Osteoarthritis: MR Imaging Findings in Different Stages of Disease and Correlation with Clinical Findings

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Abstract
To determine whether knee pain, stiffness, and limited function in patients with different stages of osteoarthritis correlate with the degree of disease assessed on magnetic resonance (MR) images and radiographs. Radiographs in 50 patients with varying degrees of osteoarthritis of the knee were assessed by using the the Western Ontario and McMaster University (WOMAC) osteoarthritis index and the Kellgren-Lawrence (KL) scale. MR images were obtained and analyzed by two readers for cartilage lesions, bone marrow edema pattern, and ligamentous and meniscal lesions. Thirteen of 16 knees with a KL score of 4 showed full-thickness cartilage lesions and bone marrow edema pattern. Cruciate ligament tears were found in five of 12 knees with a KL score of 3 and in nine of 16 knees with a KL score of 4. While the KL score correlated significantly (P <.05) with the grade of cartilage lesions, and a substantially higher percentage of lesions with higher KL scores were found on MR images, the correlations between MR imaging findings and KL score versus clinical findings were not significant (P >.05). Significant differences between WOMAC scores were found only for the grades of cartilage lesions (P <.05). Cartilage lesions, bone marrow edema pattern, and meniscal and ligamentous lesions were frequently demonstrated on MR images in patients with advanced osteoarthritis. Clinical findings showed no significant correlations with KL score and extent of findings at MR imaging.