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Radiographic Findings of Osteoarthritis versus Arthroscopic Findings of Articular Cartilage Degeneration in the Tibiofemoral Joint¹

¹ From the Departments of Radiology (R.K., D.G.B., P.T.S., J.P.F., A.A.D.S.) and Statistics (J.P.F.), University of Wisconsin Hospital, Clinical Science Center-E3/311, 600 Highland Ave, Madison, WI 53792-3252. Received April 7, 2005; revision requested June 7; revision received July 1; accepted July 21; final version accepted August 5. Address correspondence to R.K. (e-mail: rkijowski{at}mail.radiology.wisc.edu).

Purpose: To retrospectively correlate radiographic findings of osteoarthritis of the tibiofemoral joint with arthroscopic findings of articular cartilage degeneration within the tibiofemoral joint in patients with chronic knee pain.

Materials and Methods: The study was performed in compliance with HIPAA regulations. Approval from an institutional review board and a waiver of informed consent were obtained. The study group consisted of 125 patients with osteoarthritis of the tibiofemoral joint (66 men, 59 women; age range, 35–77 years; average age, 52 years) and 25 patients of similar age (14 men, 11 women; age range, 36–69 years; average age, 50 years) with no osteoarthritis of the tibiofemoral joint. All patients underwent standing anteroposterior radiography of the knee prior to arthroscopic knee surgery. Each articular surface of the tibiofemoral joint was graded at arthroscopy. Two radiologists retrospectively reviewed the knee radiographs to determine the presence of marginal osteophytes, joint space narrowing, subchondral sclerosis, and subchondral cysts. The sensitivity and specificity of the radiographic features of osteoarthritis for the detection of articular cartilage degeneration within the medial and lateral compartments of the tibiofemoral joint were determined.

Results: The sensitivity of marginal osteophytes, joint space narrowing, subchondral sclerosis, and subchondral cysts for the detection of articular cartilage degeneration was 67%, 46%, 16%, and 10%, respectively, for the medial compartment and 49%, 7%, 6%, and 3%, respectively, for the lateral compartment. The specificity of marginal osteophytes, joint space narrowing, subchondral sclerosis, and subchondral cysts for the detection of articular cartilage degeneration was 73%, 95%, 100%, and 100%, respectively, for the medial compartment and 81%, 100%, 100%, and 100%, respectively, for the lateral compartment.

Conclusion: Marginal osteophytes were the most sensitive radiographic feature for the detection of osteoarthritis of the tibiofemoral joint. Joint space narrowing, subchondral sclerosis, and subchondral cysts were less sensitive radiographic features of osteoarthritis and rarely occurred in the absence of associated osteophyte formation.

© RSNA, 2006

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