Fogarty Alexandra E, Chiang Michael C, Douglas Stephanie, Yaeger Lauren H, Ambrosio Fabrisia, Lattermann Christian, Jacobs Cale, Borg-Stein Joanne, Tenforde Adam S
Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Charlestown, Massachusetts, USA.
PM R. 2025 Jan;17(1):96-106. doi: 10.1002/pmrj.13217. Epub 2024 Jul 31.
Intraarticular knee injuries and subsequent posttraumatic arthritis (PTOA) are common in athletes. Unfortunately, PTOA may significantly affect performance and overall function, but this condition remains difficult to characterize. In this review, we provide an overview of imaging modalities used to evaluate PTOA among athletes and physically active individuals following knee injury, with the goal to discuss the strengths and limitations of their application in this population. A literature search was performed to identify clinical studies focusing of knee injuries in athletes and athletic persons, specifically using imaging for diagnosis or monitoring disease progression. A total of 81 articles were identified, and 23 were included for review. Studies on plain radiographs (n = 8) and magnetic resonance imaging (MRI) assessed arthritic burden (n = 13), with MRI able to depict the earliest cartilage changes. Few studies (n = 2) leveraged ultrasound. Challenges persist, particularly regarding standardization and reliability across different radiographic grading systems. Additionally, further research is needed to establish the clinical significance of techniques to assess cartilage composition on MRI, including ultrashort echo-time enhanced T2*, T1rho and T2 imaging. Addressing these challenges through standardized protocols and intensified research efforts will enhance the diagnostic utility of imaging modalities in musculoskeletal medicine and enable high-quality prospective studies.
膝关节内损伤及随后的创伤后骨关节炎（PTOA）在运动员中很常见。不幸的是，PTOA可能会显著影响运动表现和整体功能，但这种情况仍难以确切描述。在本综述中，我们概述了用于评估运动员和身体活跃个体膝关节损伤后PTOA的成像方式，目的是讨论其在该人群中应用的优势和局限性。进行了文献检索，以确定关注运动员和从事体育运动者膝关节损伤的临床研究，特别是使用成像进行疾病诊断或监测疾病进展的研究。共识别出81篇文章，其中23篇纳入综述。关于X线平片（n = 8）和磁共振成像（MRI）的研究评估了关节炎负担（n = 13），MRI能够描绘出最早的软骨变化。利用超声的研究很少（n = 2）。挑战依然存在，尤其是在不同影像学分级系统的标准化和可靠性方面。此外，需要进一步研究以确定MRI上评估软骨成分的技术的临床意义，包括超短回波时间增强T2*、T1rho和T2成像。通过标准化方案和加大研究力度应对这些挑战，将提高成像方式在肌肉骨骼医学中的诊断效用，并推动高质量的前瞻性研究。
