EULAR report on the use of ultrasonography in painful knee osteoarthritis. Part 1: Prevalence of inflammation in osteoarthritis
Objectives: To assess the prevalence of inflammation in subjects with chronic painful knee osteoarthritis (OA), as determined by the presence of synovitis or joint effusion at ultrasonography (US); and to evaluate the correlation between synovitis, effusion, and clinical parameters. Methods: A cross...
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| Published in | Annals of the rheumatic diseases Vol. 64; no. 12; pp. 1703 - 1709 |
|---|---|
| Main Authors | , , , , , , , , , , , , , , , |
| Format | Journal Article Web Resource |
| Language | English |
| Published |
London
BMJ Publishing Group Ltd and European League Against Rheumatism
01.12.2005
BMJ Elsevier Limited BMJ Group |
| Subjects | |
| Online Access | Get full text |
| ISSN | 0003-4967 1468-2060 1468-2060 |
| DOI | 10.1136/ard.2005.037994 |
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| Abstract | Objectives: To assess the prevalence of inflammation in subjects with chronic painful knee osteoarthritis (OA), as determined by the presence of synovitis or joint effusion at ultrasonography (US); and to evaluate the correlation between synovitis, effusion, and clinical parameters. Methods: A cross sectional, multicentre, European study was conducted under the umbrella of EULAR-ESCISIT. Subjects had primary chronic knee OA (ACR criteria) with pain during physical activity ⩾30 mm for at least 48 hours. Clinical parameters were collected by a rheumatologist and an US examination of the painful knee was performed by a radiologist or rheumatologist within 72 hours of the clinical examination. Ultrasonographic synovitis was defined as synovial thickness ⩾4 mm and diffuse or nodular appearance, and a joint effusion was defined as effusion depth ⩾4 mm. Results: 600 patients with painful knee OA were analysed. At US 16 (2.7%) had synovitis alone, 85 (14.2%) had both synovitis and effusion, 177 (29.5%) had joint effusion alone, and 322 (53.7%) had no inflammation according to the definitions employed. Multivariate analysis showed that inflammation seen by US correlated statistically with advanced radiographic disease (Kellgren-Lawrence grade ⩾3; odds ratio (OR) = 2.20 and 1.91 for synovitis and joint effusion, respectively), and with clinical signs and symptoms suggestive of an inflammatory “flare”, such as joint effusion on clinical examination (OR = 1.97 and 2.70 for synovitis and joint effusion, respectively) or sudden aggravation of knee pain (OR = 1.77 for joint effusion). Conclusion: US can detect synovial inflammation and effusion in painful knee OA, which correlate significantly with knee synovitis, effusion, and clinical parameters suggestive of an inflammatory “flare”. |
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| AbstractList | Objectives:
To assess the prevalence of inflammation in subjects with chronic painful knee osteoarthritis (OA), as determined by the presence of synovitis or joint effusion at ultrasonography (US); and to evaluate the correlation between synovitis, effusion, and clinical parameters.
Methods:
A cross sectional, multicentre, European study was conducted under the umbrella of EULAR-ESCISIT. Subjects had primary chronic knee OA (ACR criteria) with pain during physical activity ⩾30 mm for at least 48 hours. Clinical parameters were collected by a rheumatologist and an US examination of the painful knee was performed by a radiologist or rheumatologist within 72 hours of the clinical examination. Ultrasonographic synovitis was defined as synovial thickness ⩾4 mm and diffuse or nodular appearance, and a joint effusion was defined as effusion depth ⩾4 mm.
Results:
600 patients with painful knee OA were analysed. At US 16 (2.7%) had synovitis alone, 85 (14.2%) had both synovitis and effusion, 177 (29.5%) had joint effusion alone, and 322 (53.7%) had no inflammation according to the definitions employed. Multivariate analysis showed that inflammation seen by US correlated statistically with advanced radiographic disease (Kellgren-Lawrence grade ⩾3; odds ratio (OR) = 2.20 and 1.91 for synovitis and joint effusion, respectively), and with clinical signs and symptoms suggestive of an inflammatory "flare", such as joint effusion on clinical examination (OR = 1.97 and 2.70 for synovitis and joint effusion, respectively) or sudden aggravation of knee pain (OR = 1.77 for joint effusion).
Conclusion:
US can detect synovial inflammation and effusion in painful knee OA, which correlate significantly with knee synovitis, effusion, and clinical parameters suggestive of an inflammatory "flare". Objectives: To assess the prevalence of inflammation in subjects with chronic painful knee osteoarthritis (OA), as determined by the presence of synovitis or joint effusion at ultrasonography (US); and to evaluate the correlation between synovitis, effusion, and clinical parameters. Methods: A cross sectional, multicentre, European study was conducted under the umbrella of EULAR-ESCISIT. Subjects had primary chronic knee OA (ACR criteria) with pain during physical activity ⩾30 mm for at least 48 hours. Clinical parameters were collected by a rheumatologist and an US examination of the painful knee was performed by a radiologist or rheumatologist within 72 hours of the clinical examination. Ultrasonographic synovitis was defined as synovial thickness ⩾4 mm and diffuse or nodular appearance, and a joint effusion was defined as effusion depth ⩾4 mm. Results: 600 patients with painful knee OA were analysed. At US 16 (2.7%) had synovitis alone, 85 (14.2%) had both synovitis and effusion, 177 (29.5%) had joint effusion alone, and 322 (53.7%) had no inflammation according to the definitions employed. Multivariate analysis showed that inflammation seen by US correlated statistically with advanced radiographic disease (Kellgren-Lawrence grade ⩾3; odds ratio (OR) = 2.20 and 1.91 for synovitis and joint effusion, respectively), and with clinical signs and symptoms suggestive of an inflammatory “flare”, such as joint effusion on clinical examination (OR = 1.97 and 2.70 for synovitis and joint effusion, respectively) or sudden aggravation of knee pain (OR = 1.77 for joint effusion). Conclusion: US can detect synovial inflammation and effusion in painful knee OA, which correlate significantly with knee synovitis, effusion, and clinical parameters suggestive of an inflammatory “flare”. OBJECTIVES: To assess the prevalence of inflammation in subjects with chronic painful knee osteoarthritis (OA), as determined by the presence of synovitis or joint effusion at ultrasonography (US); and to evaluate the correlation between synovitis, effusion, and clinical parameters. METHODS: A cross sectional, multicentre, European study was conducted under the umbrella of EULAR-ESCISIT. Subjects had primary chronic knee OA (ACR criteria) with pain during physical activity greater than or equal to 30 mm for at least 48 hours. Clinical parameters were collected by a rheumatologist and an US examination of the painful knee was performed by a radiologist or rheumatologist within 72 hours of the clinical examination. Ultrasonographic synovitis was defined as synovial thickness greater than or equal to 4 mm and diffuse or nodular appearance, and a joint effusion was defined as effusion depth greater than or equal to 4 mm. RESULTS: 600 patients with painful knee OA were analysed. At US 16 (2.7%) had synovitis alone, 85 (14.2%) had both synovitis and effusion, 177 (29.5%) had joint effusion alone, and 322 (53.7%) had no inflammation according to the definitions employed. Multivariate analysis showed that inflammation seen by US correlated statistically with advanced radiographic disease (Kellgren-Lawrence grade greater than or equal to 3; odds ratio (OR) = 2.20 and 1.91 for synovitis and joint effusion, respectively), and with clinical signs and symptoms suggestive of an inflammatory "flare", such as joint effusion on clinical examination (OR = 1.97 and 2.70 for synovitis and joint effusion, respectively) or sudden aggravation of knee pain (OR = 1.77 for joint effusion). CONCLUSION: US can detect synovial inflammation and effusion in painful knee OA, which correlate significantly with knee synovitis, effusion, and clinical parameters suggestive of an inflammatory "flare". Objectives: To assess the prevalence of inflammation in subjects with chronic painful knee osteoarthritis (OA), as determined by the presence of synovitis or joint effusion at ultrasonography (US); and to evaluate the correlation between synovitis, effusion, and clinical parameters. Methods: A cross sectional, multicentre, European study was conducted under the umbrella of EULAR-ESCISIT. Subjects had primary chronic knee OA (ACR criteria) with pain during physical activity [= or >, slanted]30 mm for at least 48 hours. Clinical parameters were collected by a rheumatologist and an US examination of the painful knee was performed by a radiologist or rheumatologist within 72 hours of the clinical examination. Ultrasonographic synovitis was defined as synovial thickness [= or >, slanted]4 mm and diffuse or nodular appearance, and a joint effusion was defined as effusion depth [= or >, slanted]4 mm. Results: 600 patients with painful knee OA were analysed. At US 16 (2.7%) had synovitis alone, 85 (14.2%) had both synovitis and effusion, 177 (29.5%) had joint effusion alone, and 322 (53.7%) had no inflammation according to the definitions employed. Multivariate analysis showed that inflammation seen by US correlated statistically with advanced radiographic disease (Kellgren-Lawrence grade [= or >, slanted]3; odds ratio (OR) = 2.20 and 1.91 for synovitis and joint effusion, respectively), and with clinical signs and symptoms suggestive of an inflammatory "flare", such as joint effusion on clinical examination (OR = 1.97 and 2.70 for synovitis and joint effusion, respectively) or sudden aggravation of knee pain (OR = 1.77 for joint effusion). Conclusion: US can detect synovial inflammation and effusion in painful knee OA, which correlate significantly with knee synovitis, effusion, and clinical parameters suggestive of an inflammatory "flare". To assess the prevalence of inflammation in subjects with chronic painful knee osteoarthritis (OA), as determined by the presence of synovitis or joint effusion at ultrasonography (US); and to evaluate the correlation between synovitis, effusion, and clinical parameters. A cross sectional, multicentre, European study was conducted under the umbrella of EULAR-ESCISIT. had primary chronic knee OA (ACR criteria) with pain during physical activity >or=30 mm for at least 48 hours. Clinical parameters were collected by a rheumatologist and an US examination of the painful knee was performed by a radiologist or rheumatologist within 72 hours of the clinical examination. Ultrasonographic synovitis was defined as synovial thickness >or=4 mm and diffuse or nodular appearance, and a joint effusion was defined as effusion depth >or=4 mm. 600 patients with painful knee OA were analysed. At US 16 (2.7%) had synovitis alone, 85 (14.2%) had both synovitis and effusion, 177 (29.5%) had joint effusion alone, and 322 (53.7%) had no inflammation according to the definitions employed. Multivariate analysis showed that inflammation seen by US correlated statistically with advanced radiographic disease (Kellgren-Lawrence grade >or=3; odds ratio (OR)=2.20 and 1.91 for synovitis and joint effusion, respectively), and with clinical signs and symptoms suggestive of an inflammatory "flare", such as joint effusion on clinical examination (OR=1.97 and 2.70 for synovitis and joint effusion, respectively) or sudden aggravation of knee pain (OR=1.77 for joint effusion). US can detect synovial inflammation and effusion in painful knee OA, which correlate significantly with knee synovitis, effusion, and clinical parameters suggestive of an inflammatory "flare". Objectives: To assess the prevalence of inflammation in subjects with chronic painful knee osteoarthritis (OA), as determined by the presence of synovitis or joint effusion at ultrasonography (US); and to evaluate the correlation between synovitis, effusion, and clinical parameters. Methods: A cross sectional, multicentre, European study was conducted under the umbrella of EULAR-ESCISIT. Subjects had primary chronic knee OA (ACR criteria) with pain during physical activity >= 30 mm for at least 48 hours. Clinical parameters were collected by a rheumatologist and an US examination of the painful knee was performed by a radiologist or rheumatologist within 72 hours of the clinical examination. Ultrasonographic synovitis was defined as synovial thickness >= 4 mm and diffuse or nodular appearance, and a joint effusion was defined as effusion depth >= 4 mm. Results: 600 patients with painful knee OA were analysed. At US 16 (2.7%) had synovitis alone, 85 (14.2%) had both synovitis and effusion, 177 (29.5%) had joint effusion alone, and 322 (53.7%) had no inflammation according to the definitions employed. Multivariate analysis showed that inflammation seen by US correlated statistically with advanced radiographic disease (Kellgren-Lawrence grade >= 3; odds ratio (OR) = 2.20 and 1.91 for synovitis and joint effusion, respectively), and with clinical signs and symptoms suggestive of an inflammatory "flare'', such as joint effusion on clinical examination (OR = 1.97 and 2.70 for synovitis and joint effusion, respectively) or sudden aggravation of knee pain (OR = 1.77 for joint effusion). Conclusion: US can detect synovial inflammation and effusion in painful knee OA, which correlate significantly with knee synovitis, effusion, and clinical parameters suggestive of an inflammatory "flare''. To assess the prevalence of inflammation in subjects with chronic painful knee osteoarthritis (OA), as determined by the presence of synovitis or joint effusion at ultrasonography (US); and to evaluate the correlation between synovitis, effusion, and clinical parameters.OBJECTIVESTo assess the prevalence of inflammation in subjects with chronic painful knee osteoarthritis (OA), as determined by the presence of synovitis or joint effusion at ultrasonography (US); and to evaluate the correlation between synovitis, effusion, and clinical parameters.A cross sectional, multicentre, European study was conducted under the umbrella of EULAR-ESCISIT.METHODSA cross sectional, multicentre, European study was conducted under the umbrella of EULAR-ESCISIT.had primary chronic knee OA (ACR criteria) with pain during physical activity >or=30 mm for at least 48 hours. Clinical parameters were collected by a rheumatologist and an US examination of the painful knee was performed by a radiologist or rheumatologist within 72 hours of the clinical examination. Ultrasonographic synovitis was defined as synovial thickness >or=4 mm and diffuse or nodular appearance, and a joint effusion was defined as effusion depth >or=4 mm.SUBJECTShad primary chronic knee OA (ACR criteria) with pain during physical activity >or=30 mm for at least 48 hours. Clinical parameters were collected by a rheumatologist and an US examination of the painful knee was performed by a radiologist or rheumatologist within 72 hours of the clinical examination. Ultrasonographic synovitis was defined as synovial thickness >or=4 mm and diffuse or nodular appearance, and a joint effusion was defined as effusion depth >or=4 mm.600 patients with painful knee OA were analysed. At US 16 (2.7%) had synovitis alone, 85 (14.2%) had both synovitis and effusion, 177 (29.5%) had joint effusion alone, and 322 (53.7%) had no inflammation according to the definitions employed. Multivariate analysis showed that inflammation seen by US correlated statistically with advanced radiographic disease (Kellgren-Lawrence grade >or=3; odds ratio (OR)=2.20 and 1.91 for synovitis and joint effusion, respectively), and with clinical signs and symptoms suggestive of an inflammatory "flare", such as joint effusion on clinical examination (OR=1.97 and 2.70 for synovitis and joint effusion, respectively) or sudden aggravation of knee pain (OR=1.77 for joint effusion).RESULTS600 patients with painful knee OA were analysed. At US 16 (2.7%) had synovitis alone, 85 (14.2%) had both synovitis and effusion, 177 (29.5%) had joint effusion alone, and 322 (53.7%) had no inflammation according to the definitions employed. Multivariate analysis showed that inflammation seen by US correlated statistically with advanced radiographic disease (Kellgren-Lawrence grade >or=3; odds ratio (OR)=2.20 and 1.91 for synovitis and joint effusion, respectively), and with clinical signs and symptoms suggestive of an inflammatory "flare", such as joint effusion on clinical examination (OR=1.97 and 2.70 for synovitis and joint effusion, respectively) or sudden aggravation of knee pain (OR=1.77 for joint effusion).US can detect synovial inflammation and effusion in painful knee OA, which correlate significantly with knee synovitis, effusion, and clinical parameters suggestive of an inflammatory "flare".CONCLUSIONUS can detect synovial inflammation and effusion in painful knee OA, which correlate significantly with knee synovitis, effusion, and clinical parameters suggestive of an inflammatory "flare". |
| Author | Conaghan, P Baron, G Schmidely, N Backhaus, M Burmester, G Grassi, W Wakefield, R Ravaud, P Martin-Mola, E So, A Malaise, M Emery, P Dougados, M Le Bars, M D’Agostino, M A Brasseur, J-L |
| AuthorAffiliation | Rheumatology Department, Cochin Hospital, Paris, France |
| AuthorAffiliation_xml | – name: Rheumatology Department, Cochin Hospital, Paris, France |
| Author_xml | – sequence: 1 givenname: M A surname: D’Agostino fullname: D’Agostino, M A organization: Rheumatology Department, Saint Tiltman Hospital, Liege, Belgium – sequence: 2 givenname: P surname: Conaghan fullname: Conaghan, P organization: Rheumatology Department, Saint Tiltman Hospital, Liege, Belgium – sequence: 3 givenname: M surname: Le Bars fullname: Le Bars, M organization: Rheumatology Department, Saint Tiltman Hospital, Liege, Belgium – sequence: 4 givenname: G surname: Baron fullname: Baron, G organization: Rheumatology Department, Saint Tiltman Hospital, Liege, Belgium – sequence: 5 givenname: W surname: Grassi fullname: Grassi, W organization: Rheumatology Department, Saint Tiltman Hospital, Liege, Belgium – sequence: 6 givenname: E surname: Martin-Mola fullname: Martin-Mola, E organization: Rheumatology Department, Saint Tiltman Hospital, Liege, Belgium – sequence: 7 givenname: R surname: Wakefield fullname: Wakefield, R organization: Rheumatology Department, Saint Tiltman Hospital, Liege, Belgium – sequence: 8 givenname: J-L surname: Brasseur fullname: Brasseur, J-L organization: Rheumatology Department, Saint Tiltman Hospital, Liege, Belgium – sequence: 9 givenname: A surname: So fullname: So, A organization: Rheumatology Department, Saint Tiltman Hospital, Liege, Belgium – sequence: 10 givenname: M surname: Backhaus fullname: Backhaus, M organization: Rheumatology Department, Saint Tiltman Hospital, Liege, Belgium – sequence: 11 givenname: M surname: Malaise fullname: Malaise, M organization: Rheumatology Department, Saint Tiltman Hospital, Liege, Belgium – sequence: 12 givenname: G surname: Burmester fullname: Burmester, G organization: Rheumatology Department, Saint Tiltman Hospital, Liege, Belgium – sequence: 13 givenname: N surname: Schmidely fullname: Schmidely, N organization: Rheumatology Department, Saint Tiltman Hospital, Liege, Belgium – sequence: 14 givenname: P surname: Ravaud fullname: Ravaud, P organization: Rheumatology Department, Saint Tiltman Hospital, Liege, Belgium – sequence: 15 givenname: M surname: Dougados fullname: Dougados, M organization: Rheumatology Department, Saint Tiltman Hospital, Liege, Belgium – sequence: 16 givenname: P surname: Emery fullname: Emery, P organization: Rheumatology Department, Saint Tiltman Hospital, Liege, Belgium |
| BackLink | http://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=17267473$$DView record in Pascal Francis https://www.ncbi.nlm.nih.gov/pubmed/15878903$$D View this record in MEDLINE/PubMed |
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| Keywords | Sonography Knee Prevalence Knee osteoarthritis Diseases of the osteoarticular system Rheumatology Inflammation Epidemiology Pain Echography Arthropathy Degenerative disease Osteoarthritis |
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| References | Amor (10.1136/ard.2005.037994_bib3) 1993; 43 Likar (10.1136/ard.2005.037994_bib2) 1997; 84 Walther (10.1136/ard.2005.037994_bib14) 2001; 44 Bellamy (10.1136/ard.2005.037994_bib6) 1997; 24 Bellamy (10.1136/ard.2005.037994_bib28) 1988; 15 Pelletier (10.1136/ard.2005.037994_bib34) 2001; 44 Creamer (10.1136/ard.2005.037994_bib1) 1996; 23 Aisen (10.1136/ard.2005.037994_bib15) 1984; 153 Rubaltelli (10.1136/ard.2005.037994_bib25) 1992; 13 Hill (10.1136/ard.2005.037994_bib12) 2001; 28 Fornage (10.1136/ard.2005.037994_bib19) 1995 Kellgren (10.1136/ard.2005.037994_bib22) 1963; 2 Wakefield (10.1136/ard.2005.037994_bib24) 2003; 48 (10.1136/ard.2005.037994_bib5) 1996; 55 Altman (10.1136/ard.2005.037994_bib20) 1986; 29 Dieppe (10.1136/ard.2005.037994_bib8) 1993; 52 Backhaus (10.1136/ard.2005.037994_bib26) 2001; 60 Dougados (10.1136/ard.2005.037994_bib30) 1987; 30 Ayral (10.1136/ard.2005.037994_bib10) 1999; 26 Buderer (10.1136/ard.2005.037994_bib31) 1996; 3 Dougados (10.1136/ard.2005.037994_bib29) 1994; 23 Karim (10.1136/ard.2005.037994_bib32) 2004; 2 Ayral (10.1136/ard.2005.037994_bib7) 2001; 44 Kane (10.1136/ard.2005.037994_bib17) 2003; 30 Dougados (10.1136/ard.2005.037994_bib4) 1995; 7 Fernandez-Madrid (10.1136/ard.2005.037994_bib11) 1995; 2 Steinbrocker (10.1136/ard.2005.037994_bib23) 1949; 140 Hammer (10.1136/ard.2005.037994_bib13) 1986; 15 Grassi (10.1136/ard.2005.037994_bib16) 1999; 28 Fiocco (10.1136/ard.2005.037994_bib18) 1996; 35 Dougados (10.1136/ard.2005.037994_bib27) 1997 Kellgren (10.1136/ard.2005.037994_bib21) 1957; 16 Felson (10.1136/ard.2005.037994_bib33) 2001; 3134 Dougados (10.1136/ard.2005.037994_bib9) 1992; 19 |
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| Snippet | Objectives: To assess the prevalence of inflammation in subjects with chronic painful knee osteoarthritis (OA), as determined by the presence of synovitis or... To assess the prevalence of inflammation in subjects with chronic painful knee osteoarthritis (OA), as determined by the presence of synovitis or joint... OBJECTIVES: To assess the prevalence of inflammation in subjects with chronic painful knee osteoarthritis (OA), as determined by the presence of synovitis or... Objectives: To assess the prevalence of inflammation in subjects with chronic painful knee osteoarthritis (OA), as determined by the presence of synovitis or... |
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| StartPage | 1703 |
| SubjectTerms | Aged Arthritis Biological and medical sciences Cross-Sectional Studies Diseases of the osteoarticular system effusion Europe - epidemiology Extended Report Exudates and Transudates Exudates and Transudates - diagnostic imaging Female Human health sciences Humans Inflammation K&L Kellgren and Lawrence Knee Knee Joint - diagnostic imaging knees magnetic resonance imaging Male Medical sciences Middle Aged Miscellaneous. Osteoarticular involvement in other diseases MRI Multivariate Analysis NMR Nuclear magnetic resonance Osteoarthritis Osteoarthritis, Knee Osteoarthritis, Knee - diagnostic imaging Osteoarthritis, Knee - epidemiology Pain Pain Measurement Prevalence Rheumatology Rhumatologie Sciences de la santé humaine Severity of Illness Index Studies synovitis Synovitis - diagnostic imaging Synovitis - epidemiology Ultrasonic imaging Ultrasonography VAS visual analogue scale Western Ontario and McMaster Universities Osteoarthritis Index WOMAC |
| Title | EULAR report on the use of ultrasonography in painful knee osteoarthritis. Part 1: Prevalence of inflammation in osteoarthritis |
| URI | http://ard.bmj.com/content/64/12/1703.full https://api.istex.fr/ark:/67375/NVC-7P3J489P-H/fulltext.pdf https://www.ncbi.nlm.nih.gov/pubmed/15878903 https://www.proquest.com/docview/1777984553 https://www.proquest.com/docview/19381962 https://www.proquest.com/docview/68799818 http://orbi.ulg.ac.be/handle/2268/72431 https://pubmed.ncbi.nlm.nih.gov/PMC1755310 |
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