Imaging the articular cartilage

Imaging the articular cartilage has not been an easy task. Being radiolucent, it cannot be seen with conventional radiography or CT scan. It is inaccessible to ultrasound.

Often the evidence of worn out cartilage is gathered from plain radiograph when the joint space is reduced. But this is already a late presentation of disease.

MRI proves to be an invaluable tool for assessing articular cartilage, particularly in the setting of trauma. On GRE Water Image as shown in the images in this article, normal articular cartilage shows as a high signal (bright) rim that surrounds the articular surfaces. On MRI, thinning, fissuring or focal defect can readily be demonstrable.


This image shows full thickness cartilage loss (arrowheads) here in the medial condyle in a patient with recent road traffic accident.

Identifying early cartilage loss is important to help patients take active measures to reduce further damage to the cartilage. Interventions may include lifestyle changes like weight modification or use of supportive devices, pharmacological approach or surgery.

In this centre, our MRI is fully capable of performing GRE Water image to evaluate the articular cartilage thickness. Most of the times, the scan done is in conjunction with assessment of the other internal knee structures such as the menisci and ligaments.