Format

Send to

Choose Destination
Arthritis Care Res (Hoboken). 2019 Mar;71(3):385-389. doi: 10.1002/acr.23592.

Relationship Between Patient-Reported Swelling and Magnetic Resonance Imaging-Defined Effusion-Synovitis in Patients With Meniscus Tears and Knee Osteoarthritis.

Author information

1
Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
2
Brigham and Women's Hospital, Boston, Massachusetts.
3
Boston University School of Medicine, Boston, Massachusetts.
4
Weil Cornell Medicine, New York, New York.
5
Mayo Clinic, Rochester, Minnesota.

Abstract

OBJECTIVE:

Synovitis is a prevalent feature in patients with knee osteoarthritis (OA) and meniscal tear and is associated with pain and cartilage damage. Patient-reported swelling is also prevalent in this population. The aim of this study was to investigate the cross-sectional association between patient-reported swelling and effusion-synovitis detected by magnetic resonance imaging (MRI) in patients with OA and meniscal tear.

METHODS:

We used baseline data from a multicenter, randomized controlled trial, Meniscal Tear in Osteoarthritis Research (METEOR). MRI-identified effusion-synovitis, a proxy for effusion and synovitis on noncontrast MRIs, was graded as none/small versus medium/large. Using MRI-identified effusion-synovitis as the gold standard, we assessed the sensitivity, specificity, and positive predictive value of patient self-reported swelling in the previous week (none, intermittent, constant) to detect effusion and synovitis.

RESULTS:

We analyzed data from 276 patients. Twenty-five percent of patients reported no swelling, 40% had intermittent swelling, and 36% had constant swelling. Fifty-two percent had MRI-identified medium/large-grade effusion-synovitis. As compared with MRI-identified effusion-synovitis, any patient-reported swelling (versus none) had a sensitivity of 84% (95% confidence interval [95% CI] 77-89), a specificity of 34% (95% CI 26-43), and a positive predictive value of 57% (95% CI 54-61). A history of constant swelling (versus none or intermittent) showed a sensitivity of 46% (95% CI 37-54), a specificity of 75% (95% CI 67-82), and a positive predictive value of 66% (95% CI 58-74).

CONCLUSION:

We found that the sensitivity and specificity of patient-reported swelling were modest when compared with effusion-synovitis detected by MRI. These data urge caution against using patient-reported swelling as a proxy of inflammation manifesting as effusion-synovitis.

PMID:
29726627
PMCID:
PMC6215743
[Available on 2020-03-01]
DOI:
10.1002/acr.23592

Supplemental Content

Full text links

Icon for Wiley
Loading ...
Support Center