Advances in cartilage imaging techniques

Guermazi A, Eckstein F, Gold G, Hayashi D, Jarraya M, Kogan F, Li X, Link TM, Nebelung S, Oei EH, Omoumi P, Saarakkala S, Trattnig S, Wirth W, Roemer FW (2026)

Publication Type: Journal article, Review article

Publication year: 2026

Journal

DOI: 10.1038/s41584-026-01353-x

Abstract

Articular cartilage is crucial for joint function; however, it has limited regenerative capacity when damaged, a hallmark of many rheumatic diseases. Non-invasive imaging is essential for early diagnosis, therapeutic monitoring and prognostication. MRI remains the reference standard, offering detailed assessment of both morphological and compositional cartilage changes. Technological advances, including high-resolution and compositional MRI techniques such as T2 mapping, T1ρ, delayed gadolinium-enhanced MRI of cartilage, sodium imaging, diffusion imaging and ultra-short echo-time imaging, enable early detection of matrix alterations that precede structural breakdown. CT arthrography, although it involves radiation, serves as a valuable alternative when MRI is contra-indicated, offering high performance in the detection and evaluation of cartilage surface lesions. Emerging modalities, such as ultrasonography and PET, offer additional functional insights but are currently limited in scope. Artificial intelligence is poised to transform cartilage imaging through accelerated acquisition, automated segmentation, improved interpretation and enhanced efficiency, with growing clinical adoption. Advanced cartilage imaging will probably have an increasingly important role in clinical rheumatology, particularly for the optimization of individualized management of cartilage pathology.

Involved external institutions

Stanford University United States (USA) (US) University of California San Francisco (UCSF) United States (USA) (US) Chondrometrics GmbH Germany (DE) VA Boston Healthcare System United States (USA) (US) Boston University United States (USA) (US) Paracelsus Medizinische Privatuniversität Austria (AT) Tufts University United States (USA) (US) Harvard University United States (USA) (US) Cleveland Clinic United States (USA) (US) Universitätsklinikum Aachen (UKA) Germany (DE) Erasmus University Medical Center (MC) Netherlands (NL) Lausanne University Hospital / Centre hospitalier universitaire vaudois (CHUV) Switzerland (CH) Oulun Yliopisto / University of Oulo Finland (FI) Medizinische Universität Wien Austria (AT)

How to cite

APA:

Guermazi, A., Eckstein, F., Gold, G., Hayashi, D., Jarraya, M., Kogan, F.,... Roemer, F.W. (2026). Advances in cartilage imaging techniques. Nature Reviews Rheumatology. https://doi.org/10.1038/s41584-026-01353-x

MLA:

Guermazi, Ali, et al. "Advances in cartilage imaging techniques." Nature Reviews Rheumatology (2026).

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