Objectives
It is unknown whether joint inflammation precedes other articular
tissue damage in osteoarthritis. Therefore, this study
aims to determine if synovitis
precedes the development of radiographic knee osteoarthritis (ROA).
Methods
The participants in this nested case–control study were selected from
persons in the Osteoarthritis Initiative with knees
that had a Kellgren Lawrence grading
(KLG)=0 at baseline (BL). These knees were evaluated annually with
radiography and non-contrast-enhanced
MRI over 4 years. MRIs were assessed
for effusion-synovitis and Hoffa-synovitis. Case knees were defined by
ROA (KLG≥2) on
the postero-anterior knee
radiographs at any assessment after BL. Radiographs were assessed at P0
(time of onset of ROA),
1 year prior to P0 (P-1) and at BL.
Controls were participants who did not develop incident ROA (iROA) from
BL to 48 months).
Results
133 knees of 120 persons with ROA (83 women) were matched to 133 control
knees (83 women). ORs for occurrence of iROA associated
with the presence of
effusion-synovitis at BL, P-1 and P0 were 1.56 (95% CI 0.86 to 2.81),
3.23 (1.72 to 6.06) and 4.7 (1.10
to 2.95), respectively. The ORs for
the occurrence of iROA associated with the presence of Hoffa-synovitis
at BL, P-1 and
P0 were 1.80 (1.1 to 2.95), 2.47
(1.45 to 4.23) and 2.40 (1.43 to 4.04), respectively.
Conclusions Effusion-synovitis and Hoffa-synovitis strongly predicted the development of iROA.
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Keywords: OA, synovitis, osteoarthritis of the knee, osteoarthritis, MRI osteoarthritis, Dr Pietsch
