Periarticular lesions detected on magnetic resonance imaging - Prevalence in knees with and without symptoms
Periarticular lesions detected on magnetic resonance imaging - Prevalence in knees with and without symptoms
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DOI：
10.1002/art.11254
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发表时间：
2003-10-01
影响因子：
--
通讯作者：
Felson, DT
中科院分区：
文献类型：
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作者：
Hill, CL;Gale, DR;Felson, DT
Objective.通过磁共振成像（MRI）评估有或无膝关节疼痛的老年人关节周围病变的患病率，并评估这些病变与膝关节疼痛的相关性。受试者年龄在45岁及以上，有或没有膝关节疼痛，从退伍军人事务部医疗中心和社区招募。在所有受试者中获得负重后前位、skyline和侧位X线片。受试者分为3组：有放射学OA（罗阿）和膝关节疼痛的受试者（n = 376），有罗阿和无膝关节疼痛的受试者（n = 51），以及既无罗阿也无膝关节疼痛的受试者（n = 24）。使用1.5T扫描仪，采用T1和T2加权和质子密度自旋回波成像序列对单膝（膝关节疼痛受试者中症状更明显的膝关节）进行成像。MRI检查关节周围病变的存在情况，根据病变的一般位置分为髌周病变（髌骨、髌下浅、髌下深）或“其他关节周围病变”（半膜-胫骨侧副韧带滑囊炎、鹅滑囊炎、髂胫束综合征、胫腓骨囊肿）。膝关节疼痛的患者比无症状的受试者有更严重的放射学疾病。12.1%的膝关节疼痛和罗阿患者、20.5%的罗阿和无膝关节疼痛的患者以及0%的既无罗阿也无膝关节疼痛的受试者存在髌周病变（髌骨或髌下浅表病变）（P = 0.116）。在有罗阿和膝关节疼痛的患者中，其他关节周围病变的发生率为14.9%，在有罗阿但无膝关节疼痛的患者中，其他关节周围病变的发生率仅为3.9%，而在无膝关节疼痛且无罗阿的患者中，其他关节周围病变的发生率为0%（P = 0.004）。尽管髌骨周围病变在膝关节疼痛和无膝关节疼痛的受试者中同样常见，但其他关节周围病变（包括滑囊炎和髂胫束综合征）在膝关节疼痛的受试者中明显更常见，并可能导致这些个体的疼痛。
Objective. To evaluate, using magnetic resonance imaging (MRI), the prevalence of periarticular lesions in older persons with or without knee pain, and to assess the association of these lesions with knee pain.Methods. Subjects ages 45 years and older, with or without knee pain, were recruited from Veterans Affairs medical centers and from the community. Weight-bearing posteroanterior, skyline, and lateral radiographs were obtained in all subjects. Subjects were divided into 3 groups: those with radiographic OA (ROA) and knee pain (n = 376), those with ROA and no knee pain (n = 51), and those with neither ROA nor knee pain (n = 24). A single knee (the more symptomatic one in subjects with knee pain) was imaged with a 1.5T scanner using T1- and T2-weighted and proton-density spin-echo imaging sequences. MRIs were read for the presence of periarticular lesions, which were categorized (according to their general location) as being either peripatellar (prepatellar, superficial infrapatellar, deep infrapatellar) or "other periarticular lesions" (semimembranosus-tibial collateral ligament bursitis, anserine bursitis, iliotibial band syndrome, tibiofibular cyst).Results. Patients with knee pain had more severe radiographic disease than did subjects who were asymptomatic. Peripatellar lesions (prepatellar or superficial infrapatellar) were present in 12.1% of the patients with knee pain and ROA, in 20.5% of the patients with ROA and no knee pain, and in 0% of subjects with neither ROA nor knee pain (P = 0.116). However, other periarticular lesions were present in 14.9% of patients with both ROA and knee pain, in only 3.9% of patients with ROA but no knee pain, and in 0% of the group with no knee pain and no ROA (P = 0.004).Conclusion. Although peripatellar lesions are equally common among subjects with knee pain and those without knee pain, other periarticular lesions (including bursitis and iliotibial band syndrome) are significantly more common among subjects with knee pain and may contribute to pain in these individuals.