Musculoskeletal and Quantitative Imaging Research Group, Department of Radiology & Biomedical Imaging, University of California, San Francisco, 185 Berry Street, Suite 350, San Francisco, CA, 94107, USA.
Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA.
Skeletal Radiol. 2019 Sep;48(9):1357-1365. doi: 10.1007/s00256-019-3166-y. Epub 2019 Feb 9.
To investigate the natural history of central osteophytes (COs) by analyzing the structure and matrix composition of CO-associated cartilage using 3-T MRI at and 1-3 years before the onset of COs.
Baseline, 4- and 6-year knee MRIs of 400 participants in the Osteoarthritis Initiative were screened for the appearance of new COs. Twenty-eight subjects developed 31 COs. Using MRIs at CO onset and 1-3 years before CO onset, cartilage T2 values were calculated for the local cartilage preceding COs and the surrounding cartilage. Cartilage lesions local to the site of COs and bone marrow edema like lesions (BMELs) subjacent to COs were graded using whole organ MRI scores (WORMS). Wilcoxon tests were used to compare T2 values from the local and the surrounding cartilage at each time point and to compare T2 and WORMS between time points. Knee symptoms were recorded during this period.
All subjects showed local cartilage lesions before the development of COs. Mean cartilage WORMS increased from 1.56 ± 0.66 a period of 3 years before to 2.39 ± 0.75 with onset of COs (p = 0.008). Local T2 values in the area of the later-appearing COs were significantly higher compared with T2 values of the surrounding cartilage 3 (p = 0.044) and 2 years earlier (p = 0.031) and with the onset of COs (p = 0.025). No significant increase in symptoms was found with the onset of COs.
This study provides evidence that focal cartilage structural and compositional degeneration precedes COs. No significant aggravation of knee symptoms was reported during the evolution of COs.
通过在 CO 出现前 1 至 3 年和出现时使用 3-T MRI 分析 CO 相关软骨的结构和基质组成，来研究中央骨赘（CO）的自然史。
筛选 Osteoarthritis Initiative 中 400 名参与者的基线、4 年和 6 年膝关节 MRI，以发现新的 CO。28 名受试者共出现 31 个 CO。使用 CO 出现时和出现前 1-3 年的 MRI，计算 CO 前局部软骨和周围软骨的软骨 T2 值。使用全器官 MRI 评分（WORMS）对 CO 局部的软骨病变和 CO 下的骨髓水肿样病变（BMEL）进行分级。使用 Wilcoxon 检验比较每个时间点局部和周围软骨的 T2 值，并比较各时间点的 T2 值和 WORMS 值。在此期间记录膝关节症状。
所有受试者在 CO 出现前均显示局部软骨病变。WORMS 评分从 CO 出现前 3 年的 1.56±0.66 增加到 CO 出现时的 2.39±0.75（p=0.008）。与周围软骨相比，CO 后期出现部位的局部 T2 值在出现时（p=0.025）和出现前 3 年（p=0.031）和 2 年（p=0.044）时显著升高。在 CO 出现时，没有发现膝关节症状显著加重。
本研究提供了证据表明，局灶性软骨结构和成分退变先于 CO。在 CO 发展过程中，没有报告膝关节症状明显加重。
