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Signal intensity alteration in the infrapatellar fat pad at baseline for the prediction of knee symptoms and structure in older adults: a cohort study
  1. Weiyu Han1,2,
  2. Dawn Aitken1,
  3. Zhaohua Zhu1,
  4. Andrew Halliday3,
  5. Xia Wang1,
  6. Benny Antony1,
  7. Flavia Cicuttini4,
  8. Graeme Jones1,
  9. Changhai Ding1,4,5
  1. 1Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
  2. 2Department of Orthopaedics, 3rd Affiliated Hospital of Southern Medical University, Guangzhou, China
  3. 3Department of Radiology, Royal Hobart Hospital, Hobart, Tasmania, Australia
  4. 4Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
  5. 5Arthritis Research Institute, 1st Affiliated Hospital, Anhui Medical University, Hefei, Anhui, China
  1. Correspondence to Dr Changhai Ding, Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, Tasmania 7000, Australia; Changhai.Ding{at}


Objective To describe the associations between infrapatellar fat pad (IPFP) signal intensity alteration at baseline and knee symptoms and structural changes in older adults.

Methods A total of 874 subjects (mean 62.1 years, 50.1% female) selected randomly from local community were studied at baseline and 770 were followed up (only 357 had MRI at follow-up) over 2.6 years. T1-weighted or T2-weighted fat suppressed MRI was used to assess IPFP signal intensity alteration (0–3), cartilage volume, cartilage defects and bone marrow lesions (BMLs) at baseline and 2.6 years later. Knee pain was assessed by self-administered Western Ontario and McMaster Osteoarthritis Index questionnaire. Radiographic osteoarthritis (OA) was assessed.

Results In cross-sectional analyses, IPFP signal intensity alteration was significantly and positively associated with total knee pain as well as knee cartilage defects, BMLs and knee radiographic OA and negatively associated with patellar cartilage volume after adjustment for age, sex, body mass index and/or radiographic OA. Longitudinally, baseline signal intensity alteration within IPFP was significantly and positively associated with increases in knee pain when going upstairs/downstairs as well as increases in tibiofemoral cartilage defects and BMLs, and negatively associated with change in lateral tibial cartilage volume in multivariable analyses.

Conclusions IPFP signal intensity alteration at baseline was associated with knee structural abnormalities and clinical symptoms cross-sectionally and longitudinally in older adults, suggesting that it may serve as an important imaging biomarker in knee OA.

  • Inflammation
  • Magnetic Resonance Imaging
  • Knee Osteoarthritis

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