Associations between MRI features versus knee pain severity and progression: Data from the Vancouver Longitudinal Study of Early Knee Osteoarthritis

• Published in: PloS one Vol. 12; no. 5; p. e0176833
• Main Authors: Sayre, Eric C, Guermazi, Ali, Esdaile, John M, Kopec, Jacek A, Singer, Joel, Thorne, Anona, Nicolaou, Savvas, Cibere, Jolanda
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 04.05.2017; Public Library of Science (PLoS)
• Subjects: Abnormalities; Adipose tissue; Adults; Age; Age composition; Aged; Antibodies; Arthritis; Arthroplasty (knee); Arthroscopy; Biocompatibility; Bioindicators; Biology and Life Sciences; Biomarkers; Biometrics; Body mass; Body mass index; Bone (subchondral); Bone marrow; Cartilage; Cartilage diseases; Collection; Cysts; Damage; Data acquisition; Data collection; Defects; Deformities; Development and progression; Female; Flow charts; Generalized linear models; Hip; Households; Humans; Inflammation; Joint diseases; Joint surgery; Knee; Knee pain; Lesions; Longitudinal Studies; Magnetic resonance imaging; Male; Measuring instruments; Medicine; Medicine and Health Sciences; Middle Aged; Muscle strength; NMR; Nuclear magnetic resonance; Osteoarthritis; Osteoarthritis, Knee - complications; Osteoarthritis, Knee - diagnostic imaging; Pain; Pain - etiology; Pain Measurement; Patients; Population; Population studies; Populations; Public health; Quality; Radiology; Research and Analysis Methods; Resonance; Source studies; Statistical analysis; Subchondral bone; Surgery; Surgical implants; Canada
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0176833

To determine associations between features of osteoarthritis (OA) on MRI and knee pain severity and knee pain progression. Baseline, 3.3- and 7.5-year assessments were performed for 122 subjects with baseline knee pain (age 40-79), sample-weighted for population (with knee pain) representativeness. MRIs were scored for: osteophytes (0:absent to 3:large); cartilage (0:normal to 4:full thickness defect; 0/1 collapsed); subchondral sclerosis (0:none to 3:>50% of site), subchondral cyst (0:absent to 3:severe), bone marrow lesions (0:none to 3:≥50% of site); and meniscus (0:normal to 3:maceration/resection), in 6-8 regions each. Per feature, scores were averaged across regions. Effusion/synovitis (0:absent to 3:severe) was analyzed as ≥2 vs. <2. Linear models predicted WOMAC knee pain severity (0-100), and binary models predicted 10+ (minimum perceptible clinical improvement [MPCI]) and 20+ (minimum clinically important difference [MCID]) increases. Models were adjusted for age, sex, BMI (and follow-up time for longitudinal models). Pain severity was associated with osteophytes (7.17 per unit average; 95% CI = 3.19, 11.15) and subchondral sclerosis (11.03; 0.68, 21.39). MPCI-based pain increase was associated with osteophytes (odds ratio per unit average 3.20; 1.36, 7.55), subchondral sclerosis (5.69; 1.06, 30.44), meniscal damage (1.68; 1.08, 2.61) and effusion/synovitis ≥2 (2.25; 1.07, 4.71). MCID-based pain increase was associated with osteophytes (3.79; 1.41, 10.20) and cartilage defects (2.42; 1.24, 4.74). Of the features investigated, only osteophytes were consistently associated with pain cross-sectionally and longitudinally in all models. This suggests an important role of bone in early knee osteoarthritis.