Magnetic Resonance Imaging-Based Cartilage Loss in Painful Contralateral Knees With and Without Radiographic Joint Space Narrowing: Data From the Osteoarthritis Initiative
Magnetic Resonance Imaging-Based Cartilage Loss in Painful Contralateral Knees With and Without Radiographic Joint Space Narrowing: Data From the Osteoarthritis Initiative
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DOI：
10.1002/art.24791
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发表时间：
2009-09-15
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影响因子：
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通讯作者：
Hunter, David
中科院分区：
文献类型：
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作者：
Eckstein, Felix;Benichou, Olivier;Hunter, David
目标。通过核磁共振成像(MRI)来确定晚期放射学疾病(关节内侧间隙变窄[mJSN])的膝关节是否比对侧(无或少于mJSN)的膝关节发生更大的纵向软骨丢失。研究对象选自2,678例骨性关节炎患者，根据双侧疼痛表现、体重指数和GT；25(kg/m(2))，1个膝关节MJSN，对侧膝关节无或少于MJSN，双膝无外侧JSN。80名参与者(平均+/-SD年龄60.6+/-9.1岁)符合这些标准。由有经验的读者不考虑时间点和mJSN状态，从基线和随访1年的双膝关节MRI(稳态矢状双回波3.0T)开始分析胫骨内侧和股骨软骨的形态。MRI显示mJSN多的对侧膝关节的内侧软骨丢失(-80µm)大于mJSN较少的对侧膝关节(-57mum)。MJSN评分为2级或3级的患者差异有统计学意义(P=0.005.0 5~0.0 8)，而MJSN评分为1级的患者差异无统计学意义(P=0.2 8~0.98)。在MJSN较多的膝关节中，软骨丢失随MJSN分级的增加而增加(股骨内侧P=0.003)。MJSN分级2~3级的膝关节，负重股骨内侧的软骨损失率明显高于股骨后部和胫骨内侧(P=0.048)。进展型MJSN患者的膝关节软骨丢失明显大于MJSN较少的对侧患者。这些数据表明，X线片可以用来对快速结构进展者进行分层，并且MRI软骨厚度的丢失在晚期放射学疾病中更为明显。
Objective. To determine by magnetic resonance imaging (MRI), whether knees with advanced radiographic disease (medial joint space narrowing [mJSN]) encounter greater longitudinal cartilage loss than contralateral knees with earlier disease (no or less mJSN).Methods. Participants were selected from 2,678 cases in the Osteoarthritis Initiative, based on exhibition of bilateral pain, body mass index >25 (kg/m(2)), mJSN in 1 knee, no or less mJSN in the contralateral knee, and no lateral JSN in both knees. Eighty participants (mean +/- SD age 60.6 +/- 9.1 years) fulfilled these criteria. Medial tibial and femoral cartilage morphology was analyzed from the baseline and the 1-year followup MRI (sagittal double echo at steady state by 3.0T) of both knees by experienced readers blinded to the time point and mJSN status.Results. Knees with more radiographic mJSN displayed greater medial cartilage loss (-80 mu m) assessed by MRI than contralateral knees with less mJSN (-57 mu m). The difference reached statistical significance in participants with an mJSN grade of 2 or 3 (P = 0.005-0.08), but not in participants with an mJSN grade of 1 (P = 0.28-0.98). In knees with more mJSN, cartilage loss increased with higher grades of mJSN (P = 0.003 in the medial femur). Knees with an mJSN grade of 2 or 3 displayed greater cartilage loss in the weight-bearing medial femur than in the posterior femur or in the medial tibia (P = 0.048).Conclusion. Knees with advanced mJSN displayed greater cartilage loss than contralateral knees with less mJSN. These data suggest that radiography can be used to stratify fast structural progressors, and that MRI cartilage thickness loss is more pronounced at advanced radiographic disease stage.