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Observational Study
. 2016 Feb;75(2):390-5.
doi: 10.1136/annrheumdis-2014-205894. Epub 2014 Dec 8.

Synovitis in knee osteoarthritis: a precursor of disease?

I Atukorala  1 , C K Kwoh  2 , A Guermazi  3 , F W Roemer  4 , R M Boudreau  5 , M J Hannon  5 , D J Hunter  6
Affiliations
Observational Study

Synovitis in knee osteoarthritis: a precursor of disease?

I Atukorala et al. Ann Rheum Dis. 2016 Feb.

Abstract

Objectives: It is unknown whether joint inflammation precedes other articular tissue damage in osteoarthritis. Therefore, this study aims to determine if synovitis precedes the development of radiographic knee osteoarthritis (ROA).

Methods: The participants in this nested case-control study were selected from persons in the Osteoarthritis Initiative with knees that had a Kellgren Lawrence grading (KLG)=0 at baseline (BL). These knees were evaluated annually with radiography and non-contrast-enhanced MRI over 4 years. MRIs were assessed for effusion-synovitis and Hoffa-synovitis. Case knees were defined by ROA (KLG≥2) on the postero-anterior knee radiographs at any assessment after BL. Radiographs were assessed at P0 (time of onset of ROA), 1 year prior to P0 (P-1) and at BL. Controls were participants who did not develop incident ROA (iROA) from BL to 48 months).

Results: 133 knees of 120 persons with ROA (83 women) were matched to 133 control knees (83 women). ORs for occurrence of iROA associated with the presence of effusion-synovitis at BL, P-1 and P0 were 1.56 (95% CI 0.86 to 2.81), 3.23 (1.72 to 6.06) and 4.7 (1.10 to 2.95), respectively. The ORs for the occurrence of iROA associated with the presence of Hoffa-synovitis at BL, P-1 and P0 were 1.80 (1.1 to 2.95), 2.47 (1.45 to 4.23) and 2.40 (1.43 to 4.04), respectively.

Conclusions: Effusion-synovitis and Hoffa-synovitis strongly predicted the development of iROA.

Keywords: Knee Osteoarthritis; Magnetic Resonance Imaging; Synovitis.

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Conflict of interest statement

Competing interest

Drs. Atukorala, Hunter, Boudreau, and Mr. Hannon report no competing interest.

Ali Guermazi is President and co-owner of the Boston Core Imaging Lab (BICL), a company providing MRI reading services to academic researchers and to industry. He has provided consulting services to Novartis, Merck Serono, Sanofi-Aventis, TissueGene and Genzyme.

Frank Roemer is CMO and co-owner of the Boston Core Imaging Lab (BICL), a company providing MRI reading services to academic researchers and to industry. He has provided consulting services to Merck Serono.

C. Kent Kwoh has provided consulting services to Novartis and has received research support from Astra-Zeneca.

Figures

Figure 1
Figure 1
Effusion- synovitis and Hoffa synovitis on Magnetic resonance imaging
Figure 2
Figure 2
Schema detailing the timing of onset of ROA (radiographic KOA) with number of subjects who developing ROA at each time point. P0 =time of onset of ROA), P-1=1 year prior to P0, and BL=Baseline. N=Number (%). Red line – 1 year prior to the onset ROA
See this image and copyright information in PMC

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