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This chapter describes the most promising magnetic resonance imaging (MRI)-based biomarkers for quantitative imaging of molecular changes in cartilage during early osteoarthritis. The overview discusses the current status of emerging technologies, such as sodium, T, and chemical exchange saturation transfer (CEST) MRI that target proteoglycans of the tissue, their role in disease management and developing disease-modifying therapies, as well as their limitations. Also presented is an outline of potential future technical developments including extensions of these methods to ultra-high field 7 T MRI scanners.

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