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Recently, additional modalities such as MRI and ultrasound have enhanced OSTEOARTHRITIS diagnosis and management. Degeneration of articular cartilage is a sign of progression of OA. Plain radiographs cannot detect early chondral damage. Instead, MRI can provide information about size and structural integrity of cartilage. This can be extremely useful in identifying full or partial thickness changes of articular cartilage in OSTEOARTHRITIS. MRI can also be used to identify predisposing factors for OA such a meniscal and anterior cruciate ligament injuries. Ultrasound can also assess the synovium for hypertrophy and inflammation. The Rheumatoid Arthritis Clinical Trials Ultrasonography Taskforce defines ultrasound-detected synovial hypertrophy as “abnormal hypoechoic intra articular tissue that is, nondisplaceable and poorly compressible and which may exhibit Doppler signal.”Ultrasound technology offers many advantages, including low cost, lack of ionizing radiation, ability to image structure dynamically, and can be used for interventional procedures. MRI can be used to detect OA in deeper joints such as the hip and shoulder that ultrasound cannot assess.