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Compositional MRI assessment of cartilage: what is it and what is its potential for sports medicine?
  1. Ali Guermazi1,
  2. Frank W Roemer1,2
  1. 1Department of Radiology, Boston University School of Medicine, Boston, Massachusetts, USA
  2. 2Department of Radiology, University of Erlangen, Erlangen, Germany
  1. Correspondence to Professor Ali Guermazi, Department of Radiology, Boston University School of Medicine, 820 Harrison Avenue, FGH Building, 3rd Floor, Boston, MA 02118, USA; guermazi{at}

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Compositional MRI reveals biochemical and microstructural changes in cartilage well before changes are visible to the eye/arthroscopist. Compositional MRI focuses on early and potentially reversible injury stages, and may (1) help identify athletes at risk prior to the development of overt joint damage or (2) help to determine time to return to play in a postinjury scenario.1

Compositional MRI is not yet in clinical use, but it is being used with increasing frequency in osteoarthritis (OA) research for ‘pre-morphologic’ evaluation of cartilage (figure 1)2 and to assess biochemical response of joint tissue, primarily cartilage, to loading through physical activity.3 It has been used to image the biochemical response in knees after ACL reconstruction,4 meniscus surgery5 and cartilage repair6 (figure 2).

Figure 1

Defining disease state of osteoarthritis. Adapted from Kwoh.11

Figure 2

Knee of a patient 24 months after microfracture cartilage repair of the medial central femoral condyle. (A) Sagittal three-dimentional T1-weighted gradient echo MRI showing a normal morphological appearance of the cartilage repair tissue and native medial posterior femoral condyle …

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  • Competing interests AG is the president of Boston Imaging Core Lab, LLC (BICL), Boston, MA, a company providing radiological image assessment services. He is a consultant to MerckSerono, Genzyme, OrthoTrophix and TissueGene. FWR is a shareholder of BICL.

  • Provenance and peer review Commissioned; externally peer reviewed.

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