Empirical Evaluation of the Inter-Relationship of Articular Elements Involved in the Pathoanatomy of Knee Osteoarthritis Using Magnetic Resonance Imaging

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dc.contributor.author Meredith, Dennis S en_US
dc.contributor.author Losina, Elena en_US
dc.contributor.author Neumann, Gesa en_US
dc.contributor.author Yoshioka, Hiroshi en_US
dc.contributor.author Lang, Philipp K en_US
dc.contributor.author Katz, Jeffrey N en_US
dc.date.accessioned 2011-12-29T22:21:53Z
dc.date.available 2011-12-29T22:21:53Z
dc.date.copyright 2009 en_US
dc.date.issued 2009-10-29 en_US
dc.identifier.citation Meredith, Dennis S, Elena Losina, Gesa Neumann, Hiroshi Yoshioka, Philipp K Lang, Jeffrey N Katz. "Empirical evaluation of the inter-relationship of articular elements involved in the pathoanatomy of knee osteoarthritis using Magnetic Resonance Imaging" BMC Musculoskeletal Disorders 10:133. (2009) en_US
dc.identifier.issn 1471-2474 en_US
dc.identifier.uri http://hdl.handle.net/2144/2568
dc.description.abstract BACKGROUND: In this cross-sectional study, we conducted a comprehensive assessment of all articular elements that could be measured using knee MRI. We assessed the association of pathological change in multiple articular structures involved in the pathoanatomy of osteoarthritis. METHODS: Knee MRI scans from patients over 45 years old were assessed using a semi-quantitative knee MRI assessment form. The form included six distinct elements: cartilage, bone marrow lesions, osteophytes, subchondral sclerosis, joint effusion and synovitis. Each type of pathology was graded using an ordinal scale with a value of zero indicating no pathology and higher values indicating increasingly severe levels of pathology. The principal dependent variable for comparison was the mean cartilage disease score (CDS), which captured the aggregate extent of involvement of articular cartilage. The distribution of CDS was compared to the individual and cumulative distributions of each articular element using the Chi-squared test. The correlations between pathological change in the various articular structures were assessed in a Spearman correlation table. RESULTS: Data from 140 patients were available for review. The cohort had a median age of 61 years (range 45-89) and was 61% female. The cohort included a wide spectrum of OA severity. Our analysis showed a statistically significant trend towards pathological change involving more articular elements as CDS worsened (p-value for trend < 0.0001). Comparison of CDS to change in the severity of pathology of individual articular elements showed statistically significant trends towards more severe pathology as CDS worsened for osteophytes (p-value for trend < 0.0001), bone marrow lesions (p = 0.0003), and subchondral sclerosis (p = 0.009), but not joint effusion or synovitis. There was a moderate correlation between cartilage damage, osteophytes and BMLs as well as a moderate correlation between joint effusion and synovitis. However, cartilage damage and osteophytes were only weakly associated with synovitis or joint effusion. CONCLUSION: Our results support an inter-relationship of multiple articular elements in the pathoanatomy of knee OA. Prospective studies of OA pathogenesis in humans are needed to correlate these findings to clinically relevant outcomes such as pain and function. en_US
dc.description.sponsorship Doris Duke Foundation; National Institutes of Health (P60 AR 47782; K24 AR 02123) en_US
dc.language.iso en en_US
dc.publisher BioMed Central en_US
dc.rights Copyright 2009 Meredith et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution 2.0 License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. en_US
dc.rights.uri http://creativecommons.org/licenses/by/2.0 en_US
dc.title Empirical Evaluation of the Inter-Relationship of Articular Elements Involved in the Pathoanatomy of Knee Osteoarthritis Using Magnetic Resonance Imaging en_US
dc.type article en_US
dc.identifier.doi 10.1186/1471-2474-10-133 en_US
dc.identifier.pubmedid 19874594 en_US
dc.identifier.pmcid 2774678 en_US

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