Correlations of Medial Joint Space Width on Fixed-Flexed Standing Computed Tomography and Radiographs With Cartilage and Meniscal Morphology on Magnetic Resonance Imaging

Arthritis Care Res (Hoboken). 2016 Oct;68(10):1410-6. doi: 10.1002/acr.22888.


Objective: To assess whether medial tibiofemoral joint space width (JSW) on 3-dimensional (3-D) standing computed tomography (SCT) correlates more closely with magnetic resonance imaging cartilage morphology (CM) and meniscal scores than does radiographic 2-D JSW.

Methods: Participants in the Multicenter Osteoarthritis Study, who had standing fixed-flexion posteroanterior knee radiographs, were recruited. Medial tibiofemoral 3-D JSW on SCT and 2-D JSW on fixed-flexion radiographs were compared with medial tibiofemoral cartilage and meniscal morphology using the Whole-Organ Magnetic Resonance Imaging Score (WORMS). Associations between the area of the articular surface with 3-D JSW <2.5 mm on SCT, radiographic minimal 2-D JSW, and the WORMS-CM and meniscal scores were assessed using Spearman's rho.

Results: For the 19 participants included (33 knees), mean ± SD age was 66.9 ± 5.4 years, body mass index was 29.5 ± 4.4 kg/m(2) , 42.1% of participants were female, and the Kellgren/Lawrence grades were 0 (21.2%), 1 (36.4%), 2 (18.2%), and 3 (24.2%). The articular surface area with 3-D JSW <2.5 mm on SCT correlated with WORMS-CM scores for the central medial tibia (rs = 0.84, P < 0.001), central medial femur (rs = 0.60, P < 0.007), and posterior medial meniscal tear (rs = 0.39, P < 0.026), as did other cut points for 3-D JSW. Correlations with radiographic minimal 2-D JSW were -0.66, -0.52, and -0.40, respectively, differing from SCT only for tibial cartilage (P = 0.001).

Conclusion: Greater surface area with a low JSW, measured by SCT, correlates more strongly with the severity of tibial cartilage lesions, while correlating with medial femoral cartilage and meniscal damage to a similar extent as radiographic minimal JSW. SCT may enable valid stratification of participants in clinical trials, through quickly and inexpensively characterizing osteoarthritis features.

Publication types

  • Evaluation Study

MeSH terms

  • Aged
  • Cartilage, Articular / diagnostic imaging*
  • Cartilage, Articular / pathology
  • Female
  • Femur / diagnostic imaging
  • Humans
  • Knee Joint / diagnostic imaging*
  • Knee Joint / pathology
  • Magnetic Resonance Imaging*
  • Male
  • Menisci, Tibial / diagnostic imaging*
  • Menisci, Tibial / pathology
  • Middle Aged
  • Osteoarthritis, Knee / diagnostic imaging
  • Osteoarthritis, Knee / pathology
  • Posture
  • Radiography*
  • Tibia / diagnostic imaging
  • Tomography, X-Ray Computed*