The most reliable indicators of chondromalacia are focal contour irregularities of the hyaline cartilage and/or thinning of the hyaline cartilage associated with high signal intensity changes within frank defects or contour irregularities with T2-weighted images.
A normal signal intensity is no assurance that softening of the cartilage is not present. Focal or diffuse areas of increased or decreased signal alterations of the hyaline cartilage without a contour deformity or cartilaginous thinning do not correlate reliably with arthroscopic staging of chondromalacia. For the evaluation of stage III and IV chondromalacia, the accuracy of MR was 89%. Chondromalacia in stages I and II could not be reliably identified with MR imaging. Proton density and T2 (0) weighted images were obtained in all patients. Axial magnetic resonance (MR) imaging of the patellofemoral compartment was performed in 75 patients with arthroscopic correlation.
