Quantitative and Semi-Quantitative Assessment of Synovitis on MRI and the Relationship with Symptoms in Symptomatic Knee Osteoarthritis

Perry, Thomas; Yang, Xiaotian; van Santen, James; Arden, Nigel; Kluzek, Stefan

Abstract

Objectives: Synovitis in symptomatic knee osteoarthritis (KOA) is common and is associated with joint symptoms. Optimal synovial measurement on magnetic resonance imaging (MRI) is however, unclear. Our aims were to examine the relationship between MRI-measures of synovitis and knee symptoms in symptomatic KOA.

Methods: Data from a randomised, multicentre, placebo-controlled trial (UK-VIDEO) of vitamin-D therapy in symptomatic KOA were utilised. Participants reported knee symptoms using WOMAC at baseline and annually. On contrast-enhanced (CE) MRI, synovial thickness was measured using established, semi-quantitative methods whilst synovial tissue volume (STV) was assessed as absolute STV (aSTV) and relative to the width of femoral condyle (rSTV). STV of the infrapatellar region was also assessed. Associations between synovial measures and symptoms were analysed using multiple linear regression modelling.

Results: No linear association was observed between knee symptoms and synovitis thickness scores. Whole joint aSTV (0.88, 95% CI 0.17 to 1.59) and infrapatellar aSTV (5.96, 95% CI 1.22 to 10.7) were positively associated with knee pain. Whole joint rSTV had a stronger association with pain (7.96, 95% CI 2.60 to 13.33) and total scores (5.63, 95% CI 0.32 to 10.94). Even stronger associations were found for infrapatellar rSTV with pain (55.47, 95% CI 19.99 to 90.96), function (38.59, 95% CI 2.1 to 75.07) and total scores (41.64, 95% CI 6.56 to 76.72).

Conclusions: Whole joint and site-specific infrapatellar STV measures on CE-MRI were associated with knee pain respectively. Volumes relative to the size of the femoral condyle may be promising outcome measures in KOA trials.

Keywords: synovitis, knee, osteoarthritis, MRI, quantitative, semi-quantitative

Citation

Perry, T., Yang, X., van Santen, J., Arden, N., & Kluzek, S. (2021). Quantitative and Semi-Quantitative Assessment of Synovitis on MRI and the Relationship with Symptoms in Symptomatic Knee Osteoarthritis. Journal of Rheumatology, 60(4), 1763-1773. https://doi.org/10.1093/rheumatology/keaa619

• Journal Article Type: Article
• Acceptance Date: Aug 21, 2020
• Online Publication Date: Oct 23, 2020
• Publication Date: 2021-04
• Deposit Date: Sep 3, 2020
• Publicly Available Date: Oct 24, 2021
• Journal: Journal of Rheumatology
• Print ISSN: 0315-162X
• Publisher: Journal of Rheumatology
• Peer Reviewed: Peer Reviewed
• Volume: 60
• Issue: 4
• Pages: 1763-1773
• DOI: https://doi.org/10.1093/rheumatology/keaa619
• Public URL: https://nottingham-repository.worktribe.com/output/4880749
• Publisher URL: https://academic.oup.com/rheumatology/advance-article/doi/10.1093/rheumatology/keaa619/5937238