Atlas: Cartilage Abnormalities and Scores
The following chapter illustrates cartilage abnormalities and provides semiquantitative scores for these lesions. The focus of this chapter is on the most frequently used Recht (modified Noyes and Stabler) score [1, 2] and Whole-Organ-MRI-Score (WORMS) [3
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Atlas: Cartilage Abnormalities and Scores Hans Liebl and Thomas M. Link
Keywords Atlas • Typical MRI findings • Noyes and Stabler MRI classification • WORMS • Recht score • Grades • Cartilage abnormalities The following chapter illustrates cartilage abnormalities and provides semiquantitative scores for these lesions. The focus of this chapter is on the most frequently used Recht (modified Noyes and Stabler) score [1, 2] and Whole-Organ-MRIScore (WORMS) [3]. These scores have been used in a number of previous studies and have been found helpful in assessing the grade of cartilage lesions, in particular in degenerative joint disease, and in monitoring cartilage abnormalities [4–7]. The individual scores were explained in detail in the previous chapter. The standard modified Noyes and Stabler MRI classification [1, 2] differentiates four grades: a grade 1 cartilage lesion is defined as a focal signal abnormality of the cartilage with or without swelling; a grade 2a lesion is a focal defect involving less than half of the cartilage thickness; a grade 2b lesion affects more than 50% of the cartilage layer; and a grade 3 lesion is defined as involving the entire cartilage layer and exposing the bone. Grade 3A lesions have a normal bony surface, and 3B lesions include an erosion of the bony surface (Figs. 9.1–9.23). The whole-organ magnetic resonance imaging score (WORMS) [3] assesses both depth and size of the cartilage lesions using an eight-point scale: grade 1 lesions have a normal thickness but abnormal signal on fluid sensitive sequences; grade 2.0 lesions are partial-thickness focal
defects, which are smaller than 1 cm in the greatest width; grade 2.5 are full-thickness focal defects smaller than 1 cm in greatest width; grade 3 lesions are defined as multiple areas of partial-thickness (grade 2.0) defects intermixed with areas of normal thickness, or a Grade 2.0 defect wider than 1 cm but affecting
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