Menzies Research Institute Tasmania, University of Tasmania, Hobart, Tasmania, Australia.
Department of Radiology, Royal Hobart Hospital, Hobart, Tasmania, Australia.
Ann Rheum Dis. 2016 Mar;75(3):519-25. doi: 10.1136/annrheumdis-2014-206676. Epub 2014 Dec 30.
To describe the cross-sectional and longitudinal associations between knee regional effusion-synovitis and structural changes in older adults.
A total of 977 subjects were randomly selected from the local community (mean 62 years, 50% female) at baseline and 404 were followed up 2.6 years later. T2-weighted MRI was used to assess knee effusion-synovitis in four subregions: suprapatellar pouch, central portion, posterior femoral recess and subpopliteal recess. Knee cartilage defects, cartilage volume and bone marrow lesions (BMLs) were measured using MRI at baseline and follow-up.
Cross-sectionally, effusion-synovitis in most subregions was significantly associated with a higher risk of cartilage defects, BMLs and reduced cartilage volume. Longitudinally, suprapatellar pouch effusion-synovitis at baseline predicted an increase in cartilage defects (p<0.01), loss of cartilage volume (p=0.04) and an increase in BMLs (p=0.02) in multivariable analyses. The significant associations of effusion-synovitis with cartilage volume and BMLs disappeared after adjustment for cartilage defects. Effusion-synovitis in whole knee joint (p<0.01) and subpopliteal recess (p<0.05) was consistently associated with longitudinal changes in cartilage defects but not in cartilage volume and BMLs.
There are independent associations between knee joint effusion-synovitis and knee cartilage defects in both cross-sectional and longitudinal analyses, suggesting a potential causal relationship. The associations of effusion-synovitis with BMLs and cartilage volume were largely dependent on cartilage defects, suggesting potential causal pathways.
描述老年人膝关节关节腔积液-滑膜炎与结构变化的横断面和纵向关联。
本研究共纳入 977 名随机选择的当地社区居民（平均年龄 62 岁，50%为女性）作为基线人群，其中 404 人在 2.6 年后完成了随访。采用 T2 加权 MRI 评估膝关节四个亚区（髌上囊、中央部、股骨后隐窝和腘窝）的关节腔积液-滑膜炎。基线和随访时均采用 MRI 评估膝关节软骨缺损、软骨体积和骨髓病变（BML）。
横断面研究显示，大多数亚区的关节腔积液-滑膜炎与软骨缺损、BML 和软骨体积减少的风险增加显著相关。纵向研究显示，基线时髌上囊关节腔积液-滑膜炎与软骨缺损（p<0.01）、软骨体积丢失（p=0.04）和 BML 增加（p=0.02）的多变量分析结果显著相关。在调整软骨缺损后，关节腔积液-滑膜炎与软骨体积和 BML 的显著相关性消失。全膝关节（p<0.01）和腘窝（p<0.05）关节腔积液-滑膜炎与软骨缺损的纵向变化持续相关，但与软骨体积和 BML 无关。
膝关节关节腔积液-滑膜炎与膝关节软骨缺损在横断面和纵向分析中均存在独立关联，提示可能存在因果关系。关节腔积液-滑膜炎与 BML 和软骨体积的关联在很大程度上取决于软骨缺损，提示存在潜在的因果途径。
