Delayed gadolinium-enhanced magnetic resonance imaging of cartilage in the long-term follow-up after Perthes disease.

Abstract

BACKGROUND:

Aim of this study was to assess the glycosaminoglycan content in hip joint cartilage in mature hips with a history of Legg-Calvé-Perthes (LCPD) disease using delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC).

METHODS:

Thirty one hips in 27 adults (mean age: 30.5+/-10.9 y) with LCPD in childhood were included. Mean follow-up after diagnosis was 24.5+/-11.4 years. Clinical symptoms and standard radiographic parameters were evaluated. dGEMRIC indices were calculated as T1(Gd) mean values in four coronal MRI slices medially, centrally, and laterally. For comparison, the morphologically normal appearing contra-lateral hips (21 hips) were assessed.

RESULTS:

The following T1(Gd) values for the LCPD group were noted: medial (507+/-100 ms), central (543+/-104 ms), and lateral (553+/-105 ms). The total T1(Gd) mean value was 534+/-104 ms. The difference between LCPD and normal hips was statistically significant only for the medial compartment (P=0.018).

CONCLUSIONS:

Hip joint cartilage after LCPD shows a significant glycosaminoglycan loss in the medial compartment while this decrease is less apparent centrally and laterally. dGEMRIC allows direct assessment of cartilage matrix biochemistry and may depict the complex damage pattern of hip joint cartilage after LCPD spatially and qualitatively better than other radiographic methods.

LEVEL OF EVIDENCE:

Prognostic study, Level II-1 (retrospective study).

• Authors: Christoph Zilkens, Arne Holstein, Bernd Bittersohl, Marcus Jäger, Tanja Haamberg, Falk Miese, Young-Jo Kim, Tallal C Mamisch, Rüdiger Krauspe
• Journal: Journal of pediatric orthopedics (J Pediatr Orthop) Vol. 30 Issue 2 Pg. 147-53 (Mar 2010) ISSN: 1539-2570 [Electronic] United States
• PMID: 20179562 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Contrast Media
• Glycosaminoglycans
• Gadolinium DTPA

Topics

• Adolescent
• Adult
• Cartilage, Articular (diagnostic imaging, pathology)
• Contrast Media
• Female
• Follow-Up Studies
• Gadolinium DTPA
• Glycosaminoglycans (metabolism)
• Hip Joint (diagnostic imaging, pathology)
• Humans
• Legg-Calve-Perthes Disease (diagnostic imaging, pathology)
• Magnetic Resonance Imaging (methods)
• Male
• Middle Aged
• Radiography
• Retrospective Studies
• Time Factors
• Young Adult