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Published in: Journal of Orthopaedic Surgery and Research 1/2018

Open Access 01-12-2018 | Research article

Upper tibial MRI vascular marks lost in early knee osteoarthritis

Authors: Michael Beverly, Gil Stamm, Thomas W. Hamilton, David W Murray, Hemant G Pandit

Published in: Journal of Orthopaedic Surgery and Research | Issue 1/2018

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Abstract

Background

We describe upper tibial radiating vascular marks on MRI scans. They are lost in early osteoarthritis (OA).

Methods

A literature search revealed no previous description of upper tibial MRI radial vascular marks. Fifty-six consecutive patients with anteroposterior knee X-rays and an axial PD_SPAIR MRI scan of the same knee within 1 year were studied. Their mean age was 53.1 years (range 22–85) with 27 males and 29 females. The medial and lateral compartments of each knee were scored for osteoarthritis using the Kellgren-Lawrence (K-L) classification. Marks on the MRI scans were counted by layer and quadrant position.

Results

Radial vascular marks were present in the first axial upper tibial subchondral slice, peaked between 6 and 10 mm depth and were absent by 16 mm depth. There was no association with age, left or right knee, BMI, or weight. There was more K-L graded OA medially and more vascular marks laterally. There was an inverse correlation between the number of marks and early grades of osteoarthritis medially (p < 0.001) and laterally (p < 0.002).

Conclusion

We demonstrate previously undescribed subchondral vascular marks on axial MRI scans of the tibia and their inverse correlation with the presence and severity of early knee osteoarthritis. Our work offers a new insight into the possible vascular aetiology of osteoarthritis and potentially a means of earlier diagnosis and a therapeutic target.
Literature
3.
go back to reference Trueta J, Harrison MHM. The normal vascular anatomy of the femoral head in adult man. Journal of Bone and Joint Surgery-British Volume. 1953;35(3):442–61.CrossRef Trueta J, Harrison MHM. The normal vascular anatomy of the femoral head in adult man. Journal of Bone and Joint Surgery-British Volume. 1953;35(3):442–61.CrossRef
4.
go back to reference Brookes M, Revell WJ. Blood supply of bone: scientific aspects. London: Springer-Verlag; 1998.CrossRef Brookes M, Revell WJ. Blood supply of bone: scientific aspects. London: Springer-Verlag; 1998.CrossRef
5.
go back to reference Gray H, Standring S, Ellis H, Berkovitz BKB. Gray's anatomy : the anatomical basis of clinical. Practice. 39th ed. Edinburgh ; New York: Elsevier Churchill Livingstone; 2005. Gray H, Standring S, Ellis H, Berkovitz BKB. Gray's anatomy : the anatomical basis of clinical. Practice. 39th ed. Edinburgh ; New York: Elsevier Churchill Livingstone; 2005.
7.
go back to reference Crock HV, Yoshizawa H. Blood-supply of lumbar vertebral column. Clin Orthop Relat Res. 1976;115:6–21. Crock HV, Yoshizawa H. Blood-supply of lumbar vertebral column. Clin Orthop Relat Res. 1976;115:6–21.
8.
go back to reference Denham RA. Hip mechanics. The Journal of bone and joint surgery British volume. 1959;41-B:550–7.CrossRef Denham RA. Hip mechanics. The Journal of bone and joint surgery British volume. 1959;41-B:550–7.CrossRef
9.
go back to reference Beverly M, Pflug J, Mathie R. Bone - a flexible perfused sponge. J Bone Joint Surg Br. 1987;69:494. Beverly M, Pflug J, Mathie R. Bone - a flexible perfused sponge. J Bone Joint Surg Br. 1987;69:494.
10.
go back to reference Beverly M, Murray D. Factors affecting intraosseous pressure measurement. J Orthop Surg Res. 2018;13(1):187.CrossRef Beverly M, Murray D. Factors affecting intraosseous pressure measurement. J Orthop Surg Res. 2018;13(1):187.CrossRef
11.
go back to reference Azuma H. Intraosseous pressure as a measure of hemodynamic changes in bone marrow. Angiology. 1964;15:396–406.CrossRef Azuma H. Intraosseous pressure as a measure of hemodynamic changes in bone marrow. Angiology. 1964;15:396–406.CrossRef
12.
go back to reference Ficat RP. Idiopathic bone necrosis of the femoral head. Early diagnosis and treatment. The Journal of bone and joint surgery British volume. 1985;67(1):3–9.CrossRef Ficat RP. Idiopathic bone necrosis of the femoral head. Early diagnosis and treatment. The Journal of bone and joint surgery British volume. 1985;67(1):3–9.CrossRef
13.
go back to reference Laroche M, Ludot I, Thiechart M, Arlet J, Pieraggi M, Chiron P, Moulinier L, Cantagrel A, Puget J, Utheza G, et al. Study of the intraosseous vessels of the femoral head in patients with fractures of the femoral neck or osteoarthritis of the hip. Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA. 1995;5(4):213–7.CrossRef Laroche M, Ludot I, Thiechart M, Arlet J, Pieraggi M, Chiron P, Moulinier L, Cantagrel A, Puget J, Utheza G, et al. Study of the intraosseous vessels of the femoral head in patients with fractures of the femoral neck or osteoarthritis of the hip. Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA. 1995;5(4):213–7.CrossRef
14.
go back to reference Lemperg RK, Arnoldi CC. The significance of intraosseous pressure in normal and diseased states with special reference to the intraosseous engorgement-pain syndrome. Clin Orthop Relat Res. 1978;136:143–56. Lemperg RK, Arnoldi CC. The significance of intraosseous pressure in normal and diseased states with special reference to the intraosseous engorgement-pain syndrome. Clin Orthop Relat Res. 1978;136:143–56.
15.
go back to reference Beverly M, Urban J, Murray D. Factors affecting physiology of intraosseous pressure measurement. Osteoarthr Cartil. 2016;24:S343.CrossRef Beverly M, Urban J, Murray D. Factors affecting physiology of intraosseous pressure measurement. Osteoarthr Cartil. 2016;24:S343.CrossRef
16.
go back to reference Kellgren JH, Lawrence JS. Radiological assessment of osteo-arthrosis. Ann Rheum Dis. 1957;16(4):494–502.CrossRef Kellgren JH, Lawrence JS. Radiological assessment of osteo-arthrosis. Ann Rheum Dis. 1957;16(4):494–502.CrossRef
17.
go back to reference Beverly M. Bone compression, intraosseous pressure and vascular drainage. Scand J Rheumatol. 1986;(Suppl 60):24. Beverly M. Bone compression, intraosseous pressure and vascular drainage. Scand J Rheumatol. 1986;(Suppl 60):24.
18.
go back to reference Demondion X, Delfaut EM, Drizenko A, Boutry N, Francke JP, Cotten A. Radio-anatomic demonstration of the vertebral lumbar venous plexuses: an MRI experimental study. Surgical and radiologic anatomy : SRA. 2000;22(3–4):151–6.CrossRef Demondion X, Delfaut EM, Drizenko A, Boutry N, Francke JP, Cotten A. Radio-anatomic demonstration of the vertebral lumbar venous plexuses: an MRI experimental study. Surgical and radiologic anatomy : SRA. 2000;22(3–4):151–6.CrossRef
20.
go back to reference Lynch JA, Roemer FW, Nevitt MC, Felson DT, Niu J, Eaton CB, Guermazi A. Comparison of BLOKS and WORMS scoring systems part I. Cross sectional comparison of methods to assess cartilage morphology, meniscal damage and bone marrow lesions on knee MRI: data from the osteoarthritis initiative. Osteoarthritis and cartilage / OARS, Osteoarthritis Research Society. 2010;18(11):1393–401. https://doi.org/10.1016/j.joca.2010.08.017.CrossRefPubMedCentral Lynch JA, Roemer FW, Nevitt MC, Felson DT, Niu J, Eaton CB, Guermazi A. Comparison of BLOKS and WORMS scoring systems part I. Cross sectional comparison of methods to assess cartilage morphology, meniscal damage and bone marrow lesions on knee MRI: data from the osteoarthritis initiative. Osteoarthritis and cartilage / OARS, Osteoarthritis Research Society. 2010;18(11):1393–401. https://​doi.​org/​10.​1016/​j.​joca.​2010.​08.​017.CrossRefPubMedCentral
21.
go back to reference Majumdar S. Advances in MRI of the knee for osteoarthritis. New Jersey: World Scientific; 2010.CrossRef Majumdar S. Advances in MRI of the knee for osteoarthritis. New Jersey: World Scientific; 2010.CrossRef
Metadata
Title
Upper tibial MRI vascular marks lost in early knee osteoarthritis
Authors
Michael Beverly
Gil Stamm
Thomas W. Hamilton
David W Murray
Hemant G Pandit
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Journal of Orthopaedic Surgery and Research / Issue 1/2018
Electronic ISSN: 1749-799X
DOI
https://doi.org/10.1186/s13018-018-0991-y

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