MRI not yet reliable for predicting development of knee osteoarthritis

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  • Although MRI is better than X-rays for identifying damage to cartilage, bone, and meniscus that is associated with higher risk for developing knee osteoarthritis (OA), it does not discriminate well enough to be used for diagnosis.

Why this matters

  • Improvements in MRI techniques commonly available in clinical practice are needed before MRI imaging can become a practical tool for predicting development of knee OA.

Study design

  • MRI exams and radiographs at baseline obtained for 148 Cohort Hip and Cohort Knee study participants with a Kellgren Lawrence (KL) score ≤1 and with determination of knee OA (KL score, ≥2) at 5 y.
  • Calculations of ORs for MRI parameters and later development of knee OA, and development of prediction model with the measures identified as being significantly associated with radiographic knee OA.
  • Funding: ZonMW, the Netherlands Organization for Health Research and Development, and the European Society of Radiology.

Key results

  • Combining 5 MRI features associated with development of radiographic knee OA, including cartilage defects, osteophytes, and bone marrow lesions into a prediction model, resulted in sensitivity of 66% and specificity of 67%.


  • Only moderate-to-fair interobserver reliability in evaluating MRI for cartilage defects and bone marrow lesions.