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Table 1 Strengths and limitations of radiography and magnetic resonance imaging

From: Why radiography should no longer be considered a surrogate outcome measure for longitudinal assessment of cartilage in knee osteoarthritis

  Radiography Magnetic resonance Imaging
Strengths • Inexpensive
• Widely available
• Short examination time
• Sensitive to change
• Specific because it directly shows cartilage
• Positioning is not an issue, since cartilage can be directly visualized
• Treats the joint as a whole organ
Limitations • Not sensitive to change: minimal progression is not identifiable, so large patient sample size and lengthy studies are required
• Not specific: meniscal extrusion and damage may account for joint space narrowing
• Change in positioning is problematic in multicenter and long-term studies
• Does not show other important structures that account for pain in osteoarthritis
• Expensive
• Limited availability
• Long examination time
• Requires expert knowledge (that is, input of radiologist is essential) for choice of appropriate pulse sequences and imaging protocol
• Difficulties with repositioning
• Challenges of imaging obese patients who do not fit the coil
• Images with identical pulse sequences may not be obtained across all sites in multicenter magnetic resonance imaging studies