Radiographic Findings of Osteoarthritis versus Arthroscopic Findings of Articular Cartilage Degeneration in the Tibiofemoral Joint

Published Online:Jun 1 2006https://doi.org/10.1148/radiol.2393050584

Abstract

Purpose: To retrospectively correlate radiographic findings of osteoarthritis of the tibiofemoral joint with arthroscopic findings of articular cartilage degeneration within the tibiofemoral joint in patients with chronic knee pain.

Materials and Methods: The study was performed in compliance with HIPAA regulations. Approval from an institutional review board and a waiver of informed consent were obtained. The study group consisted of 125 patients with osteoarthritis of the tibiofemoral joint (66 men, 59 women; age range, 35–77 years; average age, 52 years) and 25 patients of similar age (14 men, 11 women; age range, 36–69 years; average age, 50 years) with no osteoarthritis of the tibiofemoral joint. All patients underwent standing anteroposterior radiography of the knee prior to arthroscopic knee surgery. Each articular surface of the tibiofemoral joint was graded at arthroscopy. Two radiologists retrospectively reviewed the knee radiographs to determine the presence of marginal osteophytes, joint space narrowing, subchondral sclerosis, and subchondral cysts. The sensitivity and specificity of the radiographic features of osteoarthritis for the detection of articular cartilage degeneration within the medial and lateral compartments of the tibiofemoral joint were determined.

Results: The sensitivity of marginal osteophytes, joint space narrowing, subchondral sclerosis, and subchondral cysts for the detection of articular cartilage degeneration was 67%, 46%, 16%, and 10%, respectively, for the medial compartment and 49%, 7%, 6%, and 3%, respectively, for the lateral compartment. The specificity of marginal osteophytes, joint space narrowing, subchondral sclerosis, and subchondral cysts for the detection of articular cartilage degeneration was 73%, 95%, 100%, and 100%, respectively, for the medial compartment and 81%, 100%, 100%, and 100%, respectively, for the lateral compartment.

Conclusion: Marginal osteophytes were the most sensitive radiographic feature for the detection of osteoarthritis of the tibiofemoral joint. Joint space narrowing, subchondral sclerosis, and subchondral cysts were less sensitive radiographic features of osteoarthritis and rarely occurred in the absence of associated osteophyte formation.

References

1 Lawrence RC, Hochberg MC, Kelsey JL, et al. Estimates of the prevalence of selected arthritic and musculoskeletal diseases in the United States. J Rheumatol 1989; 16: 427–431. Medline, Google Scholar
2 Spector TD, Hart DJ. How serious is knee osteoarthritis? Ann Rheum Dis 1992;51:1105–1106. Crossref, Medline, Google Scholar
3 Spector TD, Hart DJ, Byrne J, Harris PA, Dacre JE, Doyle DV. Definition of osteoarthritis of the knee for epidemiology studies. Ann Rheum Dis 1993;52:790–794. Crossref, Medline, Google Scholar
4 Lysholm J, Hamberg P, Gillquist J. The correlation between osteoarthritis as seen on radiographs and on arthroscopy. Arthroscopy 1987;3:161–165. Crossref, Medline, Google Scholar
5 Fife RS, Brandt KD, Braunstein EM, et al. Relationship between arthroscopic evidence of cartilage damage and radiographic evidence of joint space narrowing in early osteoarthritis of the knee. Arthritis Rheum 1991;34:377–382. Crossref, Medline, Google Scholar
6 Boegard T, Rudling O, Petersson IF, Jonsson K. Correlation between radiographically diagnosed osteophytes and magnetic resonance detected cartilage defects in the tibiofemoral joint. Ann Rheum Dis 1998;57:401–407. Crossref, Medline, Google Scholar
7 Boegard T, Rudling O, Petersson I, et al. Postero-anterior radiogram of the knee in weightbearing and semiflexion: comparison with MR imaging. Acta Radiol 1997;38:1063–1070. Medline, Google Scholar
8 Brandt KD, Fife RS, Braunstein EM, Katz B. Radiographic grading of the severity of knee osteoarthritis: relation of the Kellgren and Lawrence grade to a grade based on joint space narrowing, and correlation with arthroscopic evidence of articular cartilage degeneration. Arthritis Rheum 1991;34:1381–1386. Crossref, Medline, Google Scholar
9 Blackburn WD Jr, Bernreuter WK, Rominger M, Loose LL. Arthroscopic evaluation of knee articular cartilage: a comparison with plain radiographs and magnetic resonance imaging. J Rheumatol 1994;21:675–679. Medline, Google Scholar
10 Wada M, Baba H, Imura S, Morita A, Kusaka Y. Relationship between radiographic classification and arthroscopic findings of articular cartilage lesions in osteoarthritis of the knee. Clin Exp Rheumatol 1998;16:15–20. Medline, Google Scholar
11 Noyes FR, Stabler CL. A system for grading articular cartilage lesions at arthroscopy. Am J Sports Med 1989;17:505–513. Crossref, Medline, Google Scholar
12 Altman RD, Hochberg M, Murphy WA Jr, Wolfe F, Lequesne M. Atlas of individual radiographic features in osteoarthritis. Osteoarthritis Cartilage 1995;3(suppl A):3–70. Medline, Google Scholar
13 Kellgren J, Lawrence J. Radiologic assessment of osteoarthritis. Ann Rheum Dis 1957;16:494–501. Crossref, Medline, Google Scholar
14 Danielsson L, Hernborg J. Clinical and roentgenologic study of the knee joints with osteophytes. Clin Orthop Relat Res 1970;69:302–311. Crossref, Medline, Google Scholar
15 Hernborg J, Nilsson B. The relationship between osteophytes in the knee joint, osteoarthritis, and aging. Acta Orthop Scand 1973;44:69–74. Crossref, Medline, Google Scholar
16 Wood P. Osteoarthrosis in the community. Clin Rheum Dis 1976;2:495–507. Crossref, Google Scholar
17 Outerbridge RE. The etiology of chondromalacia patellae. J Bone Joint Surg Br 1961;43-B:752–757. Crossref, Medline, Google Scholar

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Published in print: June 2006

Vol. 239, No. 3

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