Compositional evaluation of lesion and parent bone in patients with juvenile osteochondritis dissecans of the knee using T2* mapping

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Abstract

Juvenile osteochondritis dissecans (JOCD) lesions contain cartilaginous, fibrous and osseous tissues which are difficult to distinguish with clinical, morphological magnetic resonance imaging (MRI). Quantitative T2* mapping has earlier been used to evaluate microstructure and composition of all aforementioned tissues as well as bone mineral density. However, the ability of T2* mapping to detect changes in tissue composition between different JOCD lesion regions, different disease stages, and between stable and unstable lesions has not been demonstrated. This study analyzed morphological and T2* MRI data from 25 patients (median age, 12.1 years) with 34 JOCD-affected and 13 healthy knees. Each lesion was assigned a stage reflecting the natural history of JOCD, with stages I and IV representing early and healed lesion, respectively. T2* values were evaluated within the progeny lesion, interface and parent bone of each lesion and in the control bone region. T2* was negatively correlated with JOCD stage in progeny lesion (ρ = −0.871; p < 0.001) and interface regions (ρ = −0.649; p < 0.001). Stage IV progeny showed significantly lower T2* than control bone (p = 0.028). T2* was significantly lower in parent bone than in control bone of patients with stable lesions (p = 0.009), but not in patients with unstable lesions (p = 0.14). Clinical significance: T2* mapping enables differentiation between different stages of JOCD and quantitative measurement of the ossification degree in progeny lesion and interface. The observed T2* decrease in healed and stable lesions may indicate increased bone density as a result of the active repair process. T2* mapping provides quantitative information about JOCD lesion composition.

Original languageEnglish (US)
JournalJournal of Orthopaedic Research
Early online dateOct 12 2021
DOIs
StateE-pub ahead of print - Oct 12 2021

Bibliographical note

Funding Information:
This study was supported by National Institutes of Health, including the National Institute of Arthritis and Musculoskeletal and Skin Diseases (R01 AR070020, K01 AR070894, T32 AR050938), and National Institute of Biomedical Imaging and Bioengineering (P41 EB027061). Authors have no financial or other conflicts to declare.

Publisher Copyright:
© 2021 Orthopaedic Research Society. Published by Wiley Periodicals LLC

Keywords

  • compositional magnetic resonance imaging
  • juvenile osteochondritis dissecans
  • knee joint
  • T*
  • trabecular bone

PubMed: MeSH publication types

  • Journal Article

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