Functional ankle instability as a risk factor for osteoarthritis: using T2-mapping to analyze early cartilage degeneration in the ankle joint of young.

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Functional ankle instability as a risk factor for osteoarthritis: using T2-mapping to analyze early cartilage degeneration in the ankle joint of young athletes T. Golditz, S. Steib, K. Pfeifer, M. Uder, K. Gelse, R. Janka, F.F. Hennig, G.H. Welsch Osteoarthritis and Cartilage Volume 22, Issue 10, Pages 1377-1385 (October 2014) DOI: 10.1016/j.joca.2014.04.029 Copyright © 2014 Osteoarthritis Research Society International Terms and Conditions

Fig. 1 Coronal MRI of the left ankle of a 22-year-old male control. To visualize the planes in which the ROI evaluation was performed, the medial and lateral tibio-talar region is marked. Of the 12 sagittal quantitative T2-mapping slices, two medial and two lateral slices were chosen. Osteoarthritis and Cartilage 2014 22, 1377-1385DOI: (10.1016/j.joca.2014.04.029) Copyright © 2014 Osteoarthritis Research Society International Terms and Conditions

Fig. 2 Sagittal multi-echo SE quantitative T2-mapping images of the right ankle of a 22-year-old from the Coper-group. All four assessed slices (as marked in Fig. 1) are provided with quantitative T2-maps of the tibial and the talar cartilage. Osteoarthritis and Cartilage 2014 22, 1377-1385DOI: (10.1016/j.joca.2014.04.029) Copyright © 2014 Osteoarthritis Research Society International Terms and Conditions

Fig. 3 Quantitative (SE) T2-map (sagittal) of the left ankle of a 25-year-old male from the Coper-group. The zonal (deep and superficial cartilage aspect) ROI evaluation of the tibial and the talar cartilage is visualized in a medial (A) and lateral (B) aspect of the ankle joint. Osteoarthritis and Cartilage 2014 22, 1377-1385DOI: (10.1016/j.joca.2014.04.029) Copyright © 2014 Osteoarthritis Research Society International Terms and Conditions

Fig. 4 Sagittal multi-echo SE quantitative T2-mapping images of the right ankle of a 25-year-old male volunteer with FAI. Whereas (A) visualizes the ‘early-unloading’ quantitative T2-map, (B) shows the same slice with the same cartilage area for the ‘late-unloading’ quantitative T2-map. When looking at the T2-values, a slight increase during unloading is visible. This change over time is visualized in Fig. 5. Osteoarthritis and Cartilage 2014 22, 1377-1385DOI: (10.1016/j.joca.2014.04.029) Copyright © 2014 Osteoarthritis Research Society International Terms and Conditions

Fig. 5 Gradient in ΔT2-values from anterior-lateral (left) to dorso-medial (right) as seen by the arrow comparing FAI (A) to Coper (B). ΔT2 in ms (ΔT2-value = ΔT2 (‘early-unloading’) − ΔT2 (‘late-unloading’)); T2-values representing full thickness ROIs; * indicates a significant difference (P ≤ 0.05). Whereas, in the Coper-group, a relative homogenous pattern of mainly increasing T2-values is visible, in the FAI-group, there is a clearly different pattern of behavior of the T2-values during unlading, which could be interpreted as a “shift” from anterior-lateral to dorso-medial. The percentages mark the relative difference in ΔT2 between the significant changes in the anterior-lateral and the dorso-medial part of the joint. Osteoarthritis and Cartilage 2014 22, 1377-1385DOI: (10.1016/j.joca.2014.04.029) Copyright © 2014 Osteoarthritis Research Society International Terms and Conditions