Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2010 Oct;69(10):1779-83.
doi: 10.1136/ard.2009.121426. Epub 2010 May 14.

Relation of synovitis to knee pain using contrast-enhanced MRIs

K Baker  1 , A Grainger, J Niu, M Clancy, A Guermazi, M Crema, L Hughes, J Buckwalter, A Wooley, M Nevitt, D T Felson
Affiliations
Multicenter Study

Relation of synovitis to knee pain using contrast-enhanced MRIs

K Baker et al. Ann Rheum Dis. 2010 Oct.

Abstract

Background: It has been suggested that synovitis causes joint pain. On non-contrast-enhanced MRIs synovial thickening cannot be assessed and on these images synovitis has been inconsistently associated with pain.

Objective: To assess synovial thickening in relation to knee pain severity among subjects in the Multicenter Osteoarthritis Study (MOST) using contrast-enhanced (CE) MRI.

Methods: MOST is a cohort study of people who have, or are at high risk of, knee osteoarthritis (OA). An unselected subset of 535 participants who volunteered underwent CE 1.5 T MRI of one knee. Synovitis was scored in six compartments and a summary score was created. Knee pain severity was assessed using the maximum item score on the Western Ontario and McMaster Osteoarthritis Index (WOMAC) pain scale. The association between synovitis and pain severity was examined using a logistic regression model adjusting for age, sex, body mass index (BMI), MRI bone marrow lesions and effusions in the whole sample and in a subgroup without radiographic OA.

Results: 454 of the 535 subjects undergoing CE MRI had complete data on synovitis and WOMAC pain. Mean age was 59 years, mean BMI 30 and 48% were women. In knees with moderate pain, 80% had synovitis. For knee pain, synovitis conferred a 9.2-fold increased odds compared with those without synovitis. In knees without radiographic OA (n=329), there was also an association of synovitis with an increased prevalence of pain.

Conclusion: Synovitis has a strong relation with knee pain severity, an association detected more clearly with CE MRI than suggested by previous studies using non-CE MRI measures of synovitis.

PubMed Disclaimer

Conflict of interest statement

Competing interests None.

Figures

Figure 1
Figure 1
Sagittal sequence: (A) Score of 1 in suprapatellar pouch. Score of 1 in infrapatellar fat pad. (B) Score of 2 in suprapatellar pouch. Score of 3 in infrapatellar fat pad.
Figure 2
Figure 2
Axial sequence: (A) Score of 2 in lateral patellar recess. Score of 1 in medial patellar recess. (B) Score of 3 in lateral patellar recess. Score of 1 in medial patellar recess.
See this image and copyright information in PMC

References

    1. Felson DT, Niu J, Guermazi A, et al. Correlation of the development of knee pain with enlarging bone marrow lesions on magnetic resonance imaging. Arthritis Rheum. 2007;56:2986–92. - PubMed
    1. Hill CL, Gale DG, Chaisson CE, et al. Knee effusions, popliteal cysts, and synovial thickening: association with knee pain in osteoarthritis. J Rheumatol. 2001;28:1330–7. - PubMed
    1. Hill CL, Hunter DJ, Niu J, et al. Synovitis detected on magnetic resonance imaging and its relation to pain and cartilage loss in knee osteoarthritis. Ann Rheum Dis. 2007;66:1599–603. - PMC - PubMed
    1. Torres L, Dunlop DD, Peterfy C, et al. The relationship between specific tissue lesions and pain severity in persons with knee osteoarthritis. Osteoarthr Cartil. 2006;14:1033–40. - PubMed
    1. Loeuille D, Rat AC, Goebel JC, et al. Magnetic resonance imaging in osteoarthritis: which method best reflects synovial membrane inflammation? Correlations with clinical, macroscopic and microscopic features. Osteoarthritis Cartilage. 2009;17:1186–92. - PubMed

Publication types