Radiographic vs. MRI vs. arthroscopic assessment and grading of knee osteoarthritis ‐ are we using appropriate imaging?
Abstract Purpose Radiographs and MRI scans are commonly used imaging techniques in the assessment of knee osteoarthritis. However, it currently remains uncertain how good a representation of the actual condition of the knee joint these investigations provide. By comparing them against arthroscopic f...
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Wiley
2022-01-01
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| Series: | Journal of Experimental Orthopaedics |
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| Online Access: | https://doi.org/10.1186/s40634-021-00442-y |
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| author | Samuel Newman Huzefah Ahmed Nader Rehmatullah |
| author_facet | Samuel Newman Huzefah Ahmed Nader Rehmatullah |
| author_sort | Samuel Newman |
| collection | DOAJ |
| description | Abstract Purpose Radiographs and MRI scans are commonly used imaging techniques in the assessment of knee osteoarthritis. However, it currently remains uncertain how good a representation of the actual condition of the knee joint these investigations provide. By comparing them against arthroscopic findings the aim of our study was to conclude how accurate these imaging techniques are at grading knee osteoarthritis. Methods This was a retrospective study looking at knee arthroscopies performed at a tertiary centre over a 5 year period. The Outerbridge grade given at arthroscopy was correlated with pre‐operative radiograph and MRI scores, so as to assess the reliability of these imaging techniques at predicting the actual severity of knee osteoarthritis seen. Results Kellgren‐Lawrence (KL) grading of radiographs was moderately correlated with Outerbridge grades from arthroscopy for the medial compartment of the knee (Spearman’s rho (SR) 0.483, p < 0.001), with a milder correlation in the lateral compartment (SR 0.218, p = 0.003). MRI reporting of knee osteoarthritis was moderately correlated with Outerbridge grades in the medial compartment (SR 0.451, p < 0.001), mildly correlated for both the lateral (SR 0.299, p < 0.001) and patellofemoral joint compartments (SR 0.142, p = 0.054). KL and MRI grading was moderately correlated for the medial compartment (SR 0.475, p < 0.001) and mildly correlated for the lateral compartment (SR 0.277, p < 0.001). Conclusion The ability of radiographs to represent the actual condition of knee osteoarthritis is underestimated. KL grading especially best represents the disease seen in the medial compartment of the knee joint, with a moderate correlation to Outerbridge scores given on arthroscopic assessment. We suggest that whilst MRI is a useful tool in the investigation of knee symptoms, it is often unnecessarily used in patients with OA, when in fact, radiographs alone would be sufficient. Evidence level III |
| format | Article |
| id | doaj-art-9b0beb2d396a4fc4894f49a4f0b863ea |
| institution | OA Journals |
| issn | 2197-1153 |
| language | English |
| publishDate | 2022-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Experimental Orthopaedics |
| spelling | doaj-art-9b0beb2d396a4fc4894f49a4f0b863ea2025-08-20T02:05:21ZengWileyJournal of Experimental Orthopaedics2197-11532022-01-0191n/an/a10.1186/s40634-021-00442-yRadiographic vs. MRI vs. arthroscopic assessment and grading of knee osteoarthritis ‐ are we using appropriate imaging?Samuel Newman0Huzefah Ahmed1Nader Rehmatullah2WrightingtonWigan & Leigh NHS Foundation TrustWigan LaneWN1 2NNWiganUKWrightingtonWigan & Leigh NHS Foundation TrustWigan LaneWN1 2NNWiganUKWrightingtonWigan & Leigh NHS Foundation TrustWigan LaneWN1 2NNWiganUKAbstract Purpose Radiographs and MRI scans are commonly used imaging techniques in the assessment of knee osteoarthritis. However, it currently remains uncertain how good a representation of the actual condition of the knee joint these investigations provide. By comparing them against arthroscopic findings the aim of our study was to conclude how accurate these imaging techniques are at grading knee osteoarthritis. Methods This was a retrospective study looking at knee arthroscopies performed at a tertiary centre over a 5 year period. The Outerbridge grade given at arthroscopy was correlated with pre‐operative radiograph and MRI scores, so as to assess the reliability of these imaging techniques at predicting the actual severity of knee osteoarthritis seen. Results Kellgren‐Lawrence (KL) grading of radiographs was moderately correlated with Outerbridge grades from arthroscopy for the medial compartment of the knee (Spearman’s rho (SR) 0.483, p < 0.001), with a milder correlation in the lateral compartment (SR 0.218, p = 0.003). MRI reporting of knee osteoarthritis was moderately correlated with Outerbridge grades in the medial compartment (SR 0.451, p < 0.001), mildly correlated for both the lateral (SR 0.299, p < 0.001) and patellofemoral joint compartments (SR 0.142, p = 0.054). KL and MRI grading was moderately correlated for the medial compartment (SR 0.475, p < 0.001) and mildly correlated for the lateral compartment (SR 0.277, p < 0.001). Conclusion The ability of radiographs to represent the actual condition of knee osteoarthritis is underestimated. KL grading especially best represents the disease seen in the medial compartment of the knee joint, with a moderate correlation to Outerbridge scores given on arthroscopic assessment. We suggest that whilst MRI is a useful tool in the investigation of knee symptoms, it is often unnecessarily used in patients with OA, when in fact, radiographs alone would be sufficient. Evidence level IIIhttps://doi.org/10.1186/s40634-021-00442-yRadiographicRadiographKellgren‐LawrenceMRIArthroscopicArthroscopy |
| spellingShingle | Samuel Newman Huzefah Ahmed Nader Rehmatullah Radiographic vs. MRI vs. arthroscopic assessment and grading of knee osteoarthritis ‐ are we using appropriate imaging? Journal of Experimental Orthopaedics Radiographic Radiograph Kellgren‐Lawrence MRI Arthroscopic Arthroscopy |
| title | Radiographic vs. MRI vs. arthroscopic assessment and grading of knee osteoarthritis ‐ are we using appropriate imaging? |
| title_full | Radiographic vs. MRI vs. arthroscopic assessment and grading of knee osteoarthritis ‐ are we using appropriate imaging? |
| title_fullStr | Radiographic vs. MRI vs. arthroscopic assessment and grading of knee osteoarthritis ‐ are we using appropriate imaging? |
| title_full_unstemmed | Radiographic vs. MRI vs. arthroscopic assessment and grading of knee osteoarthritis ‐ are we using appropriate imaging? |
| title_short | Radiographic vs. MRI vs. arthroscopic assessment and grading of knee osteoarthritis ‐ are we using appropriate imaging? |
| title_sort | radiographic vs mri vs arthroscopic assessment and grading of knee osteoarthritis are we using appropriate imaging |
| topic | Radiographic Radiograph Kellgren‐Lawrence MRI Arthroscopic Arthroscopy |
| url | https://doi.org/10.1186/s40634-021-00442-y |
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