The association of bone attrition with knee pain and other MRI features of osteoarthritis
The association of bone attrition with knee pain and other MRI features of osteoarthritis
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DOI：
10.1136/ard.2007.070565
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发表时间：
2008-01-01
影响因子：
27.4
通讯作者：
Felson, D. T.
中科院分区：
文献类型：
--
作者：
Hernandez-Molina, G.;Neogi, T.;Felson, D. T.
目的：确定骨磨损（软骨下骨变平或凹陷）是否与膝关节疼痛的存在及严重程度相关，并评估磨损与其他可能与疼痛相关的磁共振成像（MRI）特征的共存情况。
方法：弗雷明汉骨关节炎研究的参与者是一个未针对骨关节炎进行选择的社区队列，他们回答了有关膝关节疼痛的问题，并接受了膝关节X线和MRI检查。使用WORMS量表对MRI上的磨损、骨髓病变（BML）和积液进行评分。我们评估了有疼痛和无疼痛膝关节的磨损情况，并使用逻辑回归分析在调整年龄、性别、凯尔格伦 - 劳伦斯（K - L）分级、体重指数（BMI）、骨髓病变和积液后，其与疼痛的相关性。我们还探讨了磨损、疼痛严重程度和夜间疼痛之间的关系。
结果：在疼痛的膝关节中，28%（167/592）存在磨损（分级≥2），在无疼痛的膝关节中，10%（106/1035）存在磨损（校正比值比为1.6（95%置信区间为1.1 - 2.2））。在患有骨关节炎的膝关节（n = 368）中，如果存在磨损，74%有疼痛，如果不存在磨损，58%有疼痛（校正比值比为1.2（95%置信区间为0.7 - 2.0））。在无骨关节炎的膝关节（n = 1222）中，有磨损的膝关节中39%报告有疼痛，无磨损的膝关节中27%报告有疼痛（校正比值比为2.1（95%置信区间为1.1 - 4.0））。我们发现磨损与疼痛严重程度或磨损与夜间疼痛之间均无关联。磨损常与其他与疼痛相关的骨关节炎特征如骨髓病变和积液同时出现。
结论：磨损与膝关节疼痛独立相关。与无骨关节炎的膝关节不同，在骨关节炎膝关节中，由于可能导致疼痛的其他病理特征也同时存在，这种相关性消失。
Objective: To determine whether bone attrition (flattening or depression of the subchondral bone) was associated with the presence and severity of knee pain and to evaluate the coexistence of attrition and other MRI features likely associated with pain.Methods: Participants in the Framingham Osteoarthritis Study, a community cohort unselected for OA, answered questions about knee pain and underwent knee x rays and MRI. Attrition, bone marrow lesions (BMLs) and effusions were scored on MRI using the WORMS scale. We assessed attrition in knees with and without pain, and using logistic regression examined its association with pain adjusting for age, gender, Kellgren-Lawrence (K-L) grade, BMI, BML and effusion. We also explored the relation between attrition, pain severity and nocturnal pain.Results: Attrition (Grade >= 2) was present in 28% (167/ 592) of painful knees and in 10% (106/1035) of non-painful knees (adjusted OR 1.6 (95% Cl 1.1 to 2.2)). Of knees with OA (n = 368), 74% had pain if attrition was present and 58% if it was absent (adjusted OR 1.2 (95% Cl 0.7 to 2.0)). Of knees without OA (n = 1222), pain was reported in 39% of knees with attrition and in 27% without it (adjusted OR 2.1 (95% Cl 1.1 to 4.0)). We found no association between either attrition/pain severity or attrition/nocturnal pain. Attrition often co-occurred with other OA features associated with pain such as BMLs and effusions.Conclusions: Attrition was associated independently with knee pain. Unlike knees without OA, the association was lost in OA knees where other pathological features that may cause pain also coexisted.