Clinical significance of magnetic resonance imaging (MRI) for focal chondral lesions

To evaluate the diagnostic potential of magnetic resonance imaging (MRI) and define its role, focal chondral lesions of the femoral surface of the tibiofemoral joint were examined. Full-thickness defects were well detected prospectively (93%) with conventional MRIs initially administered for observation reference of ligaments and menisci. Optimized MRIs, which included right-angled planes to the lesion surface and magnetization transfer contrast (MTC) sequences, delineated the size of lesions (R2 = 0.648, p < 0.0001) and the difference between full- and partial-thickness defects (88% in accuracy). A forward-tilt of 30o to the femoral shaft was the average plane angle that afforded optimal visualization of the chondral lesions. Our findings advocate that routine MRIs are sufficient in detecting severe chondral lesions that require further examination, and the optimized images are highly useful in facilitating the recently developed therapeutic approaches and follow-up studies for articular cartilage defects.