Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA 94107, USA.
Arthritis Care Res (Hoboken). 2012 Feb;64(2):248-55. doi: 10.1002/acr.20672.
To evaluate the association of magnetic resonance imaging (MRI)-based knee cartilage T2 measurements and focal knee lesions with knee pain in knees without radiographic osteoarthritis (OA) among subjects with OA risk factors.
We studied the right knees of 126 subjects from the Osteoarthritis Initiative database. We randomly selected 42 subjects ages 45-55 years with OA risk factors, right knee pain (Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC] pain score ≥5), no left knee pain (WOMAC pain score 0), and no radiographic OA (Kellgren/Lawrence [K/L] score ≤1) in the right knee. We also selected 2 comparison groups: 42 subjects without knee pain in either knee and 42 with bilateral knee pain. Both groups were frequency matched to subjects with right knee pain only by sex, age, body mass index, and K/L score. All of the subjects underwent 3T MRI of the right knee. Focal knee lesions were assessed and cartilage T2 measurements were performed.
Prevalences of meniscal, bone marrow, and ligamentous lesions and joint effusion were not significantly different between the groups (P > 0.05), while cartilage lesions were more frequent in subjects with right knee pain only compared to subjects without knee pain (P < 0.05). T2 values averaged over all of the compartments were similar in subjects with right knee pain only (mean ± SD 34.4 ± 1.8 msec) and in subjects with bilateral knee pain (mean ± SD 34.7 ± 4.7 msec), but were significantly higher compared to subjects without knee pain (mean ± SD 32.4 ± 1.8 msec; P < 0.05).
These results suggest that elevated cartilage T2 values are associated with findings of pain in the early phase of OA, whereas among morphologic knee abnormalities only knee cartilage lesions are significantly associated with knee pain status.
评估磁共振成像(MRI)膝关节软骨 T2 测量值与膝关节内局灶性病变与存在骨关节炎危险因素的膝关节无放射学骨关节炎(OA)患者膝关节疼痛之间的关系。
我们研究了来自骨关节炎倡议数据库的 126 名受试者的右膝关节。我们随机选择了 42 名年龄在 45-55 岁之间有 OA 危险因素、右膝疼痛(西部安大略省和麦克马斯特大学骨关节炎指数[WOMAC]疼痛评分≥5)、左膝无疼痛(WOMAC 疼痛评分 0)且右膝无放射学 OA(Kellgren/Lawrence [K/L] 评分≤1)的受试者。我们还选择了 2 个对照组:42 名双膝均无疼痛的受试者和 42 名双膝疼痛的受试者。两组均通过性别、年龄、体重指数和 K/L 评分与仅有右膝疼痛的受试者进行频数匹配。所有受试者均接受了右膝关节 3T MRI 检查。评估了局灶性膝关节病变并进行了软骨 T2 测量。
在各组之间,半月板、骨髓、韧带病变和关节积液的患病率无显著差异(P>0.05),而仅有右膝疼痛的受试者的软骨病变较无膝痛的受试者更为常见(P<0.05)。仅有右膝疼痛的受试者(平均±标准差 34.4±1.8msec)和双膝疼痛的受试者(平均±标准差 34.7±4.7msec)的所有节段软骨 T2 值平均值相似,但均显著高于无膝痛的受试者(平均±标准差 32.4±1.8msec;P<0.05)。
这些结果表明,升高的软骨 T2 值与 OA 早期阶段的疼痛表现有关,而在形态学膝关节异常中,仅膝关节软骨病变与膝关节疼痛状态显著相关。