Associations between MRI features versus knee pain severity and progression: Data from the Vancouver Longitudinal Study of Early Knee Osteoarthritis
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....
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Published in | PloS one Vol. 12; no. 5; p. e0176833 |
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Main Authors | , , , , , , , |
Format | Journal Article |
Language | English |
Published |
United States
Public Library of Science
04.05.2017
Public Library of Science (PLoS) |
Subjects | |
Online Access | Get full text |
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Summary: | 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. |
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Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Competing Interests: Ali Guermazi is President of Boston Imaging Core Lab, LLC, and consultant to AstraZeneca, TissueGene, OrthoTrophix, Merck Serono and Genzyme. No other authors have competing interests to declare. This does not alter our adherence to PLOS ONE policies on sharing data and materials. Conceptualization: ECS AG JME JAK JS AT SN JC.Data curation: ECS.Formal analysis: ECS.Funding acquisition: JC.Investigation: JC.Methodology: ECS AG JME JAK JS AT SN JC.Project administration: JC.Resources: AG.Software: ECS.Supervision: ECS AG JME JAK JS AT SN JC.Validation: ECS AG JME JAK JS AT SN JC.Visualization: ECS AG JME JAK JS AT SN JC.Writing – original draft: ECS AG JME JAK JS AT SN JC.Writing – review & editing: ECS AG JME JAK JS AT SN JC. |
ISSN: | 1932-6203 1932-6203 |
DOI: | 10.1371/journal.pone.0176833 |