Zhu Z, Laslett L L, Jin X, Han W, Antony B, Wang X, Lu M, Cicuttini F, Jones G, Ding C
Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.
Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia; Translational Research Centre, Academy of Orthopedics, Guangdong Province, China; School of Basic Medical Science, Southern Medical University, Guangzhou, Guangdong, China.
Osteoarthritis Cartilage. 2017 Jul;25(7):1084-1092. doi: 10.1016/j.joca.2017.01.007. Epub 2017 Jan 21.
To describe cross-sectional and longitudinal associations between magnetic resonance imaging (MRI)-detected osteophytes (OPs) and knee structural abnormalities and knee pain in older adults.
A prospective population-based cohort study of 895 participants aged 50-80 years (mean age 62 years, 50% female) was performed. T1-or T2-weighted fat suppressed MRI was used to assess knee OPs, cartilage volume, cartilage defects and bone marrow lesions (BMLs) at baseline and after 2.6 years. Radiographically-detected OPs were scored according to the Osteoarthritis Research Society International (OARSI) atlas. Knee pain was assessed using a self-administered questionnaire at baseline, 2.6 and 5 years later.
85% of participants had MRI-detected OPs at baseline, while 10% of participants had radiographically-detected OPs. Cross-sectionally, higher gardes of MRI-detected OPs in all compartments were significantly, independently and site-specifically associated with higher prevalences of cartilage defects and BMLs, lower cartilage volume and higher prevalence of knee pain. Longitudinally, higher gardes of baseline MRI-detected OPs site-specifically predicted greater risks of any increase in cartilage defects or BMLs, and loss of cartilage volume in medial and lateral tibiofemoral (LTF) and total compartments over 2.6 years in multivariable analyses. These significant associations were similar in those without radiographically-detected OPs. MTF and total OP scores were significantly associated with change in total knee pain over 2.6 and 5 years but these became non-significant after adjustment for cartilage defects and BMLs.
MRI-detected knee OPs are common and appear to be clinically relevant to knee structural changes in older adults.
描述磁共振成像（MRI）检测到的骨赘（OPs）与老年人膝关节结构异常及膝关节疼痛之间的横断面和纵向关联。
对895名年龄在50 - 80岁（平均年龄62岁，50%为女性）的参与者进行了一项基于人群的前瞻性队列研究。在基线和2.6年后，使用T1加权或T2加权脂肪抑制MRI评估膝关节OPs、软骨体积、软骨缺损和骨髓病变（BMLs）。根据国际骨关节炎研究学会（OARSI）图谱对X线检测到的OPs进行评分。在基线、2.6年和5年后，使用自行填写的问卷评估膝关节疼痛情况。
85%的参与者在基线时MRI检测到有OPs，而10%的参与者X线检测到有OPs。横断面分析显示，所有关节腔中MRI检测到的OPs等级越高，与软骨缺损和BMLs的患病率越高、软骨体积越低以及膝关节疼痛的患病率越高显著、独立且部位特异性相关。纵向分析显示，在多变量分析中，基线MRI检测到的OPs等级越高，部位特异性地预测了2.6年内软骨缺损或BMLs增加以及内侧和外侧胫股（LTF）及总关节腔软骨体积丢失的更大风险。在没有X线检测到OPs的人群中，这些显著关联相似。MTF和总OP评分与2.6年和5年内膝关节总疼痛的变化显著相关，但在调整软骨缺损和BMLs后，这些相关性变得不显著。
MRI检测到的膝关节OPs很常见，并且似乎与老年人膝关节结构变化在临床上相关。
