A Novel Method for Assessing Proximal Tibiofibular Joint on MR Images in Patients With Knee Osteoarthritis

Osteoarthritis Cartilage. 2018 Dec;26(12):1675-1682. doi: 10.1016/j.joca.2018.08.011. Epub 2018 Sep 5.


Objectives: To validate a method to measure the morphological parameters of the proximal tibiofibular joint (PTFJ) in patients with knee osteoarthritis (OA).

Methods: 408 participants were examined in this cross-sectional subject-based study. We calculated the fibular contacting area of PTFJ (S) and its projection areas onto the horizontal plane (load-bearing area, Sτ), the sagittal plane (lateral stress-bolstering area, Sφ) and the coronal plane (posterior stress-bolstering area, Sυ). Joint space narrowing (JSN) and osteophyte was measured using radiographs. Cartilage defects, bone marrow lesions (BMLs) and cartilage volume were evaluated using magnetic resonance imaging (MRI).

Results: The average PTFJ fibular contacting area was 2.4 cm2 (SD, ±0.7 cm2). Intra-observer and inter-observer reliabilities of measures of PTFJ morphological parameters were excellent (≥0.90). S, Sτ and Sφ were significantly associated with JSN in the medial tibiofemoral compartment (PR: 1.40, 95% CI 1.10-1.78; PR: 1.65, 95% CI 1.25-2.18 and PR: 0.53, 95% CI 0.29-0.97, respectively). There was a significantly positive association between S, Sτ and medial and/or femoral tibial cartilage defects. S, Sτ and Sυ were significantly and positively associated with medial and/or femoral tibial BMLs (PR: 1.36, 95% CI 1.12-1.64; PR: 1.47, 95% CI 1.17-1.83; and PR: 1.39, 95% CI 1.06-1.82, respectively) after adjustment. S and Sτ were significantly and negatively associated with medial tibial cartilage volume.

Conclusions: This novel method to assess the morphological parameters of PTFJ in MRI is reproducible. These parameters are associated with knee radiographic and MRI-based OA-related structural abnormalities, suggesting clinical construct validity. Its predictive validity needs to be examined in future longitudinal studies.

Keywords: Knee osteoarthritis; MR images; Proximal tibiofibular joint.

Publication types

  • Randomized Controlled Trial
  • Validation Study

MeSH terms

  • Aged
  • Bone Marrow / diagnostic imaging
  • Cartilage, Articular / diagnostic imaging
  • Cartilage, Articular / pathology
  • Cross-Sectional Studies
  • Double-Blind Method
  • Female
  • Humans
  • Knee Joint / diagnostic imaging*
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Observer Variation
  • Osteoarthritis, Knee / diagnostic imaging*
  • Osteoarthritis, Knee / drug therapy
  • Osteoarthritis, Knee / pathology
  • Radiography
  • Reproducibility of Results
  • Vitamin D / therapeutic use
  • Weight-Bearing / physiology


  • Vitamin D