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Synovitis detected on magnetic resonance imaging and its relation to pain and cartilage loss in knee osteoarthritis
  1. Catherine L Hill (catherine.hill{at}
  1. Queen Elizabeth Hospital, Australia
    1. David J Hunter (djhunter{at}
    1. Boston University, United States
      1. Jingbo Niu (niujp{at}
      1. Boston University, United States
        1. Margaret Clancy (mclancy{at}
        1. Boston University, United States
          1. Ali Guermazi (ali.guermazi{at}
          1. Synarc, Inc., United States
            1. Harry Genant (harry.genant{at}
            1. Synarc, Inc, United States
              1. Daniel Gale (drgale{at}
              1. va Boston Healthcare system, United States
                1. Andrew Grainger ({at}
                1. Leeds Teaching Hospitals Trust, United Kingdom
                  1. Philip G Conaghan (p.conaghan{at}
                  1. University of Leeds, United Kingdom
                    1. David T Felson (dfelson{at}
                    1. Boston University, United States


                      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 including 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 semi-quantitative 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 ± 5.7kg/m2; 42% were female. There was no correlation of baseline synovitis with baseline pain score (r=0.09, p=0.17). Change in summary synovitis score was correlated with change in pain (r = 0.21, p=0.0003). An increase of one unit in summary synovitis score resulted in 3.15mm 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 OA needs to consider treatment of synovitis.

                      • MRI
                      • cartilage
                      • osteoarthritis,knee
                      • pain

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