Pre-radiographic MRI findings are associated with onset of knee symptoms: the most study

Javaid, M.K.; Lynch, J.A.; Tolstykh, I.; Guermazi, A.; Roemer, F.; Aliabadi, P.; McCulloch, C.; Curtis, J.; Felson, D.; Lane, N.E.; Torner, J.; Nevitt, M.

doi:10.1016/j.joca.2009.11.002

« Previous Next »Osteoarthritis and Cartilage
Volume 18, Issue 3 , Pages 323-328, March 2010

Pre-radiographic MRI findings are associated with onset of knee symptoms: the most study

M.K. Javaid
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
- NIHR BRU, Nuffield Department of Orthopaedics, Rheumatology and Orthopaedic Medicine, University of Oxford, UK
- Address correspondence and reprint requests to: M. K. Javaid, NIHR BRU, Nuffield Department of Orthopaedics, Rheumatology and Orthopaedic Medicine, University of Oxford, Windmill Road, Oxford OX3 7LD, UK. Tel: 44-1865-737852; Fax: 44-1865-227966.
J.A. Lynch
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
I. Tolstykh
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
A. Guermazi
- Quantitative Imaging Center (QIC), Department of Radiology, Boston University Medical Center, Boston, MA, USA
F. Roemer
- Quantitative Imaging Center (QIC), Department of Radiology, Boston University Medical Center, Boston, MA, USA
- Department of Radiology, Klinikum Augsburg, Augsburg, Germany
P. Aliabadi
- Quantitative Imaging Center (QIC), Department of Radiology, Boston University Medical Center, Boston, MA, USA
C. McCulloch
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
J. Curtis
- Division of Clinical Immunology and Rheumatology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
D. Felson
- Clinical Epidemiology Research and Training Unit, Boston University School of Medicine, Boston, MA, USA
N.E. Lane
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
- Department of Medicine, University of California at Davis School of Medicine, Sacramento, CA, USA
J. Torner
- Department of Radiology, Klinikum Augsburg, Augsburg, Germany
M. Nevitt
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA

Received 31 March 2009; accepted 1 November 2009. published online 30 November 2009.

Summary

Objective

Magnetic resonance imaging (MRI) has greater sensitivity to detect osteoarthritis (OA) damage than radiographs but it is uncertain which MRI findings in early OA are clinically important. We examined MRI abnormalities detected in knees without radiographic OA and their association with incident knee symptoms.

Method

Participants from the Multicenter Osteoarthritis Study (MOST) without frequent knee symptoms (FKS) at baseline were eligible if they also lacked radiographic features of OA at baseline. At 15 months, knees that developed FKS were defined as cases while control knees were drawn from those that remained without FKS. Baseline MRIs were scored at each subregion for cartilage lesions (CARTs); osteophytes (OST); bone marrow lesions (BML) and cysts. We compared cases and controls using marginal logistic regression models, adjusting for age, gender, race, body mass index (BMI), previous injury and clinic site.

Results

36 case knees and 128 control knees were analyzed. MRI damage was common in both cases and controls. The presence of a severe CART (P=0.03), BML (P=0.02) or OST (P=0.02) in the whole knee joint was more common in cases while subchondral cysts did not differ significantly between cases and controls (P>0.1). Case status at 15 months was predicted by baseline damage at only two locations; a BML in the lateral patella (P=0.047) and at the tibial subspinous subregions (P=0.01).

Conclusion

In knees without significant symptoms or radiographic features of OA, MRI lesions of OA in only a few specific locations preceded onset of clinical symptoms and suggest that changes in bone play a role in the early development of knee pain. Confirmation of these findings in other prospective studies of knee OA is warranted.

Key words: MRI, Knee osteoarthritis, BML, Epidemiology