Synovitis in knee osteoarthritis: a precursor of disease?

Abstract

Objectives It is unknown whether joint inflammation precedes other articular tissue damage in osteoarthritis. Therefore, this study aims to determine if synovitis precedes the development of radiographic knee OA (ROA). Methods The participants in this nested case-control study were selected from knees in the Osteoarthritis Initiative (OAI) that had a Kellgren Lawrence grading (KLG)=0 baseline (BL). These knees were evaluated annually with radiography and non contrast-enhanced magnetic resonance imaging (MRI) over 4-years. MRIs were assessed for effusion-synovitis and Hoffa-synovitis. Case knees were defined by radiographic knee osteoarthritis (ROA) (KLG >=2) on the postero-anterior knee radiographs at any assessment after baseline. Radiographs were assessed at P0 (time of onset of radiographic knee OA), 1 year prior to P0 (P-1) and at BL. Controls were participants who did not develop incident ROA (iROA) from baseline to 48 months). Results 133 knees of 120 persons with ROA (83 females) were matched to 133 control knees (83 females). Odds ratios (OR) for occurrence of iROA associated with the presence of effusion-synovitis at BL, P-1 and PO were 1.56 (95% CI 0.86–2.81), 3.23 (1.72–6.06) and 4.7(1.10–2.95), respectively. The ORs for the occurrence of iROA associated with the presence of Hoffa-synovitis at BL, P-1 and P0 were 1.80 (1.1–2.95), 2.47 (1.45–4.23) and 2.40 (1.43–4.04), respectively. Conclusions Effusion-synovitis and Hoffa-synovitis strongly predicted the development of incident ROA.

Femoral condyle insufficiency fractures: associated clinical and morphological findings and impact on outcome

“…The presence of synovitis was noted, manifest by joint effusion, diffuse hyperintense signal in the fat pad on T2/ proton density/intermediate-weighted fat-suppressed sequences, thickening of the synovial membranes, and intraarticular synovial bands or debris [24,25]. Muscle atrophy and edema were also documented.…”

Osteoarthritis year in review 2015: imaging

“…A nested caseecontrol study of participants selected from the OAI found that effusion-synovitis and Hoffa-synovitis, assessed from non-contrast-enhanced MRI, strongly predicted incident radiographic knee OA 37 . A prospective cohort study found that effusion-synovitis, assessed from non-contrast-enhanced T2-weighted MRI, predicted increased cartilage defects, cartilage volume loss, and increase in BMLs 38 .…”

Nimesulide in Treatment of Acute and Chronic Pain in Clinical Practice

“…Накопленные к настоящему времени данные позволя-ют утверждать, что универсальным механизмом развития острой и хронической боли является воспаление [3][4][5], что подтверждается данными ультразвукового исследова-ния (УЗИ) и магнитно-резонансной томографии (МРТ) [6].…”