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. 2012 Aug 29:345:e5339.
doi: 10.1136/bmj.e5339.

Prevalence of abnormalities in knees detected by MRI in adults without knee osteoarthritis: population based observational study (Framingham Osteoarthritis Study)

Ali Guermazi  1 , Jingbo Niu, Daichi Hayashi, Frank W Roemer, Martin Englund, Tuhina Neogi, Piran Aliabadi, Christine E McLennan, David T Felson
Affiliations

Prevalence of abnormalities in knees detected by MRI in adults without knee osteoarthritis: population based observational study (Framingham Osteoarthritis Study)

Ali Guermazi et al. BMJ. .

Abstract

Objective: To examine use of magnetic resonance imaging (MRI) of knees with no radiographic evidence of osteoarthritis to determine the prevalence of structural lesions associated with osteoarthritis and their relation to age, sex, and obesity.

Design: Population based observational study.

Setting: Community cohort in Framingham, MA, United States (Framingham osteoarthritis study).

Participants: 710 people aged >50 who had no radiographic evidence of knee osteoarthritis (Kellgren-Lawrence grade 0) and who underwent MRI of the knee.

Main outcome measures: Prevalence of MRI findings that are suggestive of knee osteoarthritis (osteophytes, cartilage damage, bone marrow lesions, subchondral cysts, meniscal lesions, synovitis, attrition, and ligamentous lesions) in all participants and after stratification by age, sex, body mass index (BMI), and the presence or absence of knee pain. Pain was assessed by three different questions and also by WOMAC questionnaire.

Results: Of the 710 participants, 393 (55%) were women, 660 (93%) were white, and 206 (29%) had knee pain in the past month. The mean age was 62.3 years and mean BMI was 27.9. Prevalence of "any abnormality" was 89% (631/710) overall. Osteophytes were the most common abnormality among all participants (74%, 524/710), followed by cartilage damage (69%, 492/710) and bone marrow lesions (52%, 371/710). The higher the age, the higher the prevalence of all types of abnormalities detectable by MRI. There were no significant differences in the prevalence of any of the features between BMI groups. The prevalence of at least one type of pathology ("any abnormality") was high in both painful (90-97%, depending on pain definition) and painless (86-88%) knees.

Conclusions: MRI shows lesions in the tibiofemoral joint in most middle aged and elderly people in whom knee radiographs do not show any features of osteoarthritis, regardless of pain.

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Conflict of interest statement

Competing interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf (available on request from the corresponding author) and declare: AG is the president of Boston Imaging Core Lab (BICL), LLC, and a consultant to Merck Serono, Stryker, Genzyme, AstraZeneca, and Novartis; FWR a vice president and shareholder of BICL and is a consultant to Merck Serono and National Institute of Health; ME is funded by the Swedish Research Council, the Greta and Johan Kock Foundation, King Gustaf V 80-year Birthday Foundation, and the Faculty of Medicine, Lund University, Sweden; TN is supported by NIAMS AR055127 and the Arthritis Foundation Arthritis Investigator Award.

Figures

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Fig 1 Selection process of knees included in present study
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Fig 2 Knee with multiple abnormalities on MRI indicating early stage osteoarthritis despite lack of radiographic osteoarthritis. A: coronal fat suppressed proton density weighted image shows several features of early OA detectable only by MRI. White arrowhead shows focal full thickness cartilage defect at central weight bearing part of medial femur. In addition there is adjacent subchondral bone marrow lesion presenting as area of ill defined hyperintensity (arrows). Black arrowheads show meniscal extrusion at medial joint line causing bulging of neighbouring medial collateral ligament (no arrow). B: sagittal proton density weighted image shows isolated degenerative horizontal oblique tear of posterior horn of medial meniscus extending to undersurface of meniscus adjacent to posterior tibial surface (arrows). No associated cartilage damage or subchondral bony alterations are seen
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Fig 3 Prevalence of osteoarthritis features on MRI in knees without radiographic osteoarthritis stratified by age group with standard and more stringent definitions of MRI abnormalities
See this image and copyright information in PMC

References

    1. Sacks JJ, Luo YH, Helmick CG. Prevalence of specific types of arthritis and other rheumatic conditions in the ambulatory health care system in the United States, 2001-2005. Arthritis Care Res (Hoboken) 2010;62:460-4. - PubMed
    1. Bedson J, Jordan K, Croft P. The prevalence and history of knee osteoarthritis in general practice: a case-control study. Fam Pract 2005;22:103-8. - PubMed
    1. Murphy L, Schwartz TA, Helmick CG, Renner JB, Tudor G, Koch G, et al. Lifetime risk of symptomatic knee osteoarthritis. Arthritis Rheum 2008;59:1207-13. - PMC - PubMed
    1. Wills AK, Black S, Cooper R, Coppack RJ, Hardy R, Martin KR, et al. Life course body mass index and risk of knee osteoarthritis at the age of 53 years: evidence from the 1946 British birth cohort study. Ann Rheum Dis 2012;71:655-60. - PMC - PubMed
    1. Felson DT, Zhang Y. An update on the epidemiology of knee and hip osteoarthritis with a view to prevention. Arthritis Rheum 1998;41:1343-55. - PubMed

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