Please use this identifier to cite or link to this item: http://hdl.handle.net/2440/43689
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Type: Journal article
Title: Synovitis detected on magnetic resonance imaging and its relation to pain and cartilage loss in knee osteoarthritis
Author: Hill, C.
Hunter, D.
Niu, J.
Clancy, M.
Guermazi, A.
Genant, H.
Gale, D.
Grainger, A.
Conaghan, P.
Felson, D.
Citation: Annals of the Rheumatic Diseases, 2007; 66(12):1599-1603
Publisher: British Med Journal Publ Group
Issue Date: 2007
ISSN: 0003-4967
1468-2060
Statement of
Responsibility: 
Catherine L Hill, David J Hunter, Jingbo Niu, Margaret Clancy, Ali Guermazi, Harry Genant, Daniel Gale, Andrew Grainger, Philip Conaghan, David T Felson
Abstract: Objective: To examine the relationship between longitudinal fluctuations in synovitis with change in pain and cartilage in knee osteoarthritis. Methods: Study subjects were patients 45 years of age and older with symptomatic knee osteoarthritis from the Boston Osteoarthritis of the Knee Study. Baseline and follow-up assessments at 15 and 30 months included knee magnetic resonance imaging (MRI), BMI and pain assessment (VAS) over the last week. Synovitis was scored at 3 locations (infrapatellar fat pad, suprapatellar and intercondylar regions) using a semiquantitative scale (0–3) at all 3 time points on MRI. Scores at each site were added to give a summary synovitis score (0–9). Results: We assessed 270 subjects whose mean (SD) age was 66.7 (9.2) years, BMI 31.5 (5.7) kg/m2; 42% were female. There was no correlation of baseline synovitis with baseline pain score (r = 0.09, p = 0.17). The change in summary synovitis score was correlated with the change in pain (r = 0.21, p = 0.0003). An increase of one unit in summary synovitis score resulted in a 3.15-mm increase in VAS pain score (0–100 scale). Effusion change was not associated with pain change. Of the 3 locations for synovitis, changes in the infrapatellar fat pad were most strongly related to pain change. Despite cartilage loss occurring in over 50% of knees, synovitis was not associated with cartilage loss in either tibiofemoral or patellofemoral compartment. Conclusions: Change in synovitis was correlated with change in knee pain, but not loss of cartilage. Treatment of pain in knee osteoarthritis (OA) needs to consider treatment of synovitis.
Keywords: Cartilage, Articular; Knee Joint; Humans; Arthralgia; Osteoarthritis, Knee; Synovitis; Disease Progression; Magnetic Resonance Imaging; Sensitivity and Specificity; Follow-Up Studies; Aged; Middle Aged; Female; Male
Description: Copyright © 2007 BMJ Publishing Group Ltd & European League Against Rheumatism
RMID: 0020076336
DOI: 10.1136/ard.2006.067470
Appears in Collections:Medicine publications

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