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Review
. 2023 Jan 28;13(2):363.
doi: 10.3390/life13020363.

Imaging of Cartilage and Chondral Defects: An Overview

Neha Nischal  1   2 , Karthikeyan P Iyengar  3 , Deepak Herlekar  4 , Rajesh Botchu  1
Affiliations
Review

Imaging of Cartilage and Chondral Defects: An Overview

Neha Nischal et al. Life (Basel). .

Abstract

A healthy articular cartilage is paramount to joint function. Cartilage defects, whether acute or chronic, are a significant source of morbidity. This review summarizes various imaging modalities used for cartilage assessment. While radiographs are insensitive, they are still widely used to indirectly assess cartilage. Ultrasound has shown promise in the detection of cartilage defects, but its efficacy is limited in many joints due to inadequate visualization. CT arthrography has the potential to assess internal derangements of joints along with cartilage, especially in patients with contraindications to MRI. MRI remains the favored imaging modality to assess cartilage. The conventional imaging techniques are able to assess cartilage abnormalities when cartilage is already damaged. The newer imaging techniques are thus targeted at detecting biochemical and structural changes in cartilage before an actual visible irreversible loss. These include, but are not limited to, T2 and T2* mapping, dGEMRI, T1ρ imaging, gagCEST imaging, sodium MRI and integrated PET with MRI. A brief discussion of the advances in the surgical management of cartilage defects and post-operative imaging assessment is also included.

Keywords: MRI; cartilage imaging; chondral defects; osteoarthritis.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Histology image showing the different layers of the articular cartilage.
Figure 2
Figure 2
Anteroposterior radiograph of the left knee showing Kellgren–Lawrence grade 0, 1, 2, 3, and 4 OA.
Figure 3
Figure 3
Ultrasound. Axial image showing the normal cartilage of the trochlea (a), thinning of the articular cartilage of the medial facet of the trochlea (b) and cortical irregularity (c).
Figure 4
Figure 4
CT arthrogram of the knee coronal (a) and axial (b) planes showing normal cartilage (small arrow) and focus of partial thickness cartilage defect (long arrow).
Figure 5
Figure 5
Weight-bearing CT, coronal (a) and sagittal (b) planes of the ankle.
Figure 6
Figure 6
Coronal MRI- T1 (a), PD (b), PDFS (c), STIR (d), T2 med volume (e) of the right knee.
Figure 7
Figure 7
PET–MRI of the right knee of a 41-year-old female having Kellgren–Lawrence grade 2 OA, showing great signal intensity changes (arrow) in the lateral posterior femur on a T2 SPIR image (a) with a high tracer uptake on the sagittal PET image (arrow), (b) also spatially correlated on the fused PET–MRI image (c).
Figure 8
Figure 8
Schematic of the Outerbridge classification of chondral pathologies.
Figure 9
Figure 9
Sagittal PD (a) and PDFS images (b) showing chondropathy of the articular cartilage of the patella (arrow).
Figure 10
Figure 10
Axial PDFS images (a) showing a full-thickness cartilage defect of the patella (arrow) and (b) full-thickness cartilage defects of the medial tibiofemoral joint (arrow).
Figure 11
Figure 11
PDFS sagittal (a), coronal (b) and sagittal (c) images of the knee showing a full-thickness chondral defect of the medial femoral condyle (arrow) with a displaced chondral fragment in the anterior recess (arrow).
Figure 12
Figure 12
PDFS sagittal (a) and lateral radiographs of the knee (b) showing unstable OCD of the lateral femoral condyle (arrow).
Figure 13
Figure 13
Sagittal PD (a), PDFS (b) and SEPCT images (c) showing post-OCD fixation changes with increased uptake (arrow).
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