387 Peripatellar Synovitis in Osteoarthritis: Comparison of Non-Enhanced and Enhanced Magnetic Resonance Imaging (Mri) and Its Association With Peripatellar Knee Pain. The Most Study

Marra, Monica; Roemer, Frank W.; Crema, Michel D.; Niu, Junfan; Zhang, Y.; Javaid, M.K.; Torner, J.; Lewis, Cora E.; Felson, David T.; Guermazi, Ali

doi:10.1016/s1063-4584(08)60428-8

Cited by 6 publications

(3 citation statements)

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“…However, this study clearly showed that US-detected synovial inflammation, especially MCS, was positively linearly associated with OA knee pain. Our finding that synovitis is significantly associated with OA knee pain is similar to that of prior studies 16,17,27,39,40 . Second, there was no patient with predominantly lateral compartment OA, although predominantly medial compartment OA is typical in patients with knee OA.…”

Section: Discussionsupporting

confidence: 92%

“…OA knee joints usually show signs of synovitis, even in the early stage of the disease 37,38 . MR imaging in patients who either have or are at risk for knee OA showed that high-grade synovitis was associated with knee pain compared with those with no or lowgrade synovitis 39,40 . There is evidence that synovitis is not only a secondary phenomenon in individuals with knee OA, but is also involved in the progression of cartilage loss 34 .…”

Section: Discussionmentioning

confidence: 99%

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Pain in patients with equal radiographic grades of osteoarthritis in both knees: the value of gray scale ultrasound

Shao

et al. 2012

Osteoarthritis and Cartilage

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s u m m a r yObjectives: To investigate the association of ultrasound (US) features with pain and the functional scores in patients with equal radiographic grades of osteoarthritis (OA) in both knees. Methods: Fifty-six consecutive patients with knee OA: 85 symptomatic knees (81 knees with medial pain) and 27 asymptomatic knees, and 10 healthy patients without knee OA as a control were enrolled. US was done by two ultrasonographers blinded to patient diagnoses. US features were semiquantitatively scored (0e3) when appropriate. Results: In the OA group, common US findings were marginal osteophyte, suprapatellar synovitis, suprapatellar effusion (SPE), medial meniscus protrusion, medial compartment synovitis (MCS), lateral compartment synovitis, and Baker's cyst. Only SPE and MCS were significantly associated with knee pain. Visual analog pain scale (VAS) scores on motion were positively linearly associated with SPE and MCS (P < 0.01). Only MCS was degree-dependently associated with VAS scores at rest, the Western Ontario and McMaster Universities pain subscale, and the presence of medial knee pain (P < 0.01) after adjustments for age, gender, body mass index (BMI), radiographic grade, and other US features. In the control group, no US features were associated with knee pain. Conclusions: US inflammation features, including SPE and MCS, were positively linearly associated with knee pain in motion. MCS was also degree-dependently associated with pain at rest and the presence of medial knee pain. These findings show that synovitis was one important predictive factor of pain. Further studies to confirm the association of US features and pain are warranted.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Pain in patients with equal radiographic grades of osteoarthritis in both knees: the value of gray scale ultrasound

Shao

et al. 2012

Osteoarthritis and Cartilage

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“…To our knowledge, no prior studies have used gadolinium‐enhanced MRI to quantitatively assess the SV and to study its correlation with radiographic disease severity in knee OA. Noncontrast MRI techniques using semiquantitative scoring methods may underestimate the degree of synovitis, whereas measurement of the quantitative SV using gadolinium‐enhanced MRI is currently the most sensitive way of detecting synovial hypertrophy in OA (10–12). Other authors have assessed the correlation of measures of synovitis identified on enhanced MRI with those identified on unenhanced MRI, as well as the predictive value of such measures with respect to clinical symptoms such as pain (13–15).…”

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confidence: 99%

Quantitative magnetic resonance imaging evidence of synovial proliferation is associated with radiographic severity of knee osteoarthritis

Krasnokutsky¹,

Belitskaya-Lévy²,

Bencardino³

et al. 2011

Arthritis & Rheumatism

124

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Objective To evaluate the relationships of quantitative and semi-quantitative (SQ) assessments of synovium with knee OA severity by radiographic and 3T MRI findings. Methods 58 knee OA patients underwent non-fluoroscopic fixed-flexion knee radiographs. Dynamic contrast-enhanced (CE) 3T MRI was performed pre-/post-gadolinium administration to quantify synovial volume (qSV). SQ synovial outcomes were assessed on CE and unenhanced images. Two radiologists scored X-rays using the OARSI atlas; inter-reader agreement was assessed using Kappas and concordance correlation coefficients. Multiple linear and logistic regression analysis was used to assess associations among variables while controlling the effects of age, BMI, gender and meniscal extrusion. Results KL grade, diseased compartment joint space width (dcJSW) and diseased compartment joint space narrowing (dcJSN) were significantly associated with synovial proliferation, measured as CE qSV (β = 0.78, p = 0.0001; β = -0.22, p = 0.0003; β = 0.53, p = 0.0001, respectively). Furthermore, qSV strongly correlated with total subchondral BML volume (β = 0.22, p = 0.0003). KL grade, dcJSW, and dcJSN were significantly associated with BLOKS SQ infrapatellar synovitis (OR [95%CI]: 9.05, [1.94,42.3]; 0.75 [0.54,1.03]; 2.22 [1.15,4.31], respectively) and effusion (OR [95%CI]: 5.75, [1.23,26.8]; 0.70, [0.50,0.98]; 1.96, [1.02,3.74], respectively). CE SQ synovitis also significantly associated with KL and dcJSN (β = 0.036, p = 0.0040; β = 0.015, p=0.0266, respectively), and BLOKS synovitis. Conclusion Synovitis is a characteristic feature of advancing knee OA stages, and is significantly associated with KL, JSW, JSN, and BMLs. BLOKS synovitis scoring on unenhanced MRI is associated with CE synovitis measures.

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Targeting the synovial tissue for treating osteoarthritis (OA): where is the evidence?

Attur¹,

Samuels²,

Krasnokutsky³

et al. 2010

Best Practice & Research Clinical Rheumatology

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387 Peripatellar Synovitis in Osteoarthritis: Comparison of Non-Enhanced and Enhanced Magnetic Resonance Imaging (Mri) and Its Association With Peripatellar Knee Pain. The Most Study

Cited by 6 publications

References 0 publications

Pain in patients with equal radiographic grades of osteoarthritis in both knees: the value of gray scale ultrasound

Pain in patients with equal radiographic grades of osteoarthritis in both knees: the value of gray scale ultrasound

Quantitative magnetic resonance imaging evidence of synovial proliferation is associated with radiographic severity of knee osteoarthritis

Targeting the synovial tissue for treating osteoarthritis (OA): where is the evidence?

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