Predictive value of MRI features for development of radiographic osteoarthritis in a cohort of participants with pre-radiographic knee osteoarthritis—the CHECK study

Oudenaarde, Kim van; Jobke, Björn; Oostveen, A.; Marijnissen, A.C.; Wolterbeek, Ron; Wesseling, John G.; Bierma-Zeinstra, Sita M A; Bloem, Hans L.; Reijnierse, M.; Kloppenburg, Margreet

doi:10.1093/rheumatology/kew368

Cited by 31 publications

(26 citation statements)

References 28 publications

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“…In addition, there have been reports that meniscal lesions, BMLs, and synovitis are associated with each other [32][33][34] . However, van Oudenaarde et al have suggested that the discriminative power of single MRI features is insu cient to be useful as predictors of KOA 35 . In this study, although meniscal lesions, together with BMLs, bone attrition, and synovitis, were signi cantly associated with the presence of knee symptoms, the adjusted regression model showed that this association was attenuated after adjustment for age and BMI.…”

Section: Discussionmentioning

confidence: 99%

Relationship between magnetic resonance imaging lesions and knee symptoms in early knee osteoarthritis: A cross-sectional Japanese population study

Ota

Sasaki

et al. 2020

Preprint

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Background: The prevalence of minute structural abnormalities in early knee osteoarthritis (KOA) and their association with knee symptoms remains unclear. We investigated the prevalence of abnormalities detected by magnetic resonance imaging (MRI) and their relation to knee symptoms in women without radiographic evidence of KOA.Methods: This cross-sectional cohort study in a Japanese population included 261 women without radiographic evidence of KOA, which was defined as a Kellgren‒Lawrence grade < 2. All participants underwent T2-weighted fat-suppressed MRI of their right knee. Structural abnormalities (cartilage damage, bone marrow lesions [BMLs], subchondral cysts, bone attrition, osteophytes, meniscal lesions, and synovitis) were scored according to the Whole-Organ MRI Scoring method. Knee symptoms were evaluated by the Knee injury and Osteoarthritis and Outcome Score (KOOS). Participants were divided into early KOA and non-KOA groups based on early KOA classification criteria. Logistic regression analysis was performed to evaluate the relationship between MRI abnormalities and knee symptoms.Results: Cartilage damage were the most common abnormality (53%), followed by osteophytes (43%), and BMLs (33%). The prevalence of BMLs (47%), meniscal lesions (26%), and synovitis (37%) was higher in early KOA than in non-KOA. On logistic regression analysis, synovitis (odds ratio [OR] = 1.901, P = 0.013) and meniscal lesions (OR = 1.410, P = 0.045) were positively associated with the presence of early KOA.Conclusions: The prevalence of BMLs, meniscal lesions, and synovitis was higher in symptomatic knees. Synovitis was most strongly associated with knee pain and might be a therapeutic target in patients with early KOA.

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Section: Discussionmentioning

confidence: 99%

Relationship between magnetic resonance imaging lesions and knee symptoms in early knee osteoarthritis: A cross-sectional Japanese population study

Ota

Sasaki

et al. 2020

Preprint

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“…In the early stages of KOA, the Framingham study, including 710 knees with KL grade 0/1, showed the featured MRI ndings in those with knee pain as having BMLs, attrition, and subchondral bone cysts 36 . Further, the CHECK study, a 5 year longitudinal cohort of general population, showed that the incidence risk factors for knee OA from KL grade 0/1 were BMLs, effusion, and meniscal lesion on MRI 37 . Bone abnormalities in the early stage of KL are likely to occur in the middle-aged female population [36][37] .…”

Section: Discussionmentioning

confidence: 99%

“…Further, the CHECK study, a 5 year longitudinal cohort of general population, showed that the incidence risk factors for knee OA from KL grade 0/1 were BMLs, effusion, and meniscal lesion on MRI 37 . Bone abnormalities in the early stage of KL are likely to occur in the middle-aged female population [36][37] . During menopausal transition, bone metabolism changes dramatically, corresponding to the intrinsic hormonal changes in females.…”

Section: Discussionmentioning

confidence: 99%

Epidemiological study on the relationship among menopausal condition, bone fragility, and knee osteoarthritis

Sasaki¹,

Chiba²,

Ota³

et al. 2020

Preprint

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Background: Knee osteoarthritis (KOA) occurs more often in middle-aged females. While this age-group experiences comorbid osteoporosis with menopause, its influence on KOA has not been clarified. This epidemiological study aimed to investigate the relationship between menopausal conditions, bone mineral density (BMD), and KOA. Methods: A total of 518 female volunteers who participated in the Iwaki cohort study were enrolled and divided into groups (pre- and post-menopause). Antimullerian hormone (AMH) was measured as a predictive marker for menopause in the pre-menopausal subjects. Weight-bearing anterior-posterior knee radiographs were classified by Kellgren-Lawrence grade, and grade ≥ 2 was defined as definitive KOA (DKOA). Early KOA (EKOA) was defined by Luyten’s criteria, and BMD was measured at a distal radius. The relationship between menopausal condition, BMD, and KOA was analyzed by ROC and regression analysis. Results: Fifty-two participants (10.0%) were diagnosed with EKOA and 204 (39.4%) with DKOA. A total of 393 (75.9%) females began menopause, and the prevalence of DKOA was up to 48.1% and >12.0% in pre-menopause females (p < 0.001, Odds ratio: 6.79). From the ROC analysis in pre-menopausal females, cut-off value of AMH for detecting EKOA was 0.08 ng/ml (AUC: 0.712, p5%CI: 0.527 to 0.897, p-value: 0.025, Odds ratio: 8.28). Regression analysis showed that lower AMH was related to EKOA (p=0.035, Odds ratio: 5.55) and DKOA (p=0.032, Odds 1.59), and lower BMD and high turnover bone metabolism were correlated with DKOA. Conclusions: KOA increased after menopause and was correlated with lower BMD. Furthermore, reduction in AMH was a valuable biomarker for the detection of EKOA.

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“…Except for those who are at increased risk of developing knee osteoarthritis because of, for example, positive family history, presence of generalized osteoarthritis phenotype (e.g., presence of Heberden's nodes), or previous trauma (e.g., anterior cruciate ligament tear, meniscal injury, or patellar instability), all patients with intermittent symptoms are recommended for examination to determine joint involvement 13 . Earlier diagnosis of patients at risk of developing radiographic knee osteoarthritis could offer a window of opportunity for altering the course of the disease 16 . However, current MRI findings suggestive of prediction of the development of radiographic knee osteoarthritis have poor discriminatory power because the "critical wear level," in which the physiologic aging process and the pathologic pathways toward endstage knee osteoarthritis collide, remains to be identified 17 (Fig.…”

Section: Application In Clinical Managementmentioning

confidence: 99%

Structural changes in aging-knee vs early-knee osteoarthritis: review of current evidence and future challenges

Demehri

Shakoor

2018

Osteoarthritis and Cartilage

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Predictive value of MRI features for development of radiographic osteoarthritis in a cohort of participants with pre-radiographic knee osteoarthritis—the CHECK study

Cited by 31 publications

References 28 publications

Relationship between magnetic resonance imaging lesions and knee symptoms in early knee osteoarthritis: A cross-sectional Japanese population study

Relationship between magnetic resonance imaging lesions and knee symptoms in early knee osteoarthritis: A cross-sectional Japanese population study

Epidemiological study on the relationship among menopausal condition, bone fragility, and knee osteoarthritis

Structural changes in aging-knee vs early-knee osteoarthritis: review of current evidence and future challenges

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