Comparison of patella cartilage volume and radiography in the assessment of longitudinal joint change at the patellofemoral joint

OBJECTIVE: To compare radiological assessment of the patellofemoral (PF) joint and cartilage volume as measured by magnetic resonance imaging (MRI) in a longitudinal study. METHODS: One hundred and two subjects with osteoarthritis (OA) had baseline and followup skyline and lateral radiographs and MRI of the same knee. Duration of followup was 1.94 +/- 0.23 years. Mid-patella joint space and narrowest joint space were measured on lateral PF radiographs. Minimum joint space in the lateral and medial facets was measured on skyline radiographs. Rate of progression of PF joint OA was measured quantitatively at each site. Patella cartilage volume was measured from the MRI. The rate of change in each radiographic measure was compared to the rate of change in patella cartilage volume. RESULTS: The average loss of patella cartilage was 133 +/- 143 microm(3)/yr (4.4%). The loss of joint space over the same period on lateral radiographs was 0.7 +/- 2.6 mm at the narrowest joint space and 0.2 +/- 3.8 mm at the mid-patella joint space. On the skyline radiographs, the loss of joint space at the medial facet was 0.4 +/- 3.9 mm and 0.2 +/- 3.4 mm at the lateral facet. Only change in narrowest joint space on the lateral PF radiographs correlated with change in patella cartilage volume (R = 0.22, p = 0.03). CONCLUSION: Our data suggest that narrowest joint space measured on lateral PF radiographs correlates best with loss of patella cartilage. Further work will be needed to determine how different radiological measures of the PF joint relate to the disease process in OA.