Division of Rheumatology, Orthopaedics and Dermatology, School of Medicine, University of Nottingham, Nottingham, UK.
Arthritis Research UK Pain Centre, Nottingham, UK.
Arthritis Res Ther. 2017 Dec 19;19(1):281. doi: 10.1186/s13075-017-1486-7.
An important role for synovial pathology in the initiation and progression of knee osteoarthritis has been emphasised recently. This study aimed to examine whether ultrasonography-detected synovial changes associate with knee pain (KP) in a community population.
A case-control study was conducted to compare people with early KP (n = 298), established KP (n = 100) or no KP (n = 94) at baseline. Multinomial logistic regression was used to estimate the odds ratio (OR) and 95% confidence interval (CI) between groups adjusted for radiographic osteoarthritis (ROA) severity and other confounding factors. After 1 year, 255 participants with early and established KP completed the follow-up questionnaire for changes in KP. Logistic regression with adjustment was used to determine predictors of KP worsening.
At baseline, effusion was associated with early KP (OR 2.64, 95% CI 1.57-4.45) and established KP (OR 5.07, 95% CI 2.74-9.38). Synovial hypertrophy was also associated with early KP (OR 5.43, 95% CI 2.12-13.92) and established KP (OR 13.27, 95% CI 4.97-35.43). The association with effusion diminished when adjusted for ROA. Power Doppler signal was uncommon (early KP 3%, established KP 2%, controls 0%). Baseline effusion predicted worsening of KP at 1 year (OR 1.95, 95% CI 1.05-3.64). However, after adjusting for ROA, the prediction was insignificant (adjusted OR 0.95, 95% CI 0.44-2.02).
Ultrasound effusion and synovial hypertrophy are associated with KP, but only effusion predicts KP worsening. However, the association/prediction is not independent from ROA. Power Doppler signal is uncommon in people with KP. Further study is needed to understand whether synovitis is directly involved in different types of KP.
滑膜病理学在膝骨关节炎的发生和发展中起着重要作用，这一点最近得到了强调。本研究旨在探讨关节超声检测到的滑膜变化是否与社区人群的膝关节疼痛（KP）有关。
采用病例对照研究，比较基线时早期 KP（n=298）、确诊 KP（n=100）和无 KP（n=94）人群。采用多变量逻辑回归估计组间比值比（OR）和 95%置信区间（CI），调整放射学骨关节炎（ROA）严重程度和其他混杂因素。1 年后，255 名早期和确诊 KP 患者完成了 KP 变化的随访问卷。调整后进行逻辑回归，以确定 KP 恶化的预测因素。
基线时，关节腔积液与早期 KP（OR 2.64，95%CI 1.57-4.45）和确诊 KP（OR 5.07，95%CI 2.74-9.38）相关。滑膜肥厚也与早期 KP（OR 5.43，95%CI 2.12-13.92）和确诊 KP（OR 13.27，95%CI 4.97-35.43）相关。当调整 ROA 后，与关节腔积液的相关性减弱。能量多普勒信号不常见（早期 KP 3%，确诊 KP 2%，对照组 0%）。基线时关节腔积液预测 1 年后 KP 恶化（OR 1.95，95%CI 1.05-3.64）。然而，调整 ROA 后，预测结果不显著（调整后 OR 0.95，95%CI 0.44-2.02）。
关节超声关节腔积液和滑膜肥厚与 KP 相关，但只有关节腔积液预测 KP 恶化。然而，这种相关性/预测并不独立于 ROA。能量多普勒信号在 KP 患者中不常见。需要进一步研究以了解滑膜炎是否直接参与不同类型的 KP。
