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. 2016 Oct;68(10):1410-6.
doi: 10.1002/acr.22888.

Correlations of Medial Joint Space Width on Fixed-Flexed Standing Computed Tomography and Radiographs With Cartilage and Meniscal Morphology on Magnetic Resonance Imaging

N A Segal  1 , E Frick  2 , J Duryea  3 , F Roemer  4 , A Guermazi  4 , M C Nevitt  5 , J C Torner  2 , D T Felson  4 , D D Anderson  2
Affiliations

Correlations of Medial Joint Space Width on Fixed-Flexed Standing Computed Tomography and Radiographs With Cartilage and Meniscal Morphology on Magnetic Resonance Imaging

N A Segal et al. Arthritis Care Res (Hoboken). 2016 Oct.

Abstract

Objective: To assess whether medial tibiofemoral joint space width (JSW) on 3-dimensional (3-D) standing computed tomography (SCT) correlates more closely with magnetic resonance imaging cartilage morphology (CM) and meniscal scores than does radiographic 2-D JSW.

Methods: Participants in the Multicenter Osteoarthritis Study, who had standing fixed-flexion posteroanterior knee radiographs, were recruited. Medial tibiofemoral 3-D JSW on SCT and 2-D JSW on fixed-flexion radiographs were compared with medial tibiofemoral cartilage and meniscal morphology using the Whole-Organ Magnetic Resonance Imaging Score (WORMS). Associations between the area of the articular surface with 3-D JSW <2.5 mm on SCT, radiographic minimal 2-D JSW, and the WORMS-CM and meniscal scores were assessed using Spearman's rho.

Results: For the 19 participants included (33 knees), mean ± SD age was 66.9 ± 5.4 years, body mass index was 29.5 ± 4.4 kg/m(2) , 42.1% of participants were female, and the Kellgren/Lawrence grades were 0 (21.2%), 1 (36.4%), 2 (18.2%), and 3 (24.2%). The articular surface area with 3-D JSW <2.5 mm on SCT correlated with WORMS-CM scores for the central medial tibia (rs = 0.84, P < 0.001), central medial femur (rs = 0.60, P < 0.007), and posterior medial meniscal tear (rs = 0.39, P < 0.026), as did other cut points for 3-D JSW. Correlations with radiographic minimal 2-D JSW were -0.66, -0.52, and -0.40, respectively, differing from SCT only for tibial cartilage (P = 0.001).

Conclusion: Greater surface area with a low JSW, measured by SCT, correlates more strongly with the severity of tibial cartilage lesions, while correlating with medial femoral cartilage and meniscal damage to a similar extent as radiographic minimal JSW. SCT may enable valid stratification of participants in clinical trials, through quickly and inexpensively characterizing osteoarthritis features.

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Figures

FIGURE 1
FIGURE 1
Flow Diagram of Participants Included
FIGURE 2
FIGURE 2
Illustration of 3D JSW measured by SCT (L=lateral, M=medial, P=posterior, A=anterior)
FIGURE 3
FIGURE 3
Joint Space Width Distribution and Whole Organ MRI Score for Cartilage Morphology (WORMS-CM) scores for all included knees (Numbers refer to grades of cartilage morphology using the WORMS-CM grading system)
FIGURE 4
FIGURE 4
ROC Plots of Sensitivity vs. 1-Specificity for Detection of Full Thickness Cartilage Loss on the Central Medial Femur and Tibia: % Joint Area with JSW<2.0mm and <2.5mm on SCT (top and bottom respectively) and radiographic minimum JSW
See this image and copyright information in PMC

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