CT-detected knee cartilage mineralization predicts MRI cartilage worsening in same area
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Key takeaways:
- Knee cartilage mineralization on CT may predict worsening cartilage on MRI over 2 years.
- The findings suggest “tissue-specific and localized effects of [intra-articular] mineralization” on knee OA pathology.
CT detection of intra-articular mineralization in knee cartilage, resulting from calcium crystal deposition, may predict MRI detection of worsening cartilage in the same area, according to data published in Arthritis & Rheumatology.
“Whether calcium crystals may be a cause or consequence of OA has not been clear. Studies to date have been conflicting in this regard,” Tuhina Neogi, MD, PhD, of the Boston University Chobanian & Avedisian School of Medicine, told Healio. “Understanding whether calcium crystals are a pathologic culprit rather than just an innocent bystander would provide a new potential treatment target for OA.”
To evaluate associations between intra-articular mineralization on CT and worsening cartilage on MRI, Liew and colleagues examined data from the Multicenter Osteoarthritis Study. The researchers analyzed intra-articular mineralization on whole-knee, compartment-specific and subregion-specific levels, vs. cartilage worsening after 2 years using binomial regression adjusted for age, sex and BMI.
The study included 1,673 participants, 9% of whom demonstrated any knee intra-articular mineralization and 47.4% of whom had any cartilage worsening at follow-up. One knee per participant was evaluated.
According to the researchers, cartilage mineralization on CT demonstrated a 1.39-fold higher risk (95% CI, 1.04-1.88) for cartilage worsening in the same compartment on MRI. However, mineralization of any tissue, regardless of location or tissue type, was not associated with worsening cartilage at any location, with relative risks ranging from 1.09 to 1.27, the researchers wrote.
Meanwhile, a subregion-specific analysis found that cartilage mineralization was associated with 1.56 times the risk (95% CI, 1.13-2.17) of MRI cartilage worsening in the same subregion. However, no association was found for “meniscal mineralization with cartilage worsening immediately overlying or underlying the meniscal subregion” (RR = 1.02; 95% CI, 0.73-1.42), the researchers wrote.
“Mineralization in the cartilage was associated with worsening cartilage damage in the same location, but not in other parts of the joint,” Neogi said. “It is a very localized effect, and whether that is through localized inflammation or some other mechanism is not yet known.”
Neogi added that trials of future treatments “should assess presence of baseline mineralization in the joint to see if those with such deposition respond better to the treatment.”
“For example, if we hypothesize that these calcium crystals are contributing to cartilage damage through local inflammation in the joint, then treatments targeting inflammation could be tested to see if knees with calcium deposition are the ones most likely to respond,” she said.
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