Cartilage signal intensity on T1-weighted MRI: association with risk factors and measures of knee osteoarthritis.

This study aims to assess mean signal intensity of cartilage on T1-weighted magnetic resonance imaging (MRI) images, and then examine whether mean signal intensity is associated with risk factors and measures of osteoarthritis in younger and older adults. A total of 50 younger adult subjects (mean age 41, range 29-57; 64% female; baseline only) and 168 older adult subjects (mean age 63, range 52-78; 46% female; baseline and 2.9 year followup) were randomly selected from the community. T1-weighted fat-supressed gradient recall echo MRI scans of right knees were performed. Image segmentation was performed semi-automatically, and measures of mean signal intensity and cartilage thickness for regions of cartilage were obtained. Urinary levels of C-terminal crosslinking telopeptide of type II collagen (U-CTX-II) were measured in younger adults. Cartilage defects were scored using a 5-point scale in both groups. In multivariable analyses, higher cartilage defects and BMI were significantly associated with lower same-region mean signal intensity in younger and older adults. CTX-II was negatively and significantly associated with mean signal intensity of cartilage in the lateral femoral and patellar sites. Joint space narrowing and osteophytes analysed in older adults were significantly associated with reduced mean signal intensity at various sites. Over 2.9 years, lower mean signal intensity at femoral and patellar sites and in whole knee was associated with decreases in cartilage thickness. Reduced mean signal intensity of cartilage on T1-weighted gradient recall echo MRI is associated with osteoarthritis risk factors and predicts cartilage loss suggesting low cartilage signal intensity may reflect early osteoarthritic changes.