Clinical applications of advanced magnetic resonance imaging techniques for arthritis evaluation

Figure 12 Treatment monitoring with magnetic resonance imaging in a 26-year-old gymnast with knee pain. Initial MRI (A) shows mild cartilage thinning at the medial femoral condyle with subchondral damage PD image. A moderate increase in T2 relaxation values (arrow) confirms the loss of collagen fibers in this area. Patient underwent MTX therapy and a follow-up MRI performed 3 mo later (B) demonstrates moderate chondral irregularity with focal areas of increased signal intensity on PD. T2 mapping demonstrates normalization of T2 relaxation time values compared with the pre-treatment study due to the generation of new fibrous cartilage. MRI: Magnetic resonance imaging; MTX: Microfracturing therapy; PD: Proton-density images.