MRI of the Degenerative Knee: Detecting Early Changes of Osteoarthritis

MRI of the Degenerative Knee

Osteoarthritis is an important cause of disability in our society, affecting millions and resulting in limitations on activity. It is pri­marily a disease of ar­ticular cartilage, ei­ther from distant injury or degeneration. How­ever many other changes are seen in additional tissues about the knee. Imaging offers a non­invasive means of as­ses­sing the degree of damage to the knee joint and the effec­tiveness of therapy or behavior modifica­tion.

Many imaging me­thods are available to assess the degen­erative knee. Con­ventional ra­diography can be used to detect gross loss of cartilage and other soft tissues, evident as nar­rowing of the distance bet­ween the bony com­ponents of the joint, but it does not image soft tissue directly.1 Secondary changes such as osteophyte forma­tion can be seen, but con­ventional radiography is insensitive to early chondral and meniscal damage. Frac­tures, as in the case of an osteochondral de­fect, can be detected with limited sensitivity, but chondral defects or cartilage delamination cannot be seen. Ar­thro­graphy, alone or com­­bined with con­ventional radiography, CT scan­ning, or MR imaging, is mildly in­vasive and provides information limited to the contour of the cartilage surface…

Marrow Edema

Bone marrow edema is an indication that the bone has been subjected to stress, and may be the result of trauma or tissue stress that exceeds the ability of the overlying tissue to protect the sub­chondral…

Knee Osteoarthritis


Cartilage in the Degenerative Knee

High-grade cartilage lesions that have been present for a while often have areas of overlying marrow edema.  Fast spin-echo…

Meniscal Tears and Extrusion

Damage to the knee meniscus may precede or follow dam­age to the articu­lar cartilage in osteo­arth­ritis. In cases of osteo­arthritis, the men­­is­cus is often…


Osteophyte formation is common in osteo­ar­thritis, and osteophytes are frequently seen on…

Joint Bodies and Subchondral Cysts

Bodies in the synovial joint are fre­quently calcified and filled with fatty marrow. Detection of these bodies can be difficult on MRI, and comparison with…


This article was edited from MR Imaging of the Degenerative Knee by the same author. The complete unabridged version, including all of its images and references, is available at the Apple iBooks Store. See other MSK and Joint articles here.



  1. Hunter DJ, Guermazi A. Imaging techniques in osteoarthritis. PM R. 2012 May;4(5 Suppl):S68-74.
  2. Wick MC, Jaschke W, Klauser AS. Radiological imaging of osteoarthritis of the knee. Radiologe. 2012 Oct 7.
Garry E. Gold, MD
Garry E. Gold, MD
Professor of Radiology, Stanford University School of Medicine | Faculty Page