Radiographic progression of knee osteoarthritis is associated with MRI abnormalities in both the patellofemoral and tibiofemoral joint

Osteoarthritis Cartilage. 2016 Mar;24(3):473-9. doi: 10.1016/j.joca.2015.09.021. Epub 2015 Oct 22.

Abstract

Objective: To investigate patterns of MRI abnormalities in the patellofemoral (PFJ) and tibiofemoral joint (TFJ) and their association with radiographic progression, using hypothesis free analyses.

Design: 205 patients from the GARP study with symptomatic OA at multiple sites (mean age 60 years, 80% woman, median BMI 26 kg/m(2)), underwent knee MRI at baseline. Cartilage damage, osteophytes, cysts, bone marrow lesions (BMLs) and effusion/synovitis were scored according to a validated scoring method. Baseline and 6-year TFJ and PFJ radiographs were scored (0-3) for JSN and osteophytes according to OARSI and Burnett atlases, respectively; progression was defined as ≥1 point increase. Baseline patterns of MRI abnormalities derived from principal component analysis (PCA) were associated with progression using adjusted generalized estimating equations (GEE).

Results: PCA resulted in extraction of six components, explaining 69% of variance. In 29% and 29% of 133 patients with follow-up the TFJ progressed, whereas in 15% and 9% the PFJ progressed for osteophytes and JSN, respectively. Component 1 (cartilage damage of the PFJ and osteophytes of both joints) was statistically significant associated with TFJ JSN progression and PFJ osteophyte progression. Component 2 (all lateral PFJ abnormalities except osteophytes) was associated with JSN/osteophyte progression in the PFJ alone, whereas component 3 (all medial TFJ abnormalities except osteophytes) was associated with JSN and osteophyte progression in both PFJ and TFJ.

Conclusion: Baseline structural damage and bone turnover activity, as reflected by BMLs, seem to be involved in knee OA progression. Moreover, progression in PFJ and TFJ seems to be related.

Keywords: Osteoarthritis; Radiographic progression; Synovitis.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Disease Progression
  • Female
  • Follow-Up Studies
  • Humans
  • Knee Joint / diagnostic imaging*
  • Knee Joint / pathology
  • Magnetic Resonance Imaging / methods
  • Male
  • Middle Aged
  • Osteoarthritis, Knee / diagnostic imaging*
  • Osteoarthritis, Knee / pathology
  • Osteophyte / pathology
  • Patellofemoral Joint / diagnostic imaging
  • Patellofemoral Joint / pathology
  • Radiography / methods
  • Severity of Illness Index
  • Synovitis / diagnostic imaging