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早期影像学骨关节炎与男性和女性的软骨体积及胫骨骨表面积的显著变化相关。

Early radiographic osteoarthritis is associated with substantial changes in cartilage volume and tibial bone surface area in both males and females.

作者信息

Jones G, Ding Changhai, Scott F, Glisson M, Cicuttini F

机构信息

Menzies Centre for Population Health Research, GPO Box 252-23, Tasmania 7000, Hobart, Australia.

出版信息

Osteoarthritis Cartilage. 2004 Feb;12(2):169-74. doi: 10.1016/j.joca.2003.08.010.

Abstract

OBJECTIVE

To describe the association between early radiographic osteoarthritis of the knee (ROA), knee cartilage volume and tibial bone surface area.

METHODS

Cross-sectional convenience sample of 372 male and female subjects (mean age 45 years, range 26-61). Articular cartilage volume, bone area and volume were determined at the patella, medial tibial and lateral tibial compartments by processing images acquired in the sagittal plane using T1-weighted fat saturation MRI. ROA was assessed with a standing semiflexed radiograph and the OARSI atlas for joint space narrowing and osteophytosis. Both radiographs and MRIs were performed in the right knee and read by different observers.

RESULTS

ROA (predominantly grade 1) was present in 17% of subjects of which medial joint space narrowing was most common (14%) followed by medial osteophytes (6%). Grade one medial joint space narrowing was associated with substantial reductions in cartilage volume at both the medial and lateral tibial and patellar sites within the knee (adjusted mean difference 11-13%, all P<0.001) while grade one osteophytosis was associated with substantial increases in both lateral and medial tibial joint surface area (adjusted mean difference 10-16%, all P<0.001). In contrast, osteophytosis was not associated with a significant change in cartilage volume and joint space narrowing was not associated with a significant change in tibial bone area (all P>0.05).

CONCLUSIONS

Early medial compartment ROA is associated with substantial reductions in cartilage volume and increases in bone area. These large changes, when combined with similar measurement error for MRI and radiographs, suggest that MRI may be superior at detecting and hence understanding early osteoarthritis of the knee in humans.

摘要

目的

描述膝关节早期影像学骨关节炎(ROA)、膝关节软骨体积与胫骨骨表面积之间的关联。

方法

对372名男性和女性受试者(平均年龄45岁,范围26 - 61岁)进行横断面便利抽样。通过处理使用T1加权脂肪饱和MRI在矢状面获取的图像,测定髌骨、胫骨内侧和外侧关节腔的关节软骨体积、骨面积和骨体积。采用站立半屈曲X线片和OARSI图谱评估ROA的关节间隙变窄和骨赘形成情况。X线片和MRI均在右膝进行,由不同观察者解读。

结果

17%的受试者存在ROA(主要为1级),其中内侧关节间隙变窄最为常见(14%),其次是内侧骨赘(6%)。1级内侧关节间隙变窄与膝关节内胫骨内侧、外侧以及髌骨部位的软骨体积显著减少相关(校正平均差异为11 - 13%,所有P < 0.001),而1级骨赘形成与胫骨内侧和外侧关节表面积显著增加相关(校正平均差异为10 - 16%,所有P < 0.001)。相比之下,骨赘形成与软骨体积的显著变化无关,关节间隙变窄与胫骨骨面积的显著变化无关(所有P > 0.05)。

结论

早期内侧关节腔ROA与软骨体积显著减少和骨面积增加相关。这些巨大变化,再加上MRI和X线片类似的测量误差,表明MRI在检测并因此理解人类膝关节早期骨关节炎方面可能更具优势。

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