Synovitis in knee osteoarthritis: a precursor of disease?
Synovitis in knee osteoarthritis: a precursor of disease?
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DOI：
10.1136/annrheumdis-2014-205894
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发表时间：
2016-02
影响因子：
27.4
通讯作者：
Hunter DJ
中科院分区：
文献类型：
--
作者：
Atukorala I;Kwoh CK;Guermazi A;Roemer FW;Boudreau RM;Hannon MJ;Hunter DJ
目前尚不清楚在骨关节炎中关节炎症是否先于其他关节组织损伤。因此，本研究旨在确定滑膜炎是否先于放射学膝关节OA（罗阿）的发展。这项巢式病例对照研究的参与者选自骨关节炎倡议（OAI）中Kellgren Lawrence分级（KLG）=0基线（BL）的膝关节。在4年内，每年通过X线摄影和非对比度增强磁共振成像（MRI）对这些膝关节进行评估。MRI评估了积液滑膜炎和Hoffa滑膜炎。病例膝关节定义为基线后任何评估时膝关节后前位X线片上的放射学膝关节骨关节炎（罗阿）（KLG >=2）。在P0（影像学膝关节OA发作时间）、P0前1年（P-1）和BL时评估影像学检查。对照组为从基线至48个月未发生事件罗阿（i罗阿）的参与者。120例罗阿患者（83例女性）的133个膝关节与133个对照膝关节（83例女性）匹配。BL、P-1和PO时iROA发生与渗出性滑膜炎相关的比值比（OR）分别为1.56（95% CI 0.86-2.81）、3.23（1.72-6.06）和4.7（1.10-2.95）。BL、P-1和P0时与Hoffa滑膜炎相关的iROA发生的OR分别为1.80（1.1-2.95）、2.47（1.45-4.23）和2.40（1.43-4.04）。渗出性滑膜炎和Hoffa滑膜炎强烈预测事件罗阿的发展。
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 OA (ROA). The participants in this nested case-control study were selected from knees in the Osteoarthritis Initiative (OAI) that had a Kellgren Lawrence grading (KLG)=0 baseline (BL). These knees were evaluated annually with radiography and non contrast-enhanced magnetic resonance imaging (MRI) over 4-years. MRIs were assessed for effusion-synovitis and Hoffa-synovitis. Case knees were defined by radiographic knee osteoarthritis (ROA) (KLG >=2) on the postero-anterior knee radiographs at any assessment after baseline. Radiographs were assessed at P0 (time of onset of radiographic knee OA), 1 year prior to P0 (P-1) and at BL. Controls were participants who did not develop incident ROA (iROA) from baseline to 48 months). 133 knees of 120 persons with ROA (83 females) were matched to 133 control knees (83 females). Odds ratios (OR) for occurrence of iROA associated with the presence of effusion-synovitis at BL, P-1 and PO were 1.56 (95% CI 0.86–2.81), 3.23 (1.72–6.06) and 4.7(1.10–2.95), respectively. The ORs for the occurrence of iROA associated with the presence of Hoffa-synovitis at BL, P-1 and P0 were 1.80 (1.1–2.95), 2.47 (1.45–4.23) and 2.40 (1.43–4.04), respectively. Effusion-synovitis and Hoffa-synovitis strongly predicted the development of incident ROA.