(Fig 5-A.09) Summary of MRI Findings in Cartilage Damage

https://youtu.be/RxgPEyQpa1Q

https://youtu.be/YyQWPfrVkxI

 

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📌MRI Findings in Cartilage Damage

 

✅ Depth of Cartilage Damage

Modern surgical and MRI grading systems categorize the depth of cartilage damage into four major categories:

1. Cartilage Softening: The lowest category.
2. Less than 50% Damage: Damage involving less than 50% of the cartilage thickness.
3. Greater than 50% Damage: Damage involving greater than 50% of the cartilage thickness.
4. Full-Thickness Damage: Complete damage through the cartilage thickness. 

 

✅ Cartilage Defect and Signal Intensity Changes

• In addition to localized loss of cartilage height, signal intensity changes may indicate composition changes or morphologic lesions not visible in standard clinical MRI sequences. 
• Both increases and decreases in signal intensity on T2-weighted MR images can be seen with cartilage degeneration at arthroscopy, potentially progressing to morphologic defects on subsequent MRI.

 

✅  Hyperintense Cartilage Lesions

• Hyperintense lesions in morphologically normal cartilage have a 94% positive predictive value for detecting degeneration at knee arthroscopy. 
• These lesions are typically ill-defined, located in abnormally expanded cartilage, and correlate with softening areas at arthroscopy. 
• They are due to increased water content, decreased macromolecular content, and disruption of the collagen matrix ultrastructure. 

 

✅ Hypointense Cartilage Lesions

• Hypointense lesions in morphologically normal cartilage have a 64% positive predictive value for detecting degeneration at knee arthroscopy. 
• These lesions are often in the middle zone, appearing linear or globular, and are common areas of fibrillation or fissuring at arthroscopy. 
• They are due to factors such as disruption of tissue anisotropy, magnetization transfer effects, or mature fibrocartilage. 

 

Reference

RadioGraphics. (2022). Depth of cartilage damage and grading systems. RadioGraphics, 42, 1457–1473

 

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