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The interactions between MRI-detected osteophytes and bone marrow lesions or effusion-synovitis on knee symptom
1Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
Objectives:
To investigate the longitudinal association between MRI-detected osteophyte scores and progression of knee symptoms, and whether the association was modified in the presence of bone marrow lesions (BMLs) or effusion-synovitis.
Methods:
Data from Vitamin D Effects on Osteoarthritis (VIDEO) study, a randomized, double-blinded and placebo-controlled clinical trial in symptomatic knee osteoarthritis (OA) patients, were analyzed as an exploratory study. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) was used to assess knee symptoms. Osteophytes, BMLs and effusion-synovitis were measured using MRI.
Results:
334 participants with MRI information and WOMAC score (baseline and follow-up) were included in the analyses, with 24.3% of them having knee pain increased 2 years later. Statistically significant interactions were found between MRI-detected osteophytes and BMLs or effusion-synovitis on increased knee symptoms. In participants with BMLs, higher baseline scores of MRI-detected osteophytes in most compartments were significantly associated with increased total knee pain, weight-bearing pain, stiffness, and physical dysfunction, after adjustment for age, sex, body mass index, intervention and effusion-synovitis. In participants with effusion-synovitis, higher baseline scores of MRI-detected osteophytes in almost all the compartments were significantly associated with increased total knee pain, weight-bearing pain, stiffness, and physical dysfunction, after adjustment for age, sex, body mass index, intervention and BMLs. In contrast, MRI-detected osteophyte scores were generally not associated with knee symptom progression in participants without baseline BMLs or effusion-synovitis.
Conclusions:
MRI-detected OPs are associated with increased total knee pain, weight-bearing knee pain, stiffness and physical dysfunction in participants presenting BMLs or effusion-synovitis, but not in participants lacking BMLs or effusion-synovitis. This suggests they could interact with bone or synovial abnormalities to induce symptoms in knee OA.
Insights
Osteophytes worsen knee osteoarthritis symptoms like pain and stiffness, but only when bone marrow lesions or synovitis are present. This suggests these factors interact to cause knee OA symptoms.
Area of Science:
- Osteoarthritis Research
- Biomedical Imaging
- Rheumatology
Background:
- Knee osteoarthritis (OA) is a common degenerative joint disease.
- Osteophytes, bone marrow lesions (BMLs), and effusion-synovitis are key features of knee OA.
- The interplay between these features and symptom progression is not fully understood.
Purpose of the Study:
- To examine the longitudinal association between MRI-detected osteophytes and knee symptom progression.
- To determine if BMLs or effusion-synovitis modify this association in knee OA patients.
Main Methods:
- Analysis of data from the Vitamin D Effects on Osteoarthritis (VIDEO) study.
- Inclusion of 334 symptomatic knee OA patients with baseline and 2-year follow-up MRI and WOMAC scores.
- Assessment of osteophytes, BMLs, and effusion-synovitis using MRI; knee symptoms evaluated with WOMAC.
Main Results:
- A significant interaction was observed between osteophytes and BMLs/effusion-synovitis regarding knee symptom increase.
- In participants with BMLs or effusion-synovitis, higher osteophyte scores correlated with increased knee pain, stiffness, and dysfunction.
- Osteophyte scores were not associated with symptom progression in participants without BMLs or effusion-synovitis.
Conclusions:
- MRI-detected osteophytes contribute to knee OA symptom progression primarily when BMLs or effusion-synovitis are present.
- These findings suggest that osteophytes may interact with bone and synovial abnormalities to induce or exacerbate knee OA symptoms.
- Targeting these interacting factors could be crucial for managing knee OA symptom progression.
