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Quadriceps intramuscular fat fraction rather than muscle size is associated with knee osteoarthritis

  • Kumar, D.
  • Karampinos, D.C.
  • MacLeod, T.D.
  • Lin, W.
  • Nardo, L.
  • Li, X.
  • Link, T.M.
  • Majumdar, S.
  • Souza, R.B.1, 2, 3, 4, 5, 6, 7, 3
  • 1 Musculoskeletal Quantitative Imaging Research Group
  • 2 Department of Radiology and Biomedical Imaging
  • 3 University of California San Francisco
  • 4 Institut für Radiologie
  • 5 Klinikum rechts der Isar
  • 6 Technische Universität München
  • 7 Department of Physical Therapy and Rehabilitation Science
Published Article
Osteoarthritis and Cartilage
Publication Date
Jan 01, 2013
Accepted Date
Dec 02, 2013
DOI: 10.1002/jmri.24278


ObjectivesTo compare thigh muscle intramuscular fat (intraMF) fractions and area between people with and without knee radiographic osteoarthritis (ROA); and to evaluate the relationships of quadriceps adiposity and area with strength, function and knee magnetic resonance imaging (MRI) lesions. MethodsNinety six subjects (ROA: Kellgren–Lawrence (KL) > 1; n = 30, control: KL = 0, 1; n = 66) underwent 3-T MRI of the thigh muscles using chemical shift-based water/fat MRI (fat fractions) and the knee (clinical grading). Subjects were assessed for isometric/isokinetic quadriceps/hamstrings strength, function Knee injury and Osteoarthritis Outcome Score (KOOS), stair climbing test (SCT), and 6-minute walk test (6MWT). Thigh muscle intraMF fractions, muscle area and strength, and function were compared between controls and ROA subjects, adjusting for age. Relationships between measures of muscle fat/area with strength, function, KL and lesion scores were assessed using regression and correlational analyses. ResultsThe ROA group had worse KOOS scores but SCT and 6MWT were not different. The ROA group had greater quadriceps intraMF fraction but not for other muscles. Quadriceps strength was lower in ROA group but the area was not different. Quadriceps intraMF fraction but not area predicted self-reported disability. Aging, worse KL, and cartilage and meniscus lesions were associated with higher quadriceps intraMF fraction. ConclusionQuadriceps intraMF is higher in people with knee OA and is related to symptomatic and structural severity of knee OA, whereas the quadriceps area is not. Quadriceps fat fraction from chemical shift-based water/fat MR imaging may have utility as a marker of structural and symptomatic severity of knee OA disease process.

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