The Rise and Fall of dGEMRIC Evaluation in the Adolescent Hip

• Type of Material: Article
• Authors: Kelley Marshall, Emory University; Kiery Braithwaite, Emory University; Nabile Safdar, Emory University; Naseem Shakir, Emory University; Danielle Ballard, Philadelphia College of Osteopathic Medicine; Lindsey Collier, Philadelphia College of Osteopathic Medicine; Grant Marshall, Georgia Institute of Technology; Tim Schrader, Emory University; Cliff Willimon, Children’s Healthcare of Atlanta; Nicholas Fletcher, Emory University
• Language: English
• Date: 2019-03-07
• Publisher: SAGE Publications (UK and US): Orthopaedic Journal of Sports Medicine
• Publication Version: Final Published Version
• Copyright Statement: © The Author(s) 2019
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1177/2325967119S00016
• Title of Journal or Parent Work: Orthopaedic Journal of Sports Medicine
• ISSN: 2325-9671
• Volume: 7
• Issue: 3
• Keywords: pediatrics; orthopaedics
• Research Categories: Health Sciences, Medicine and Surgery

Abstract

Delayed Gadolinium Enhanced Magnetic Resonance Imaging of Cartilage (dGEMRIC) was first introduced in 1996 by Bashir et al. as a method of indirectly evaluating glycosaminoglycan (GAG) changes in cartilage microstructure. Following publications originating from the Boston Children’s research group describing the association of early joint failure following periacetabular osteotomy (PAO) in patients with diminished preoperative cartilage T1 relaxation values, the interest in this imaging technique spread. dGEMRIC imaging was introduced into our clinical practice in 2013 with enrollment of both pediatric and adult patients. However, since the program’s apex in 2015, a marked decline in referral of adolescent patients for preoperative dGEMRIC imaging has occurred. Using data acquired during a quality analysis of the dGEMRIC program, this project was designed to investigate the utility of the dGEMRIC exam in our adolescent imaging cohort from 2013-2015 and to identify potential factors leading to decreased utilization from 2015-2018.