What can a cartilage scan really tell you?

What does an x-ray show?

An x-ray mainly shows your bones and joint space. Less space may show that the cartilage has worn thin.

A small damaged spot may not show up. That's why a normal x-ray doesn't always end the search.

What does an MRI add?

An MRI shows cartilage, bone, fluid, and nearby tissue. It can show how deep a damaged area goes.

The catch is simple. Some people have visible wear without soreness, so the MRI can't decide by itself.

Who can put the scan in context?

A visit puts the scan beside your symptoms. QC Kinetix calls the person examining your joint a medical provider.

The clinic calls its non-surgical office care regenerative treatments. One option uses a prepared portion of your own blood.

PRP is the short name for platelet-rich plasma. A clinician draws the blood, separates the portion rich in clotting platelets, and places it in the sore joint.

This care may be discussed for soreness. It isn't proof that damaged cartilage has been replaced.

What should I ask during the exam?

Ask the clinician to point to the damaged area on your scan. Then ask whether that area matches your soreness and daily limits.

Bring older images if you have them. Describe any swelling, catching, or times the joint gives way.

Write down your main questions before leaving home. That'll help you remember them during the exam.

Don't let one alarming report word decide everything. Ask what the exam confirmed and what remains uncertain.

Sources

1. In a meta-analysis of 63 studies covering 5,397 knees of 4,751 adults with NO symptoms and no injury, the pooled prevalence of cartilage defects on MRI was 24% (95% CI 15% to 34%), rising from 11% in adults under 40 to 43% in adults aged 40 and over. Meniscal tears were present in 10%, bone marrow lesions in 18% and osteophytes in 25%.

   Culvenor AG, et al. — Prevalence of knee osteoarthritis features on magnetic resonance imaging in asymptomatic uninjured adults: a systematic review and meta-analysis.. Br J Sports Med, 2019. DOI: 10.1136/bjsports-2018-099257.

2. In 1,000 consecutive knee arthroscopies, chondral or osteochondral lesions of any type were found in 61% of patients and focal defects in 19%, with a mean total defect area of 2.1 cm2 and the medial femoral condyle involved in 58%. A single ICRS grade III or IV defect of at least 1 cm2 in a patient under 40 accounted for 5.3% of all arthroscopies.

   Hjelle K, et al. — Articular cartilage defects in 1,000 knee arthroscopies.. Arthroscopy, 2002. DOI: 10.1053/jars.2002.32839.

3. Seven fellowship-trained arthroscopic surgeons graded 18 cadaveric lesions with the ICRS system. Interobserver reliability was 0.67 and correlation with histological depth was 0.91, but on average surgeons graded lesions 0.37 of a grade DEEPER than histology showed. The grade in an operative report is a good but not exact measurement.

   Dwyer T, et al. — Reliability and Validity of the Arthroscopic International Cartilage Repair Society Classification System: Correlation With Histological Assessment of Depth.. Arthroscopy, 2017. DOI: 10.1016/j.arthro.2016.12.012.

4. Twelve years after arthroscopic diagnosis, dGEMRIC and T2 mapping of 21 knees with full-thickness cartilage defects - 10 repaired at baseline with microfracture or ACI, 11 left untreated or simply debrided - showed no overall increase in cartilage degeneration in the injured knees. Radiographic osteoarthritis changes were present in 13 of the 21 knees but did not correlate with measured cartilage quality.

   Engen CN, et al. — No degeneration found in focal cartilage defects evaluated with dGEMRIC at 12-year follow-up.. Acta Orthop, 2017. DOI: 10.1080/17453674.2016.1255484.

5. Across 32 articles covering 1,019 patients, most MRI parameters measured after cartilage repair showed limited or no correlation with clinical outcome. Only 28% of studies found a correlation between outcome and the composite MOCART or Henderson score, 22% with defect fill, and five studies found a weak-to-moderate correlation with the T2 index. A better-looking repair on MRI is not reliably a better-feeling knee.

   de Windt TS, et al. — Is magnetic resonance imaging reliable in predicting clinical outcome after articular cartilage repair of the knee? A systematic review and meta-analysis.. Am J Sports Med, 2013. DOI: 10.1177/0363546512473258.

6. In 70 knees treated with particulated juvenile articular cartilage for full-thickness patellar defects, all patient-reported outcome scores improved significantly by two years (IKDC 41.1 to 73.5, Kujala 52 to 86.3). MRI showed defect fill above 66% in most patients by three months - and there was NO association between the percentage of defect fill and the outcome scores at one or two years.

   Marmor WA, et al. — Outcomes of Particulated Juvenile Articular Cartilage and Association With Defect Fill in Patients With Full-Thickness Patellar Chondral Lesions.. Orthop J Sports Med, 2024. DOI: 10.1177/23259671241249121.