Cartilage damage in femoroacetabular impingement (FAI): preliminary results on comparison of standard diagnostic vs delayed gadolinium-enhanced magnetic.

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Cartilage damage in femoroacetabular impingement (FAI): preliminary results on comparison of standard diagnostic vs delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC) B. Bittersohl, S. Steppacher, T. Haamberg, Y.-J. Kim, S. Werlen, M. Beck, K.A. Siebenrock, T.C. Mamisch Osteoarthritis and Cartilage Volume 17, Issue 10, Pages 1297-1306 (October 2009) DOI: 10.1016/j.joca.2009.04.016 Copyright © 2009 Osteoarthritis Research Society International Terms and Conditions

Fig. 1 Radial PD-weighted TSE image with an indirect arthrography effect (white arrows). Note the cartilage damage at the acetabular rim. Osteoarthritis and Cartilage 2009 17, 1297-1306DOI: (10.1016/j.joca.2009.04.016) Copyright © 2009 Osteoarthritis Research Society International Terms and Conditions

Fig. 2 MPR that is performed to create a plane that is perpendicular to the femoral head–neck (A, B) and in the center of the femoral head. On this plane (C) radial reformats with an interval of 30° were generated for accurate assessment of morphology and changes of degeneration (C). The coronal oblique plane (highlighted yellow line in C) depicting the superior zone is illustrated in (D). Note the non-spherical nature of the femoral head (white star) and a corresponding tear at the base of the labrum (line of high signal intensity). Osteoarthritis and Cartilage 2009 17, 1297-1306DOI: (10.1016/j.joca.2009.04.016) Copyright © 2009 Osteoarthritis Research Society International Terms and Conditions

Fig. 3 Morphologic VIBE reformat (A) and the corresponding T1 maps (B, C) depicting the superior zone in a cam-type hip. T1 values are visualized in a color scale (simplified bright colors – high T1 values, dark colors low T1 values), and quantified by ROI analyses. Note the drop in T1 (∼370ms) at the acetabular rim indicates a high Gd-DTPA2− infiltration due to GAG loss and cartilage degeneration. The medial zone is, in that case, less affected (∼477ms). Osteoarthritis and Cartilage 2009 17, 1297-1306DOI: (10.1016/j.joca.2009.04.016) Copyright © 2009 Osteoarthritis Research Society International Terms and Conditions

Fig. 4 T1 distribution throughout the hip joint with various radiographic grades (Tonnis grades) of OA in different types of FAI. Note the difference in T1 patterns between the cam-type and pincer-type with significantly lower T1 values when compared to the control group of asymptomatic volunteers. Osteoarthritis and Cartilage 2009 17, 1297-1306DOI: (10.1016/j.joca.2009.04.016) Copyright © 2009 Osteoarthritis Research Society International Terms and Conditions

Fig. 5 Distribution of T1 values throughout the hip joint with various MRI grades based on the extent of cartilage damage for different types of FAI. Note the difference in T1 patterns between the cam-type and the pincer-type with significantly lower T1 values when compared to the control group of asymptomatic volunteers. Also note the significant T1 drop at the anterior–superior to superior region in the cam-type with a cartilage lesion extent <0.75mm. Osteoarthritis and Cartilage 2009 17, 1297-1306DOI: (10.1016/j.joca.2009.04.016) Copyright © 2009 Osteoarthritis Research Society International Terms and Conditions

Fig. 6 Zonal variation of T1 values in different types of FAI at various grades of cartilage damage. Note the significant difference for cam-type impingement in cartilage damage <0.75mm with more severe lesions at the peripheral zone. Osteoarthritis and Cartilage 2009 17, 1297-1306DOI: (10.1016/j.joca.2009.04.016) Copyright © 2009 Osteoarthritis Research Society International Terms and Conditions

Fig. 7 Morphologic VIBE (A) and corresponding T1 reformat (B) at the superior location in a cam-type patient. Note the visual coloring quantified by the low T1 value that is pronounced peripherally at the acetabular rim (B). The PD-weighted radial image (C) demonstrates a non-spherical femoral head along with reduced head–neck offset and a basal labral tear (white arrow). Interestingly, there are no clear signs of cartilage damage in this scan. In the same patient at the posterior–superior location (D–F), T1 is mildly lowered (E). A basal labral tear (white arrow) was identified at the same location (F). Osteoarthritis and Cartilage 2009 17, 1297-1306DOI: (10.1016/j.joca.2009.04.016) Copyright © 2009 Osteoarthritis Research Society International Terms and Conditions