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Fluctuation of knee pain and changes in bone marrow lesions, effusions, and synovitis on magnetic resonance imaging
Journal article   Open access   Peer reviewed

Fluctuation of knee pain and changes in bone marrow lesions, effusions, and synovitis on magnetic resonance imaging

Yuqing Zhang, Michael Nevitt, Jingbo Niu, Cora Lewis, James Torner, Ali Guermazi, Frank Roemer, Charles McCulloch and David T Felson
Arthritis and rheumatism, Vol.63(3), pp.691-699
03/2011
DOI: 10.1002/art.30148
PMCID: PMC3056156
PMID: 21360498
url
https://doi.org/10.1002/art.30148View
Published (Version of record) Open Access

Abstract

Fluctuations in pain in patients with knee osteoarthritis (OA) are common, but risk factors for pain fluctuation are poorly understood. To best identify the structural causes of fluctuations, multiple assessments of pain status and structural lesions are needed. This study was undertaken to determine whether pain resolution is accompanied by diminution of lesions in patients with knee OA. Subjects in the Multicenter Osteoarthritis Study were queried about their knee pain by interview, and knees were assessed by magnetic resonance imaging at the baseline and 15-month and 30-month clinic visits. For those knees in which pain fluctuation was identified over 3 clinic visits, the relationship of bone marrow lesions (BMLs), synovitis, and effusion to frequent knee pain and severity of knee pain was examined using conditional logistic regression analyses. Included in the analysis were 570 subjects with knee OA (651 knees). When the BML score changed from 0 to 1, 2, 3, 4, 5-6, and 7-18 over 2 consecutive clinic visits, the odds ratios (ORs) for frequent knee pain were 1.2, 1.2, 1.5, 2.2, 2.4, and 2.5, respectively (P for trend = 0.006). The corresponding ORs were 1.5, 1.5, and 2.4 when the synovitis score changed from 0 to 1, 2, and 3-6, respectively (P for trend = 0.045). No significant association was found between the effusion score and frequent knee pain. Diminishing size of BMLs was associated with resolution of knee pain (P for trend = 0.007). Similar associations were also observed between these structural lesions and the severity of knee pain. Changes in BMLs and synovitis are associated with fluctuations in knee pain in patients with knee OA. Pain resolution occurs more frequently when BMLs become smaller.
 Arthralgia - pathology Severity of Illness Index Humans Middle Aged Risk Factors Logistic Models Male Osteoarthritis, Knee - epidemiology Synovitis - pathology Magnetic Resonance Imaging Osteoarthritis, Knee - pathology Bone Marrow - pathology Exudates and Transudates - physiology Female Aged Longitudinal Studies Synovitis - epidemiology

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