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Osteoarthritis Cartilage. 2014 Oct;22(10):1606-13. doi: 10.1016/j.joca.2013.12.013. Epub 2013 Dec 21.

Degree of synovitis on MRI by comprehensive whole knee semi-quantitative scoring method correlates with histologic and macroscopic features of synovial tissue inflammation in knee osteoarthritis.

Author information

1
Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands. Electronic address: b.j.e.de_lange@lumc.nl.
2
Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands. Electronic address: A.Ioan@lumc.nl.
3
Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands. Electronic address: E.Yusuf@lumc.nl.
4
Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands. Electronic address: A.W.Visser@lumc.nl.
5
Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands. Electronic address: H.M.J.A.Kroon@lumc.nl.
6
Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands. Electronic address: S.N.Andersen@lumc.nl.
7
Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands. Electronic address: L.van_Toorn@lumc.nl.
8
Department of Orthopaedics and Otorhinolarynogology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands. Electronic address: g.vanosch@erasmusmc.nl.
9
TNO, Leiden, The Netherlands. Electronic address: anne-marie.zuurmond@tno.nl.
10
Janssen Research & Development, LLC, Spring House, PA, USA. Electronic address: VStojano@its.jnj.com.
11
Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands. Electronic address: J.L.Bloem@lumc.nl.
12
Department Orthopaedics, Leiden University Medical Center, Leiden, The Netherlands. Electronic address: R.G.H.H.Nelissen@lumc.nl.
13
Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands. Electronic address: T.W.J.Huizinga@lumc.nl.
14
Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands; Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands. Electronic address: G.Kloppenburg@lumc.nl.

Abstract

OBJECTIVE:

To evaluate the association between synovitis on contrast enhanced (CE) MRI with microscopic and macroscopic features of synovial tissue inflammation.

METHOD:

Forty-one patients (mean age 60 years, 61% women) with symptomatic radiographic knee OA were studied: twenty underwent arthroscopy (macroscopic features were scored (0-4), synovial biopsies obtained), twenty-one underwent arthroplasty (synovial tissues were collected). After haematoxylin and eosin staining, the lining cell layer, synovial stroma and inflammatory infiltrate of synovial tissues were scored (0-3). T1-weighted CE-MRI's (3 T) were used to semi-quantitatively score synovitis at 11 sites (0-22) according to Guermazi et al. Spearman's rank correlations were calculated.

RESULTS:

The mean (SD) MRI synovitis score was 8.0 (3.7) and the total histology grade was 2.5 (1.6). Median (range) scores of macroscopic features were 2 (1-3) for neovascularization, 1 (0-3) for hyperplasia, 2 (0-4) for villi and 2 (0-3) for fibrin deposits. The MRI synovitis score was significantly correlated with total histology grade [r = 0.6], as well as with lining cell layer [r = 0.4], stroma [r = 0.3] and inflammatory infiltrate [r = 0.5] grades. Moreover, MRI synovitis score was also significantly correlated with macroscopic neovascularization [r = 0.6], hyperplasia [r = 0.6] and villi [r = 0.6], but not with fibrin [r = 0.3].

CONCLUSION:

Synovitis severity on CE-MRI assessed by a new whole knee scoring system by Guermazi et al. is a valid, non-invasive method to determine synovitis as it is significantly correlated with both macroscopic and microscopic features of synovitis in knee OA patients.

KEYWORDS:

MRI; Macroscopy; Osteoarthritis; Synovial tissue; Synovitis

PMID:
24365722
DOI:
10.1016/j.joca.2013.12.013
[Indexed for MEDLINE]
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