MRI Identifies High Prevalence of Abnormalities in Osteoarthritis Patients

A new study’s findings revealed that magnetic resonance imaging (MRI) detected a high incidence of abnormalities associated with knee osteoarthritis in middle-aged and elderly patients that had no evidence of knee osteoarthritis in X-ray images.

Ali Guermazi, MD, PhD, a professor of radiology at Boston University School of Medicine (BUSM; Boston, MA, USA) and chief of musculoskeletal imaging at Boston Medical Center (BMC), led this study in collaboration with researchers from Lund University (Sweden), Brigham and Women’s Hospital (Boston), and Klinikum Augsburg (Germany). The findings were published online August 2012 in the British Medical Journal (BMJ).

Osteoarthritis, the most typical form of arthritis, is characterized by a degeneration of cartilage and the underlying bone and other soft tissues in the joints, leading to pain and stiffness. It is responsible for a considerable portion of primary care visit and hospitalizations and has a large financial impact on healthcare. With the aging population, it is predicted that the prevalence of osteoarthritis will continue to increase.

Earlier imaging research has shown that only half of those with knee pain will have X-ray findings of osteoarthritis. This study looked at how to further evaluate a patient’s knee pain if X-rays do not show evidence of osteoarthritis. It also examined whether MRI, in these cases, is of clinical value.

This observational study looked at the prevalence of MRI-detected abnormalities in a group of adults over the age of 50 who had no signs of knee osteoarthritis in X-ray images. The researchers looked at right knee MRI scans of 710 ambulatory patients from the Framingham Osteoarthritis Study. Further analysis was performed on groups by age, gender, body mass index and the presence or absence of knee pain.

The study’s findings revealed demonstrates that approximately 90% of the knees that showed no signs of osteoarthritis using X-ray showed clear signs of osteoarthritis using MRI. Moreover, MRI abnormalities were highly prevalent even in persons whose knees were not painful, suggesting that MRI was not a useful diagnostic test in this age group to evaluate knee pain.

“These data demonstrate a very high prevalence of MRI-detected osteoarthritis features in knees with no X-ray evidence of the disease,” said Dr. Guermazi. “While the MRI could be detecting early-stage osteoarthritis, further research is needed to determine what proportion of these individuals are diagnosed with knee osteoarthritis later in life.”

The researchers noted that MRI would be too costly to perform as a routine imaging investigation.

Related Links:
Boston University School of Medicine
Lund University
Brigham and Women’s Hospital