Oda Hiromi, Igarashi Mitsuo, Sase Hiroshi, Sase Takeshi, Yamamoto Seizo
Department of Orthopaedic Surgery, Saitama Medical University, Iruma-Gun, Saitama, Japan.
J Orthop Sci. 2008 Jan;13(1):7-15. doi: 10.1007/s00776-007-1195-1. Epub 2008 Feb 16.
The findings of magnetic resonance imaging (MRI) have not been studied systematically in patients with osteoarthritis (OA). The objective here was to compare MRI findings with radiological findings in patients with knee pain and to identify factors that influence the progression of OA of the knee.
Of 212 patients with knee pain and MRI of the knee joint, 161 patients were selected for the study after exclusion of cases of trauma and other arthritides. MRI was used to evaluate the presence and degree of bone bruise, hydrarthrosis, and injuries to the cruciate ligament and meniscus. Bone bruise was classified into four types, and hydrarthrosis into four grades. Radiologically, OA progression in the femorotibial and patellofemoral joints was analyzed according to the Kellgren-Lawrence classification. Age was divided into four groups based on distribution quartiles. Logistic regression analysis and a generalized linear model with Poisson regression were used to analyze correlations among these factors.
Bone bruise was present in 87 cases, hydrarthrosis in 100, cruciate ligament injury in 20, and meniscus injury in 98. The presence of bone bruise was not related to age, cruciate ligament injury, meniscus injury, nor to OA of the patellofemoral joint, but was related to hydrarthrosis and to OA of the femorotibial joint. Femorotibial OA was much more strongly associated with bone bruise than with hydrarthrosis. Furthermore, analyzing the relation between the types of bone bruise and the degree of hydrarthrosis using a generalized linear model with Poisson regression, there was a positive correlation between the grade of bone bruise and the amount of hydrarthrosis.
A factor associated with the degree of osteoarthritis of the knee is bone bruise observed on MRI. The degree of hydrarthrosis is related to the grade of bone bruise, but is not linked to the degree of osteoarthritis.
尚未对骨关节炎（OA）患者的磁共振成像（MRI）结果进行系统研究。本研究的目的是比较膝关节疼痛患者的MRI结果与放射学结果，并确定影响膝关节OA进展的因素。
在212例有膝关节疼痛且进行了膝关节MRI检查的患者中，排除创伤和其他关节炎病例后，选取161例患者进行研究。采用MRI评估骨挫伤、关节积液以及交叉韧带和半月板损伤的存在情况及程度。骨挫伤分为四种类型，关节积液分为四个等级。放射学上，根据Kellgren-Lawrence分类分析股骨胫关节和髌股关节的OA进展情况。根据年龄分布四分位数将年龄分为四组。采用逻辑回归分析和带泊松回归的广义线性模型分析这些因素之间的相关性。
87例存在骨挫伤，100例有关节积液，20例有交叉韧带损伤，98例有半月板损伤。骨挫伤的存在与年龄、交叉韧带损伤、半月板损伤以及髌股关节OA均无关，但与关节积液和股骨胫关节OA有关。股骨胫关节OA与骨挫伤的相关性远强于与关节积液的相关性。此外，使用带泊松回归的广义线性模型分析骨挫伤类型与关节积液程度之间的关系，骨挫伤等级与关节积液量之间存在正相关。
MRI上观察到的骨挫伤是与膝关节骨关节炎程度相关的一个因素。关节积液程度与骨挫伤等级有关，但与骨关节炎程度无关。
