Diagnostic and prognostic value of delayed Gadolinium Enhanced Magnetic Resonance Imaging of Cartilage (dGEMRIC) in early osteoarthritis of the hip

A Palmer; S Fernquest; I Rombach; D Park; T Pollard; J Broomfield; N Bangerter; A Carr; S Glyn-Jones

doi:10.1016/j.joca.2017.05.004

Diagnostic and prognostic value of delayed Gadolinium Enhanced Magnetic Resonance Imaging of Cartilage (dGEMRIC) in early osteoarthritis of the hip

Osteoarthritis Cartilage. 2017 Sep;25(9):1468-1477. doi: 10.1016/j.joca.2017.05.004. Epub 2017 May 12.

Authors

A Palmer¹, S Fernquest², I Rombach², D Park², T Pollard², J Broomfield², N Bangerter³, A Carr², S Glyn-Jones²

Affiliations

¹ Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, United Kingdom. Electronic address: antony.palmer@ndorms.ox.ac.uk.
² Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, United Kingdom.
³ Electrical and Computer Engineering Department, Brigham Young University, USA.

PMID: 28506842
DOI: 10.1016/j.joca.2017.05.004

Abstract

Background: Delayed Gadolinium Enhanced Magnetic Resonance Imaging of Cartilage (dGEMRIC) can detect glycosaminoglycan loss in the acetabular cartilage of asymptomatic individuals with cam morphology. The aims of this study were to explore the relationship between cam morphology and dGEMRIC values, and to explore whether baseline dGEMRIC can predict the development of radiographic hip osteoarthritis.

Methods: Prospective cohort (SibKids) study with clinical, radiographic, and MRI assessment at baseline and five-year follow-up (n = 34). The dGEMRIC values of cartilage regions were correlated with measures of cam morphology. Receiver operating characteristic (ROC) analysis was applied to baseline variables to predict radiographic loss of joint space width.

Results: Superolateral acetabular cartilage dGEMRIC values were significantly lower in participants with cam morphology (P < 0.001), defined as an alpha angle greater than 60°. There was a negative correlation between alpha angle and the dGEMRIC value of adjacent acetabular cartilage. This relationship was strongest superoanteriorly (r = -0.697 P < 0.001). There was a positive correlation between baseline dGEMRIC and the magnitude of joint space width narrowing (r = 0.398 P = 0.030). ROC analysis of combined baseline variables (positive impingement test, alpha angle, dGEMRIC ratio) gave an Area Under the Curve (AUC) of 0.75 for predicting joint space width narrowing greater than 0.5 mm within 5 years.

Conclusions: The size and position of cam morphology determines the severity and location of progressive cartilage damage, supporting the biomechanical aetiology of femoroacetabular impingement. Baseline dGEMRIC is able to predict the development of radiographic osteoarthritis. Compositional MRI offers the potential to identify patients who may benefit from early intervention to prevent the development of osteoarthritis.

Keywords: Femoroacetabular impingement; Hip; MRI; Osteoarthritis; dGEMRIC.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Cartilage, Articular / diagnostic imaging*
Cartilage, Articular / pathology
Contrast Media
Disease Progression
Early Diagnosis
Female
Femoracetabular Impingement / complications*
Femoracetabular Impingement / diagnostic imaging
Follow-Up Studies
Gadolinium
Hip Joint / diagnostic imaging
Humans
Magnetic Resonance Imaging / methods
Male
Middle Aged
Osteoarthritis, Hip / diagnostic imaging*
Osteoarthritis, Hip / etiology*
Osteoarthritis, Hip / pathology
Prognosis
Prospective Studies
Radiography

Substances

Contrast Media
Gadolinium