Anatomical distribution of synovitis in knee osteoarthritis and its association with joint effusion assessed on non-enhanced and contrast-enhanced MRI

Roemer, Frank W.; Javaid, M K; Guermazi, Ali; Thomas, Martine; Kiran, Amit; Keen, Richard; King, Leonard; Arden, N K

doi:10.1016/j.joca.2010.07.008

Cited by 165 publications

(151 citation statements)

References 26 publications

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“…Hawker et al reported that working hours were also a possible risk factor for nocturnal knee symptoms (4). Conversely, it is documented that knee OA patients have synovitis even in the early stages of the disease, and its prevalence and number of regions increase with the severity of OA (31). More regions with synovitis in severe knee OA may be related to an increasing prevalence of nocturnal knee pain.…”

Section: Discussionmentioning

confidence: 99%

Nocturnal Knee Pain Increases With the Severity of Knee Osteoarthritis, Disturbing Patient Sleep Quality

Sasaki

Tsuda

Yamamoto

et al. 2014

Arthritis Care & Research

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Objective. Sleep disturbances frequently accompany chronic pain from osteoarthritis (OA). Effective management of sleep disturbances may require successful treatment of chronic pain, a key factor in the clinical evaluation of knee OA. However, the relationship between the severity of knee OA and sleep quality is unclear. Our purpose was to correlate the prevalence of nocturnal knee pain with different OA severity levels and to determine its influence on sleep quality. Methods. Subjects included 1,214 local volunteers with mean ؎ SD age 58.1 ؎ 13.0 years. The existence and severity of knee OA were determined by the Kellgren/Lawrence (K/L) grade, and joint space widths were measured. The presence of nocturnal knee pain and Knee Injury and Osteoarthritis Outcome Scores (KOOS) were assessed by self-completed questionnaires. Sleep quality was evaluated by the Pittsburgh Sleep Quality Index. Knee-related factors affecting sleep quality were detected using statistical methods. Results. The prevalence of nocturnal knee pain was 3.6%, 6.9%, 19.4%, 32.7%, and 75.0% in K/L grades 0, 1, 2, 3, and 4, respectively. Also, prevalence significantly increased with OA severity (P < 0.001). Sleep problems also increased with K/L grade (P ‫؍‬ 0.038), and KOOS quality of life (QOL) was significantly lower in those with OA and sleep problems. Logistic regression showed that sleep problems were related to joint space narrowing (P ‫؍‬ 0.016) and nocturnal knee pain (P ‫؍‬ 0.039). Severe OA also disturbed onset and maintenance of sleep. Conclusion. The prevalence of nocturnal knee pain and sleep problems increased with the severity of OA, impacting QOL. These results suggest the necessity of appropriate nocturnal pain control.

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Section: Discussionmentioning

confidence: 99%

Nocturnal Knee Pain Increases With the Severity of Knee Osteoarthritis, Disturbing Patient Sleep Quality

Sasaki

Tsuda

Yamamoto

et al. 2014

Arthritis Care & Research

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“…It is documented that knee OA patients have synovitis even in the early stages of the disease and its prevalence and number of regions increase with the severity of OA. 9 More regions with synovitis may be related to an increasing prevalence of nocturnal pain. 4 Previous studies have shown that BT is effective on pain in OA.…”

Section: Discussionmentioning

confidence: 99%

Effects of Balneotherapy and Physical Therapy on Sleep Quality in Patients with Osteoarthritis Aged 50 to 85 Years

et al. 2016

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Objectives: This study aims to investigate the effect of balneotherapy (BT) and physical therapy (PT) on sleep quality in patients with knee osteoarthritis (OA) aged 50 to 85 years. Patients and methods: A total of 199 patients (76 males, 123 females; mean age 67.8±7.3 years; range 50 to 85 years) suffering from knee OA (Kellgren-Lawrence grade 2-3) for more than six months were enrolled. Sleep and functional status were assessed at baseline and after 19 sessions of BT and 15 sessions of PT by using Pittsburgh Sleep Quality Index and Western Ontario and McMaster Universities Osteoarthritis Index, respectively. Results: A high prevalence of abnormal sleep quality in patients with knee OA was observed. The most common abnormality was sleep fragmentation (71%), with an increased sleep disturbance score. Patients reported significantly improved sleep, pain, stiffness, and functional status after BT and PT. Conclusion: Balneotherapy and PT improved self-reported sleep and functional status in patients with OA aged 50 to 85 years. We may conclude that BT and PT, which are used in the treatment of OA, not only reduce nocturnal pain, but also improve sleep quality.

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“…Synovial enhancement by the contrast agent provides superior image quality for the assessment of synovial volume and differentiates synovitis from joint effusion by increased vascular perfusion and capillary permeability of the synovium [167]. Synovitis scores obtained by contrast-enhanced MRI showed good correlation with arthroscopic and microscopic synovitis scores [168].…”

Section: Mri In Osteoarthritismentioning

confidence: 93%

“…Interventional studies assessing intraarticular corticosteroids or NSAIDs and paracetamol demonstrated associations between decreased synovitis and reduction of pain in patients with knee OA [171,172]. Several semiquantitative and quantitative contrast-enhanced MRI assessment systems using different subregional approaches have been proposed to quantify synovitis [65,167,[173][174][175].…”

Section: Mri In Osteoarthritismentioning

confidence: 99%

The impact of MRI on the clinical management of inflammatory arthritides

et al. 2011

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In the past two decades, MRI has gained a major role in research and clinical management of patients with inflammatory arthritides, particularly in spondyloarthritis (SpA), rheumatoid arthritis (RA), and osteoarthritis (OA). MRI is regarded as the most sensitive imaging modality for detecting early SpA in young patients with inflammatory back pain and normal radiographs of the sacroiliac joints. The recently published Assessment of SpondyloArthritis International Society classification criteria for axial SpA include for the first time a positive MRI demonstrating sacroiliitis as an imaging criterion indicative of SpA together with at least one clinical feature of SpA. Recent data show that systematic assessment of sacroiliitis displayed on MRI has much greater diagnostic utility than previously reported and highlight the diagnostic relevance of structural lesions. In RA, MRI has predictive value for the development of disease in new onset undifferentiated arthritis, and MR pathology at disease onset is a highly significant predictor of radiographic erosions. Consequently MRI has been credited with an important role in the new ACR/EULAR 2010 classification criteria for RA. In OA, bone marrow edema (BME) and synovitis may serve as biomarkers in interventional trials. Treatment interventions targeting BME and synovitis observed on MRI in inflammatory arthritides may have a disease-modifying effect as these lesions are potentially reversible and have been shown to be associated with structural progression. Research should focus on the prognostic significance of MRI lesions in larger cohorts and whether adding MRI to routine care improves clinical and radiographic outcome in patients with inflammatory arthritides.

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Anatomical distribution of synovitis in knee osteoarthritis and its association with joint effusion assessed on non-enhanced and contrast-enhanced MRI

Abstract: Definite synovitis was present in the majority of knees with or without effusion with the commonest sites being posterior to the PCL and in the suprapatellar recess. Joint effusion as measured on PD fs images does not only represent effusion but also synovial thickening.

Cited by 165 publications

References 26 publications

Nocturnal Knee Pain Increases With the Severity of Knee Osteoarthritis, Disturbing Patient Sleep Quality

Nocturnal Knee Pain Increases With the Severity of Knee Osteoarthritis, Disturbing Patient Sleep Quality

Effects of Balneotherapy and Physical Therapy on Sleep Quality in Patients with Osteoarthritis Aged 50 to 85 Years

The impact of MRI on the clinical management of inflammatory arthritides

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