-639
    CrossrefPubMedGoogle Scholar
  • 21 Cicuttini F M, Forbes A, Yuanyuan W, Rush G, Stuckey S L. Rate of knee cartilage loss after partial meniscectomy.  J Rheumatol. 2002;  29(9) 1954-1956
    PubMedGoogle Scholar
  • 22 Baratz M E, Fu F H, Mengato R. Meniscal tears: the effect of meniscectomy and of repair on intraarticular contact areas and stress in the human knee. A preliminary report.  Am J Sports Med. 1986;  14(4) 270-275
    Google Scholar
  • 23 Ahmed A M, Burke D L. In-vitro measurement of static pressure distribution in synovial joints—Part I: Tibial surface of the knee.  J Biomech Eng. 1983;  105(3) 216-225
    CrossrefPubMedGoogle Scholar
  • 24 Ihn J C, Kim S J, Park I H. In vitro study of contact area and pressure distribution in the human knee after partial and total meniscectomy.  Int Orthop. 1993;  17(4) 214-218
    PubMedGoogle Scholar
  • 25 Pagnani M J, Cooper D E, Warren R F. Extrusion of the medial meniscus.  Arthroscopy. 1991;  7(3) 297-300
    PubMedGoogle Scholar
  • 26 Costa C R, Morrison W B, Carrino J A. Medial meniscus extrusion on knee MRI: is extent associated with severity of degeneration or type of tear?.  AJR Am J Roentgenol. 2004;  183(1) 17-23
    CrossrefPubMedGoogle Scholar
  • 27 Hunter D J, Zhang Y Q, Tu X et al.. Change in joint space width: hyaline articular cartilage loss or alteration in meniscus?.  Arthritis Rheum. 2006;  54(8) 2488-2495
    CrossrefPubMedGoogle Scholar
  • 28 Adams J G, McAlindon T, Dimasi M, Carey J, Eustace S. Contribution of meniscal extrusion and cartilage loss to joint space narrowing in osteoarthritis.  Clin Radiol. 1999;  54(8) 502-506
    CrossrefPubMedGoogle Scholar
  • 29 Breitenseher M J, Trattnig S, Dobrocky I et al.. MR imaging of meniscal subluxation in the knee.  Acta Radiol. 1997;  38(5) 876-879
    PubMedGoogle Scholar
  • 30 Gale D R, Chaisson C E, Totterman S M et al.. Meniscal subluxation: association with osteoarthritis and joint space narrowing.  Osteoarthritis Cartilage. 1999;  7(6) 526-532
    CrossrefPubMedGoogle Scholar
  • 31 Berthiaume M J, Raynauld J P, Martel-Pelletier J et al.. Meniscal tear and extrusion are strongly associated with progression of symptomatic knee osteoarthritis as assessed by quantitative magnetic resonance imaging.  Ann Rheum Dis. 2005;  64(4) 556-563
    CrossrefPubMedGoogle Scholar
  • 32 Rennie W J, Finlay D B. Meniscal extrusion in young athletes: associated knee joint abnormalities.  AJR Am J Roentgenol. 2006;  186(3) 791-794
    CrossrefPubMedGoogle Scholar
  • 33 Puig L, Monllau J C, Corrales M et al.. Factors affecting meniscal extrusion: correlation with MRI, clinical, and arthroscopic findings.  Knee Surg Sports Traumatol Arthrosc. 2006;  14(4) 394-398
    CrossrefPubMedGoogle Scholar
  • 34 Tannast M, Siebenrock K A, Anderson S E. Femoroacetabular impingement: radiographic diagnosis—what the radiologist should know.  AJR Am J Roentgenol. 2007;  188(6) 1540-1552
    CrossrefPubMedGoogle Scholar
  • 35 Buckwalter J A, Saltzman C, Brown T. The impact of osteoarthritis: implications for research.  Clin Orthop Relat Res. 2004;  (427, Suppl) S6-S15
    CrossrefPubMedGoogle Scholar
  • 36 Bredella M A, Stoller D W. MR imaging of femoroacetabular impingement.  Magn Reson Imaging Clin N Am. 2005;  13(4) 653-664
    CrossrefPubMedGoogle Scholar
  • 37 Ganz R, Parvizi J, Beck M et al.. Femoroacetabular impingement: a cause for osteoarthritis of the hip.  Clin Orthop Relat Res. 2003;  (417) 112-120
    CrossrefPubMedGoogle Scholar
  • 38 Manaster B J, Zakel S. Imaging of femoral acetabular impingement syndrome.  Clin Sports Med. 2006;  25(4) 635-657
    CrossrefPubMedGoogle Scholar
  • 39 Harris W H. Etiology of osteoarthritis of the hip.  Clin Orthop Relat Res. 1986;  (213) 20-33
    PubMedGoogle Scholar
  • 40 Goodman D A, Feighan J E, Smith A D et al.. Subclinical slipped capital femoral epiphysis. Relationship to osteoarthrosis of the hip.  J Bone Joint Surg Am. 1997;  79(10) 1489-1497
    CrossrefPubMedGoogle Scholar
  • 41 Siebenrock K A, Wahab K H, Werlen S et al.. Abnormal extension of the femoral head epiphysis as a cause of cam impingement.  Clin Orthop Relat Res. 2004;  (418) 54-60
    PubMedGoogle Scholar
  • 42 Leunig M, Casillas M M, Hamlet M et al.. Slipped capital femoral epiphysis: early mechanical damage to the acetabular cartilage by a prominent femoral metaphysis.  Acta Orthop Scand. 2000;  71(4) 370-375
    CrossrefPubMedGoogle Scholar
  • 43 Pfirrmann C WA, Petersilge C A. Imaging of the painful hip and pelvis. In: Hodler J, Zollikofer ChL, von Schulthess GK Musculoskeletal Diseases and Interventional Techniques. 37th International Diagnostic Course in Davos (IDKD). Springer, Milan 2005
    Google Scholar
  • 44 Reynolds D, Lucas J, Klaue K. Retroversion of the acetabulum. A cause of hip pain.  J Bone Joint Surg Br. 1999;  81(2) 281-288
    CrossrefPubMedGoogle Scholar
  • 45 Beck M, Kalhor M, Leunig M, Ganz R. Hip morphology influences the pattern of damage to the acetabular cartilage: femoroacetabular impingement as a cause of early osteoarthritis of the hip.  J Bone Joint Surg Br. 2005;  87(7) 1012-1018
    CrossrefPubMedGoogle Scholar
  • 46 Tanzer M, Noiseux N. Osseous abnormalities and early osteoarthritis: the role of hip impingement.  Clin Orthop Relat Res. 2004;  (429) 170-177
    PubMedGoogle Scholar
  • 47 Clohisy J C, Nunley R M, Otto R J, Schoenecker P L. The frog-leg lateral radiograph accurately visualized hip cam impingement abnormalities.  Clin Orthop Relat Res. 2007;  462 115-121
    CrossrefPubMedGoogle Scholar
  • 48 Meyer D C, Beck M, Ellis T, Ganz R, Leunig M. Comparison of six radiographic projections to assess femoral head/neck asphericity.  Clin Orthop Relat Res. 2006;  445 181-185
    PubMedGoogle Scholar
  • 49 Beall D P, Sweet C F, Martin H D et al.. Imaging findings of femoroacetabular impingement syndrome.  Skeletal Radiol. 2005;  34(11) 691-701
    CrossrefPubMedGoogle Scholar
  • 50 Blankenbaker D G, Tuite M J. The painful hip: new concepts.  Skeletal Radiol. 2006;  35(6) 352-370
    CrossrefPubMedGoogle Scholar
  • 51 Pitt M J, Graham A R, Shipman J H, Birkby W. Herniation pit of the femoral neck.  AJR Am J Roentgenol. 1982;  138(6) 1115-1121
    PubMedGoogle Scholar
  • 52 Leunig M, Beck M, Kalhor M et al.. Fibrocystic changes at anterosuperior femoral neck: prevalence in hips with femoroacetabular impingement.  Radiology. 2005;  236(1) 237-246
    CrossrefPubMedGoogle Scholar
  • 53 Kassarjian A, Yoon L S, Belzile E et al.. Triad of MR arthrographic findings in patients with cam-type femoroacetabular impingement.  Radiology. 2005;  236(2) 588-592
    CrossrefPubMedGoogle Scholar
  • 54 Notzli H P, Wyss T F, Stoecklin C H et al.. The contour of the femoral head-neck junction as a predictor for the risk of anterior impingement.  J Bone Joint Surg Br. 2002;  84(4) 556-560
    CrossrefPubMedGoogle Scholar
  • 55 Davis K, Cabay M, Blankenbaker D, Mukerjhee R. The femoro-acetabular impingement alpha angle: how reliable is it? Presented at the 30th Annual Meeting of the Society of Skeletal Radiology, Orlando, FL.  Skeletal Radiol. 2007;  36 357-358
    PubMedGoogle Scholar
  • 56 Crawford J R, Villar R N. Current concepts in the management of femoroacetabular impingement.  J Bone Joint Surg Br. 2005;  87(11) 1459-1462
    PubMedGoogle Scholar
  • 57 Murphy S, Tannast M, Kim Y J, Buly R, Millis M B. Debridement of the adult hip for femoroacetabular impingement: indications and preliminary clinical results.  Clin Orthop Relat Res. 2004;  (429) 178-181
    PubMedGoogle Scholar
  • 58 Siebenrock K A, Schoeniger R, Ganz R. Anterior femoro-acetabular impingement due to acetabular retroversion. Treatment with periacetabular osteotomy.  J Bone Joint Surg Am. 2003;  85-A(2) 278-286
    PubMedGoogle Scholar
  • 59 Mardones R M, Gonzalez C, Chen Q et al.. Surgical treatment of femoroacetabular impingement: evaluation of the effect of the size of the resection. Surgical technique.  J Bone Joint Surg Am. 2006;  88(Suppl 1 Pt 1) 84-91
    CrossrefPubMedGoogle Scholar
  • 60 Espinosa N, Rothenfluh D A, Beck M, Ganz R, Leunig M. Treatment of femoro-acetabular impingement: preliminary results of labral refixation.  J Bone Joint Surg Am. 2006;  88(5) 925-935
    CrossrefPubMedGoogle Scholar
  • 61 Crawford K, Philippon M J, Sekiya J K, Rodkey W G, Steadman J R. Microfracture of the hip in athletes.  Clin Sports Med. 2006;  25(2) 327-335
    CrossrefPubMedGoogle Scholar
  • 62 Buckwalter J A. Articular cartilage injuries.  Clin Orthop Relat Res. 2002;  (402) 21-37
    CrossrefPubMedGoogle Scholar
  • 63 Ateshian G A, Lai W M, Zhu W B, Mow V C. An asymptotic solution for the contact of two biphasic cartilage layers.  J Biomech. 1994;  27(11) 1347-1360
    CrossrefPubMedGoogle Scholar
  • 64 Mow V C, Ratcliffe A. Structure and function of articular cartilage and meniscus. In: Mow VC, Hayes WC Basic Orthopedic Biomechanics. 2nd ed. Philadelphia, Pa; Lippincott-Raven 1997: 113-177
    Google Scholar
  • 65 Thompson Jr R C, Oegema Jr T R, Lewis J L, Wallace L. Osteoarthrotic changes after acute transarticular load. An animal model.  J Bone Joint Surg Am. 1991;  73(7) 990-1001
    PubMedGoogle Scholar
  • 66 Hopkinson W J, Mitchell W A, Curl W W. Chondral fractures of the knee. Cause for confusion.  Am J Sports Med. 1985;  13(5) 309-312
    CrossrefPubMedGoogle Scholar
  • 67 Potter H G, Linklater J M, Allen A A, Hannafin J A, Haas S B. Magnetic resonance imaging of articular cartilage in the knee. An evaluation with use of fast-spin-echo imaging.  J Bone Joint Surg Am. 1998;  80(9) 1276-1284
    CrossrefPubMedGoogle Scholar
  • 68 Disler D G, McCauley T R, Wirth C R, Fuchs M D. Detection of knee hyaline cartilage defects using fat-suppressed three-dimensional spoiled gradient-echo MR imaging: comparison with standard MR imaging and correlation with arthroscopy.  AJR Am J Roentgenol. 1995;  165(2) 377-382
    CrossrefPubMedGoogle Scholar
  • 69 Bredella M A, Tirman P F, Peterfy C G et al.. Accuracy of T2-weighted fast spin-echo MR imaging with fat saturation in detecting cartilage defects in the knee: comparison with arthroscopy in 130 patients.  AJR Am J Roentgenol. 1999;  172(4) 1073-1080
    CrossrefPubMedGoogle Scholar
  • 70 Kawahara Y, Uetani M, Nakahara N et al.. Fast spin-echo MR of the articular cartilage in the osteoarthrotic knee. Correlation of MR and arthroscopic findings.  Acta Radiol. 1998;  39(2) 120-125
    PubMedGoogle Scholar
  • 71 Gagliardi J A, Chung E M, Chandnani V P et al.. Detection and staging of chondromalacia patellae: relative efficacies of conventional MR imaging, MR arthrography, and CT arthrography.  AJR Am J Roentgenol. 1994;  163(3) 629-636
    PubMedGoogle Scholar
  • 72 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;  198(1) 209-212
    PubMedGoogle Scholar
  • 73 Disler D G, McCauley T R, Kelman C G et al.. Fat-suppressed three-dimensional spoiled gradient-echo MR imaging of hyaline cartilage defects in the knee: comparison with standard MR imaging and arthroscopy.  AJR Am J Roentgenol. 1996;  167(1) 127-132
    CrossrefPubMedGoogle Scholar
  • 74 Burstein D, Gray M. New MRI techniques for imaging cartilage.  J Bone Joint Surg Am. 2003;  85-A(Suppl 2) 70-77
    PubMedGoogle Scholar
  • 75 Burstein D, Gray M L. Is MRI fulfilling its promise for molecular imaging of cartilage in arthritis?.  Osteoarthritis Cartilage. 2006;  14(11) 1087-1090
    CrossrefPubMedGoogle Scholar
  • 76 Wheaton A J, Casey F L, Gougoutas A J et al.. Correlation of T1rho with fixed charge density in cartilage.  J Magn Reson Imaging. 2004;  20(3) 519-525
    CrossrefPubMedGoogle Scholar
  • 77 Regatte R R, Akella S V, Lonner J H, Kneeland J B, Reddy R. T1rho relaxation mapping in human osteoarthritis (OA) cartilage: comparison of T1rho with T2.  J Magn Reson Imaging. 2006;  23(4) 547-553
    CrossrefPubMedGoogle Scholar
  • 78 Mosher T J, Dardzinski B J, Smith M B. Human articular cartilage: influence of aging and early symptomatic degeneration on the spatial variation of T2—preliminary findings at 3 T.  Radiology. 2000;  214(1) 259-266
    CrossrefPubMedGoogle Scholar
  • 79 Mosher T J, Dardzinski B J. Cartilage MRI T2 relaxation time mapping: overview and applications.  Semin Musculoskelet Radiol. 2004;  8(4) 355-368
    Article in Thieme ConnectPubMedGoogle Scholar
  • 80 Watanabe A, Wada Y, Obata T et al.. Delayed gadolinium-enhanced MR to determine glycosaminoglycan concentration in reparative cartilage after autologous chondrocyte implantation: preliminary results.  Radiology. 2006;  239(1) 201-208
    CrossrefPubMedGoogle Scholar
  • 81 Bashir A, Gray M L, Hartke J, Burstein D. Nondestructive imaging of human cartilage glycosaminoglycan concentration by MRI.  Magn Reson Med. 1999;  41(5) 857-865
    CrossrefPubMedGoogle Scholar
  • 82 Burstein D, Velyvis J, Scott K T et al.. Protocol issues for delayed Gd(DTPA)(2-)-enhanced MRI (dGEMRIC) for clinical evaluation of articular cartilage.  Magn Reson Med. 2001;  45(1) 36-41
    CrossrefPubMedGoogle Scholar
  • 83 Tiderius C J, Olsson L E, de Verdier H et al.. Gd-DTPA2)-enhanced MRI of femoral knee cartilage: a dose-response study in healthy volunteers.  Magn Reson Med. 2001;  46(6) 1067-1071
    CrossrefPubMedGoogle Scholar
  • 84 Bashir A, Gray M L, Boutin R D, Burstein D. Glycosaminoglycan in articular cartilage: in vivo assessment with delayed Gd(DTPA)(2-)-enhanced MR imaging.  Radiology. 1997;  205(2) 551-558
    CrossrefPubMedGoogle Scholar
  • 85 Johannessen W, Auerbach J D, Wheaton A J et al.. Assessment of human disc degeneration and proteoglycan content using T1rho-weighted magnetic resonance imaging.  Spine. 2006;  31(11) 1253-1257
    CrossrefPubMedGoogle Scholar
  • 86 Wheaton A J, Borthakur A, Corbo M, Charagundla S R, Reddy R. Method for reduced SAR T1rho-weighted MRI.  Magn Reson Med. 2004;  51(6) 1096-1102
    CrossrefPubMedGoogle Scholar
  • 87 Duvvuri U, Kudchodkar S, Reddy R, Leigh J S. T1(rho) relaxation can assess longitudinal proteoglycan loss from articular cartilage in vitro.  Osteoarthritis Cartilage. 2002;  10(11) 838-844
    CrossrefPubMedGoogle Scholar
  • 88 Duvvuri U, Reddy R, Patel S D et al.. T1rho-relaxation in articular cartilage: effects of enzymatic degradation.  Magn Reson Med. 1997;  38(6) 863-867
    CrossrefPubMedGoogle Scholar
  • 89 Duvvuri U, Charagundla S R, Kudchodkar S B et al.. Human knee: in vivo T1(rho)-weighted MR imaging at 1.5 T—preliminary experience.  Radiology. 2001;  220(3) 822-826
    CrossrefPubMedGoogle Scholar
  • 90 Menezes N M, Gray M L, Hartke J R, Burstein D. T2 and T1rho MRI in articular cartilage systems.  Magn Reson Med. 2004;  51(3) 503-509
    CrossrefPubMedGoogle Scholar
  • 91 Goodwin D W, Zhu H, Dunn J F. In vitro MR imaging of hyaline cartilage: correlation with scanning electron microscopy.  AJR Am J Roentgenol. 2000;  174(2) 405-409
    PubMedGoogle Scholar
  • 92 Xia Y, Moody J B, Burton-Wurster N, Lust G. Quantitative in situ correlation between microscopic MRI and polarized light microscopy studies of articular cartilage.  Osteoarthritis Cartilage. 2001;  9(5) 393-406
    PubMedGoogle Scholar
  • 93 Xia Y, Moody J B, Alhadlaq H. Orientational dependence of T2 relaxation in articular cartilage: a microscopic MRI (microMRI) study.  Magn Reson Med. 2002;  48(3) 460-469
    CrossrefPubMedGoogle Scholar
  • 94 White L M, Sussman M S, Hurtig M et al.. Cartilage T2 assessment: differentiation of normal hyaline cartilage and reparative tissue after arthroscopic cartilage repair in equine subjects.  Radiology. 2006;  241(2) 407-414
    CrossrefPubMedGoogle Scholar
  • 95 Erickson S J, Prost R W, Timins M E. The “magic angle” effect: background physics and clinical relevance.  Radiology. 1993;  188(1) 23-25
    CrossrefPubMedGoogle Scholar
  • 96 Dunn T C, Lu Y, Jin H, Ries M D, Majumdar S. T2 relaxation time of cartilage at MR imaging: comparison with severity of knee osteoarthritis.  Radiology. 2004;  232(2) 592-598
    CrossrefPubMedGoogle Scholar
  • 97 Ayral X, Dougados M, Listrat V et al.. Arthroscopic evaluation of chondropathy in osteoarthritis of the knee.  J Rheumatol. 1996;  23(4) 698-706
    PubMedGoogle Scholar
  • 98 Brittberg M, Winalski C S. Evaluation of cartilage injuries and repair.  J Bone Joint Surg Am. 2003;  85-A(Suppl 2) 58-69
    PubMedGoogle Scholar
  • 99 Noyes F R, Stabler C L. A system for grading articular cartilage lesions at arthroscopy.  Am J Sports Med. 1989;  17(4) 505-513
    CrossrefPubMedGoogle Scholar
  • 100 Bauer M, Jackson R W. Chondral lesions of the femoral condyles: a system of arthroscopic classification.  Arthroscopy. 1988;  4(2) 97-102
    CrossrefPubMedGoogle Scholar
  • 101 Winalski C S, Gupta K B. Magnetic resonance imaging of focal articular cartilage lesions.  Top Magn Reson Imaging. 2003;  14(2) 131-144
    CrossrefPubMedGoogle Scholar
  • 102 Minas T. A practical algorithm for cartilage repair.  Oper Tech Sports Med. 2000;  8(2) 141-143
    PubMedGoogle Scholar
  • 103 Azer N M, Winalski C S, Minas T. MR imaging for surgical planning and postoperative assessment in early osteoarthritis.  Radiol Clin North Am. 2004;  42(1) 43-60
    CrossrefPubMedGoogle Scholar
  • 104 Lee K Y, Dunn T C, Steinbach L S et al.. Computer-aided quantification of focal cartilage lesions of osteoarthritic knee using MRI.  Magn Reson Imaging. 2004;  22(8) 1105-1115
    CrossrefPubMedGoogle Scholar
  • 105 Beaule P E, Zaragoza E, Copelan N. Magnetic resonance imaging with gadolinium arthrography to assess acetabular cartilage delamination. A report of four cases.  J Bone Joint Surg Am. 2004;  86-A(10) 2294-2298
    PubMedGoogle Scholar
  • 106 Kendell S D, Helms C A, Rampton J W, Garrett W E, Higgins L D. MRI appearance of chondral delamination injuries of the knee.  AJR Am J Roentgenol. 2005;  184(5) 1486-1489
    PubMedGoogle Scholar
  • 107 Rubin D A, Harner C D, Costello J M. Treatable chondral injuries in the knee: frequency of associated focal subchondral edema.  AJR Am J Roentgenol. 2000;  174(4) 1099-1106
    PubMedGoogle Scholar
  • 108 Felson D T, McLaughlin S, Goggins J et al.. Bone marrow edema and its relation to progression of knee osteoarthritis.  Ann Intern Med. 2003;  139(5 Pt 1) 330-336
    CrossrefPubMedGoogle Scholar
  • 109 Hunter D J, Zhang Y, Niu J et al.. Increase in bone marrow lesions associated with cartilage loss: a longitudinal magnetic resonance imaging study of knee osteoarthritis.  Arthritis Rheum. 2006;  54(5) 1529-1535
    CrossrefPubMedGoogle Scholar
  • 110 Carrino J A, Blum J, Parellada J A, Schweitzer M E, Morrison W B. MRI of bone marrow edema-like signal in the pathogenesis of subchondral cysts.  Osteoarthritis Cartilage. 2006;  14(10) 1081-1085
    CrossrefPubMedGoogle Scholar
  • 111 Moser T, Dosch J C, Moussaoui A, Dietemann J L. Wrist ligament tears: evaluation of MRI and combined MDCT and MR arthrography.  AJR Am J Roentgenol. 2007;  188(5) 1278-1286
    CrossrefPubMedGoogle Scholar
  • 112 Vande Berg B C, Lecouvet F E, Poilvache P et al.. Assessment of knee cartilage in cadavers with dual-detector spiral CT arthrography and MR imaging.  Radiology. 2002;  222(2) 430-436
    CrossrefPubMedGoogle Scholar
  • 113 El-Khoury G Y, Alliman K J, Lundberg H J et al.. Cartilage thickness in cadaveric ankles: measurement with double-contrast multi-detector row CT arthrography versus MR imaging.  Radiology. 2004;  233(3) 768-773
    CrossrefPubMedGoogle Scholar
  • 114 Waldt S, Bruegel M, Ganter K et al.. Comparison of multislice CT arthrography and MR arthrography for the detection of articular cartilage lesions of the elbow.  Eur Radiol. 2005;  15(4) 784-791
    CrossrefPubMedGoogle Scholar
  • 115 Anderson A E, Ellis B J, Peters C L, Weiss J A. Cartilage thickness: factors influencing multidetector CT measurements in a phantom study.  Radiology. 2008;  246(1) 133-141
    PubMedGoogle Scholar
  • 116 Vande Berg B C, Lecouvet F E, Maldague B, Malghem J. MR appearance of cartilage defects of the knee: preliminary results of a spiral CT arthrography-guided analysis.  Eur Radiol. 2004;  14(2) 208-214
    CrossrefPubMedGoogle Scholar
  • 117 Schmid M R, Pfirrmann C W, Hodler J, Vienne P, Zanetti M. Cartilage lesions in the ankle joint: comparison of MR arthrography and CT arthrography.  Skeletal Radiol. 2003;  32(5) 259-265
    CrossrefPubMedGoogle Scholar
  • 118 Nishii T, Tanaka H, Nakanishi K et al.. Fat-suppressed 3D spoiled gradient-echo MRI and MDCT arthrography of articular cartilage in patients with hip dysplasia.  AJR Am J Roentgenol. 2005;  185(2) 379-385
    CrossrefPubMedGoogle Scholar
  • 119 Nishii T, Tanaka H, Sugano N et al.. Disorders of acetabular labrum and articular cartilage in hip dysplasia: evaluation using isotropic high-resolutional CT arthrography with sequential radial reformation.  Osteoarthritis Cartilage. 2007;  15(3) 251-257
    CrossrefPubMedGoogle Scholar
  • 120 Ferkel R D. Osteochondral lesions of the talus. In: Ferkel RD, Whipple TL, Brust SE Arthroscopic surgery: The Foot and Ankle. Philadelphia; Lippincott Williams and Wilkins 1996: 145-170
    Google Scholar
  • 121 Stone J W, Guhl J F. Diagnostic arthroscopy of the ankle. In: Andrew JR, Timmerman LA Diagnostic and Operative Arthroscopy. Philadelphia, Pa; WB Saunders 1997: 423-456
    Google Scholar
  • 122 Canale S T, Belding R H. Osteochondral lesions of the talus.  J Bone Joint Surg Am. 1980;  62(1) 97-102
    PubMedGoogle Scholar
  • 123 Bosien W R, Staples O S, Russell S W. Residual disability following acute ankle sprains.  J Bone Joint Surg Am. 1955;  37-A(6) 1237-1243
    PubMedGoogle Scholar
  • 124 Chen D S, Wertheimer S J. Centrally located osteochondral fracture of the talus.  J Foot Surg. 1992;  31(2) 134-140
    PubMedGoogle Scholar
  • 125 Labovitz J M, Schweitzer M E. Occult osseous injuries after ankle sprains: incidence, location, pattern, and age.  Foot Ankle Int. 1998;  19(10) 661-667
    PubMedGoogle Scholar
  • 126 Sijbrandij E S, van Gils A P, Louwerens J W, de Lange E E. Posttraumatic subchondral bone contusions and fractures of the talotibial joint: occurrence of “kissing” lesions.  AJR Am J Roentgenol. 2000;  175(6) 1707-1710
    PubMedGoogle Scholar
  • 127 Baums M H, Heidrich G, Schultz W et al.. Autologous chondrocyte transplantation for treating cartilage defects of the talus.  J Bone Joint Surg Am. 2006;  88(2) 303-308
    CrossrefPubMedGoogle Scholar
  • 128 Gobbi A, Francisco R A, Lubowitz J H, Allegra F, Canata G. Osteochondral lesions of the talus: randomized controlled trial comparing chondroplasty, microfracture, and osteochondral autograft transplantation.  Arthroscopy. 2006;  22(10) 1085-1092
    CrossrefPubMedGoogle Scholar
  • 129 Hangody L, Fules P. Autologous osteochondral mosaicplasty for the treatment of full-thickness defects of weight-bearing joints: ten years of experimental and clinical experience.  J Bone Joint Surg Am. 2003;  85-A(Suppl 2) 25-32
    PubMedGoogle Scholar
  • 130 Lahm A, Erggelet C, Steinwachs M, Reichelt A. Arthroscopic management of osteochondral lesions of the talus: results of drilling and usefulness of magnetic resonance imaging before and after treatment.  Arthroscopy. 2000;  16(3) 299-304
    PubMedGoogle Scholar
  • 131 Nelson S C, Haycock D M. Arthroscopy-assisted retrograde drilling of osteochondral lesions of the talar dome.  J Am Podiatr Med Assoc. 2005;  95(1) 91-96
    PubMedGoogle Scholar
  • 132 Berndt A L, Harty M. Transchondral fractures (osteochondritis dissecans) of the talus.  J Bone Joint Surg Am. 1959;  41A 998-1020
    PubMedGoogle Scholar
  • 133 Anderson I F, Crichton K J, Grattan-Smith T, Cooper R A, Brazier D. Osteochondral fractures of the dome of the talus.  J Bone Joint Surg Am. 1989;  71(8) 1143-1152
    PubMedGoogle Scholar
  • 134 Hepple S, Winson I G, Glew D. Osteochondral lesions of the talus: a revised classification.  Foot Ankle Int. 1999;  20(12) 789-793
    CrossrefPubMedGoogle Scholar
  • 135 Mintz D N, Tashjian G S, Connell D A et al.. Osteochondral lesions of the talus: a new magnetic resonance grading system with arthroscopic correlation.  Arthroscopy. 2003;  19(4) 353-359
    CrossrefPubMedGoogle Scholar
  • 136 Zinman C, Wolfson N, Reis N D. Osteochondritis dissecans of the dome of the talus. Computed tomography scanning in diagnosis and follow-up.  J Bone Joint Surg Am. 1988;  70(7) 1017-1019
    PubMedGoogle Scholar
  • 137 Cheng M S, Ferkel R D, Applegate G R. Osteochondral lesions of the talus: a radiologic and surgical comparison. Presented at the annual meeting of the American Academy of Orthopaedic Surgeons New Orleans 1995
    Google Scholar
  • 138 Beltran J, Shankman S. MR imaging of bone lesions of the ankle and foot.  Magn Reson Imaging Clin N Am. 2001;  9(3) 553-566
    PubMedGoogle Scholar
  • 139 Dipaola J D, Nelson D W, Colville M R. Characterizing osteochondral lesions by magnetic resonance imaging.  Arthroscopy. 1991;  7(1) 101-104
    CrossrefPubMedGoogle Scholar
  • 140 De Smet A A, Ilahi O A, Graf B K. Reassessment of the MR criteria for stability of osteochondritis dissecans in the knee and ankle.  Skeletal Radiol. 1996;  25(2) 159-163
    CrossrefPubMedGoogle Scholar
  • 141 O'Connor M A, Palaniappan M, Khan N, Bruce C E. Osteochondritis dissecans of the knee in children. A comparison of MRI and arthroscopic findings.  J Bone Joint Surg Br. 2002;  84(2) 258-262
    CrossrefPubMedGoogle Scholar
  • 142 Kijowski R, De Smet A, Blankenbaker D. Magnetic resonance imaging (MRI) criteria for stability and instability in patients with juvenile and adult osteochondritis dissecans (OCD) of the femoral condyles. Paper presented at the 92nd Scientific Assembly and Annual Meeting of the Radiological Society of North America, Chicago 2006
    Google Scholar
  • 143 Kramer J, Stiglbauer R, Engel A, Prayer L, Imhof H. MR contrast arthrography (MRA) in osteochondrosis dissecans.  J Comput Assist Tomogr. 1992;  16(2) 254-260
    CrossrefPubMedGoogle Scholar
  • 144 Miller T T, Bucchieri J S, Joshi A, Staron R B, Feldman F. Pseudodefect of the talar dome: an anatomic pitfall of ankle MR imaging.  Radiology. 1997;  203(3) 857-858
    PubMedGoogle Scholar
  • 145 Rosenberg Z S, Mellado J. Central pseudodefect of the talus: a potential ankle MR interpretation pitfall.  J Comput Assist Tomogr. 1999;  23(5) 718-720
    CrossrefPubMedGoogle Scholar

Carl S WinalskiM.D. 

Imaging Institute, Crile Bldg., A-21, Cleveland Clinic

9500 Euclid Ave., Cleveland, OH 44195

Email: winalsc@ccf.org

      >