Advances in Imaging of Osteoarthritis and Cartilage

Targeted CE per ARRT’s Discipline, Category, and Subcategory classification:
[Note: Discipline-specific Targeted CE credits may be less than the total Category A credits approved for this course.]

Magnetic Resonance Imaging: 2.50
Patient Care: 0.50
Patient Interactions and Management: 0.50
Procedures: 2.00
Musculoskeletal: 2.00

Radiography: 0.75
Patient Care: 0.50
Patient Interactions and Management: 0.50
Procedures: 0.25
Extremity Procedures: 0.25

Registered Radiologist Assistant: 2.50
Procedures: 2.50
Musculoskeletal and Endocrine Sections: 2.50

Sonography: 0.75
Patient Care: 0.50
Patient Interactions and Management: 0.50
Procedures: 0.25
Superficial Structures and Other Sonographic Procedures: 0.25

Outline

1. Introduction
2. Role of Radiography and Recent Developments
3. The Role of MR Imaging
   1. MR Imaging-based Whole-joint Assessment of Knee OA with Semiquantitative Scoring Methods
   2. MR Imaging Techniques for Morphologic Assessment of Cartilage
   3. MR Imaging Field Strength, Extremity MR Imaging, and Weight-bearing MR Imaging
   4. Quantitative Morphologic Cartilage Assessment
   5. MR Imaging of Biochemical Properties of Articular Cartilage
   6. Evaluation of Cartilage Repair
4. The Role of US
5. Treatment
6. Outlook

Objectives

Upon completion of this course, students will:

1. be familiar with the types of synovial joints
2. understand the most common types of arthritis
3. describe the role of conventional radiography in diagnosing osteoarthritis of the knee
4. understand the role of MRI in evaluating knee joint cartilage and its biochemical composition
5. understand predisposition factors that may lead to getting osteoarthritis
6. understand the new MR imaging techniques used in diagnosing osteoarthritis
7. know the significance of joint space width and presence of osteophytes in the knee
8. understand the grading system as described by the Kellgren-Lawrence system
9. understand the grading system as described by Osteoarthritis Research Society
10. be familiar with the different criteria for joint space width measurements
11. understand the radiological signs on a knee radiograph to diagnose osteoarthritis
12. describe positioning of the knee to obtain the Lyon-Schuss projection
13. describe the difference between the Lyon-Schuss position and fixed flexion position/radiographic view
14. understand how cartilage is assessed using the Outerbridge scale in a clinical setting and its grading system parameters
15. describe the three semiquantitative scoring systems for whole organ assessment of knee osteoarthritis
16. understand the grading system of the Osteoarthritis Research Society international atlas classification
17. describe the types of joint space width measurements in each imaging modality and its role in diagnosing osteoarthritis of the knee
18. understand the three semiquantitative scoring systems for whole organ assessment of knee osteoarthritis
19. understand the benefits of using fat suppression techniques in MRI of the knee for evaluation of the cartilage
20. understand the benefits of using SPGR MRI techniques in the assessment of knee cartilage
21. understand the benefits of three dimensional DESS MRI in evaluating knee cartilage
22. describe the semiquantitative scoring systems for knee osteoarthritis and what WORMS, KOSS and BLOKS stand for
23. understand the basic MRI protocols and planes for imaging the knee for osteoarthritis
24. understand the limitations of low-field MRI orthopedic units
25. understand the benefits of using a 3T MRI system
26. understand the benefits of a dedicated, low-field extremity MRI system
27. understand which magnetic field strengths are used for research only
28. describe what can be assessed from quantitative measurement of cartilage morphology in a MR scan
29. understand the limitations of using cartilage volume as a determining factor in discriminating between a healthy patient and one with osteoarthritis
30. describe the risk factors for cartilage loss as identified with quantitative measurement of cartilage morphology
31. know what type of electrical charge glucosaminoglycans possess
32. understand what is symptomatic of the earliest stages of cartilage degeneration
33. understand the strengths and weakness of each MR imaging technique for morphologic assessment of knee cartilage
34. understand the benefits and limitations of 23NA (Sodium) MRI
35. understand how T2 mapping in MRI describes the composition of hyaline articular cartilage in the knee joint
36. describe what In vivo MR imaging studies of knee cartilage reveal
37. understand the common surgical interventions to repair damaged knee cartilage
38. understand how knee cartilage is evaluated after surgery using MRI
39. understand the role of T2 mapping in evaluation knee cartilage post-surgical repair
40. understand the disadvantages of using diagnostic ultrasound for evaluation of the knee for osteoarthritis