Pre-radiographic osteoarthritic changes are highly prevalent in the medial patella and medial posterior femur in older persons: Framingham OA study  D.

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Pre-radiographic osteoarthritic changes are highly prevalent in the medial patella and medial posterior femur in older persons: Framingham OA study  D. Hayashi, D.T. Felson, J. Niu, D.J. Hunter, F.W. Roemer, P. Aliabadi, A. Guermazi  Osteoarthritis and Cartilage  Volume 22, Issue 1, Pages 76-83 (January 2014) DOI: 10.1016/j.joca.2013.10.007 Copyright © 2013 Osteoarthritis Research Society International Terms and Conditions

Fig. 1 Flow chart for subject inclusion. Osteoarthritis and Cartilage 2014 22, 76-83DOI: (10.1016/j.joca.2013.10.007) Copyright © 2013 Osteoarthritis Research Society International Terms and Conditions

Fig. 2 Subregions of the knee joint as defined by WORMS. Subregional division of the knee joint as defined by the WORMS system. The patella (left illustration) is divided into medial (M) and lateral (L) subregions in the axial plane. The patellar ridge is included in the medial compartment. Scoring of cartilage damage, bone marrow lesions, bone attrition, and subchondral cysts are based on these two subregions. Scoring of osteophytes was done at the four locations of the patella: medial edge and lateral edge (using the axial image), and superior pole and inferior pole (using the sagittal image). The central illustration represents a sagittal slice of the knee joint. The anterior femoral subregion (A) corresponds to the trochlea, a component of the patellofemoral joint. The central (C) and (P) posterior femoral subregions, as well as the anterior (A), central (C) and posterior (P) subregions of the tibia comprise the tibiofemoral joint. In the right illustration, which represents a coronal slice, the tibiofemoral joint is divided into the lateral (L) and medial (M) subregions. The tibia has a subspinous (S) subregion. In the present study, all but tibial S subregion was included for analysis. Osteoarthritis and Cartilage 2014 22, 76-83DOI: (10.1016/j.joca.2013.10.007) Copyright © 2013 Osteoarthritis Research Society International Terms and Conditions

Fig. 3 Graphic representation of the semiquantitative grading of cartilage damage using the WORMS with actual examples of MRI. Cartilage signal and morphology were scored using an eight-point scale: 0 = normal and thickness and signal; 1 = normal thickness but increased signal on FS PD-weighted TSE image; 2.0 = partial-thickness focal defect <1 cm in greatest width; 2.5 = full-thickness focal defect <1 cm in greatest width; 3 = multiple areas of partial-thickness (grade 2.0) defects intermixed with areas of normal thickness, or a grade 2.0 defect wider than 1 cm but <75% of the subregion; 4 = diffuse (≥75% of the subregion) partial-thickness loss; 5 = multiple areas of full-thickness loss (grade 2.5) or a grade 2.5 lesion wider than 1 cm but <75% of the subregion; 6 = diffuse (≥75% of the subregion) full-thickness loss. Osteoarthritis and Cartilage 2014 22, 76-83DOI: (10.1016/j.joca.2013.10.007) Copyright © 2013 Osteoarthritis Research Society International Terms and Conditions

Fig. 4 Example of an osteophyte that was not visible on radiography but was on MRI. (a) No obvious osteophyte is visualized at the margin of medial femur in this radiograph. The bony margin appears smooth (arrow). (b) Coronal intermediate-weighted fat-suppressed image clearly depicts a grade 4 osteophyte (arrow) at the margin of the medial distal femur. In (a), the osteophyte cannot be visualized because of overlapping normal bony margin of the distal femur. Osteoarthritis and Cartilage 2014 22, 76-83DOI: (10.1016/j.joca.2013.10.007) Copyright © 2013 Osteoarthritis Research Society International Terms and Conditions