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Ann Rheum Dis. 2007 Dec;66(12):1599-603. Epub 2007 May 9.

Synovitis detected on magnetic resonance imaging and its relation to pain and cartilage loss in knee osteoarthritis.

Author information

1
Boston University School of Medicine, A203, 80 E. Concord Street, Boston, MA 02118, USA.

Abstract

OBJECTIVE:

To examine the relationship between longitudinal fluctuations in synovitis with change in pain and cartilage in knee osteoarthritis.

METHODS:

Study subjects were patients 45 years of age and older with symptomatic knee osteoarthritis from the Boston Osteoarthritis of the Knee Study. Baseline and follow-up assessments at 15 and 30 months included knee magnetic resonance imaging (MRI), BMI and pain assessment (VAS) over the last week. Synovitis was scored at 3 locations (infrapatellar fat pad, suprapatellar and intercondylar regions) using a semiquantitative scale (0-3) at all 3 time points on MRI. Scores at each site were added to give a summary synovitis score (0-9).

RESULTS:

We assessed 270 subjects whose mean (SD) age was 66.7 (9.2) years, BMI 31.5 (5.7) kg/m(2); 42% were female. There was no correlation of baseline synovitis with baseline pain score (r = 0.09, p = 0.17). The change in summary synovitis score was correlated with the change in pain (r = 0.21, p = 0.0003). An increase of one unit in summary synovitis score resulted in a 3.15-mm increase in VAS pain score (0-100 scale). Effusion change was not associated with pain change. Of the 3 locations for synovitis, changes in the infrapatellar fat pad were most strongly related to pain change. Despite cartilage loss occurring in over 50% of knees, synovitis was not associated with cartilage loss in either tibiofemoral or patellofemoral compartment.

CONCLUSIONS:

Change in synovitis was correlated with change in knee pain, but not loss of cartilage. Treatment of pain in knee osteoarthritis (OA) needs to consider treatment of synovitis.

PMID:
17491096
PMCID:
PMC2095318
DOI:
10.1136/ard.2006.067470
[Indexed for MEDLINE]
Free PMC Article

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