LIVRE JDG 2012

C. Lapra, S. Chomel, M. Bakir

230

Delayed gadolinium-enhancedMRI of cartilage

(dGEMRIC)

[30]: these sequences consist of

an intra-articular injection of a double dose of

gadolinium, associated with the patient walking

for 15 minutes. The examination is done after

90 minutes. It is a “molecular” study of the

cartilage that is not routinely done. In healthy

cartilage, gadolinium (Gd) does not penetrate

cartilage; Gd fixation increases if the

glycoaminoglycan content decreases.

Associated lesions: synovitis, subchondral

bone edema

Many studies have shown that the pain of

arthrosis was often linked to secondary lesions

associated with edema of the subchondral bone

due to trabecular bone microcracks and

synovial inflammation, which explains the

evolution in spurts [14, 18, 32].

Synovitis

(fig. 11)

Fig. 10: There is cartilage thinning of the lateral patellar facet, not visible on the T2 map.

Fig. 11: Same patient, MRI. - a: Right knee MRI with injection: synovitis. b: On the left knee (Proton density),

the joint space is more impaired but there is less synovial inflammation.