Magnetic resonance imaging is the optimal modality for assessing articular
cartilage because of superior soft tissue contrast, direct visualization of
articular cartilage, and multiplanar capability. Despite these advantages,
there has been disagreement as to the efficacy of magnetic resonance imagi
ng of articular cartilage. The reason for this controversy is multifactoria
l but in part is attributable to the lack of the use of optimized pulse seq
uences for articular cartilage. The current authors will review the current
state of the art of magnetic resonance imaging of articular cartilage and
cartilage repair procedures, discuss future new directions in imaging strat
egies and methods being developed to measure cartilage thickness and volume
measurements, and propose a magnetic resonance imaging protocol to evaluat
e cartilage that is achievable on most magnetic resonance scanners, vendor
independent, practical (time and cost efficient), and accepted and used by
a majority of musculoskeletal radiologists.