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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

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


Authors

Thomas Perry

Xiaotian Yang

James van Santen

Nigel Arden

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STEFAN KLUZEK Stefan.Kluzek@nottingham.ac.uk
Clinical Associate Professor



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

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