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. 2016 May 17;2(1):e000234.
doi: 10.1136/rmdopen-2015-000234. eCollection 2016.

Bakers' cyst and tibiofemoral abnormalities are more distinctive MRI features of symptomatic osteoarthritis than patellofemoral abnormalities

A W Visser  1 , B Mertens  2 , M Reijnierse  3 , J L Bloem  3 , R de Mutsert  4 , S le Cessie  5 , F R Rosendaal  6 , M Kloppenburg  7
Affiliations

Bakers' cyst and tibiofemoral abnormalities are more distinctive MRI features of symptomatic osteoarthritis than patellofemoral abnormalities

A W Visser et al. RMD Open. .

Abstract

Objective: To investigate which structural MR abnormalities discriminate symptomatic knee osteoarthritis (OA), taking co-occurrence of abnormalities in all compartments into account.

Methods: The Netherlands Epidemiology of Obesity (NEO) study is a population-based cohort aged 45-65 years. In 1285 participants (median age 56 years, 55% women, median body mass index (BMI) 30 kg/m(2)), MRI of the right knee were obtained. Structural abnormalities (osteophytes, cartilage loss, bone marrow lesions (BMLs), subchondral cysts, meniscal abnormalities, effusion, Baker's cyst) at 9 patellofemoral and tibiofemoral locations were scored following the knee OA scoring system. Symptomatic OA in the imaged knee was defined following the American College of Rheumatology criteria. Logistic ridge regression analyses were used to investigate which structural abnormalities discriminate best between individuals with and without symptomatic OA, crude and adjusted for age, sex and BMI.

Results: Symptomatic knee OA was present in 177 individuals. Structural MR abnormalities were highly frequent both in individuals with OA and in those without. Baker's cysts showed the highest adjusted regression coefficient (0.293) for presence of symptomatic OA, followed by osteophytes and BMLs in the medial tibiofemoral compartment (0.185-0.279), osteophytes in the medial trochlear facet (0.262) and effusion (0.197).

Conclusions: Baker's cysts discriminate best between individuals with and without symptomatic knee OA. Structural MR abnormalities, especially in the medial side of the tibiofemoral joint and effusion, add further in discriminating symptomatic OA. Baker's cysts may present as a target for treatment.

Keywords: Epidemiology; Knee Osteoarthritis; Magnetic Resonance Imaging.

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Figures

Figure 1
Figure 1
Network graph illustrating the relation between the assessed structural abnormalities on different locations within the knee joint in the total NEO study population. Lines represent a relation between the presence of two abnormalities. BMLs, bone marrow lesions; NEO, the Netherlands Epidemiology of Obesity study.
Figure 2
Figure 2
ROC curve of one of the three analyses sets (set 1, AUC=0.7189). The ROC curves of set 2 and set 3 were comparable (AUC set 2=0.698, AUC set 3=0.693). AUC, area under the curve; ROC, receiver operating characteristic.
Figure 3
Figure 3
MRI in individuals with symptomatic knee osteoarthritis illustrating the structural abnormalities that discriminate symptomatic knee osteoarthritis best. (A) Axial fat suppressed proton density (PD) MRI showing a Baker's cyst, effusion and an osteophyte in the medial trochlear facet. (B) Coronal PD MRI showing osteophytes in the medial femoral condyle and medial tibial plateau. (C) Coronal fat suppressed PD MRI showing BMLs in the medial femoral condyle and medial tibial plateau. BML, bone marrow lesions.
See this image and copyright information in PMC

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