Beattie K A, Boulos P, Pui M, O'Neill J, Inglis D, Webber C E, Adachi J D
Department of Medical Sciences, McMaster University, Hamilton, ON, Canada.
Osteoarthritis Cartilage. 2005 Mar;13(3):181-6. doi: 10.1016/j.joca.2004.11.001.
To estimate the prevalence of bone and soft tissue abnormalities in asymptomatic knees using peripheral magnetic resonance imaging (pMRI) and to examine the relationship between these abnormalities and Kellgren-Lawrence (K-L) graded X-rays.
Volunteers (20-68 years) with no history of knee pain, injury or bone or joint disease were recruited. Individuals underwent a single MRI scan and radiograph of their non-dominant knee. pMR images were acquired in sagittal plane using a 3-D gradient-echo protocol. Two radiologists graded the presence and severity of cartilage degeneration, osteophytosis, meniscal and ligamentous abnormalities, bone marrow edema and subchondral cysts. X-rays were acquired using a fixed-flexion technique and graded using the K-L scale.
Forty-four individuals, mean age (SD) 41.1 (14.2) years, participated. K-L grading of X-rays revealed 29 individuals were grade 0, 12 were grade 1 and 3 were grade 2. Five individuals showed evidence of cartilage lesions, the femoral trochlea, medial femur and patella being those regions most commonly affected. Twelve individuals (27.3%) showed evidence of osteophytosis, nine of whom did not show evidence on X-ray. Forty-three individuals showed evidence of at least one meniscal abnormality while 27 individuals (61.4%) had abnormalities in at least three of the four regions of the knee.
Our results suggest that osteophytes may be more prevalent in this population than radiographic data suggests due to the limitations of two-dimensional imaging. Meniscal degeneration or tears, a risk factor for knee osteoarthritis, are highly prevalent in asymptomatic individuals with the medial anterior and posterior horns being the most commonly affected regions.
利用外周磁共振成像(pMRI)评估无症状膝关节的骨与软组织异常的患病率,并研究这些异常与凯尔格伦-劳伦斯(K-L)分级X线片之间的关系。
招募无膝关节疼痛、损伤或骨与关节疾病史的志愿者(20 - 68岁)。对个体的非优势膝关节进行单次MRI扫描和X线摄影。使用三维梯度回波协议在矢状面采集pMR图像。两名放射科医生对软骨退变、骨赘形成、半月板和韧带异常、骨髓水肿及软骨下囊肿的存在情况和严重程度进行分级。使用固定屈曲技术采集X线片并采用K-L量表进行分级。
44名个体参与研究,平均年龄(标准差)为41.1(14.2)岁。X线片的K-L分级显示,29名个体为0级,12名个体为1级,3名个体为2级。5名个体有软骨损伤的证据,股骨滑车、股骨内侧和髌骨是最常受累的部位。12名个体(27.3%)有骨赘形成的证据,其中9名个体在X线片上无此表现。43名个体有至少一项半月板异常的证据,而27名个体(61.4%)在膝关节四个区域中的至少三个区域存在异常。
我们的结果表明,由于二维成像的局限性,该人群中骨赘的实际患病率可能高于X线片数据显示的情况。半月板退变或撕裂是膝关节骨关节炎的一个危险因素,在无症状个体中非常普遍,其中内侧前后角是最常受累的区域。