Section of Rheumatology, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts.
Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.
Arthritis Rheumatol. 2023 Dec;75(12):2161-2168. doi: 10.1002/art.42649. Epub 2023 Oct 15.
Intra-articular (IA) calcium crystal deposition is common in knee osteoarthritis (OA), but of unclear significance. It is possible that low-grade, crystal-related inflammation may contribute to knee pain. We examined the longitudinal relation of computed tomography (CT)-detected IA mineralization to the development of knee pain.
We used data from the National Institutes of Health-funded longitudinal Multicenter Osteoarthritis Study. Participants had knee radiographs and bilateral knee CTs at baseline, and pain assessments every 8 months for 2 years. CT images were scored using the Boston University Calcium Knee Score. We longitudinally examined the relation of CT-detected IA mineralization to the risk of frequent knee pain (FKP), intermittent or constant knee pain worsening, and pain severity worsening using generalized linear mixed-effects models.
We included 2,093 participants (mean age 61 years, 57% women, mean body mass index 28.8 kg/m ). Overall, 10.2% of knees had IA mineralization. The presence of any IA mineralization in the cartilage was associated with 2.0 times higher odds of having FKP (95% confidence interval [CI] 1.38-2.78) and 1.86 times more frequent intermittent or constant pain (95% CI 1.20-2.78), with similar results seen for the presence of any IA mineralization in the meniscus or joint capsule. A higher burden of IA mineralization anywhere within the knee was associated with a higher odds of all pain outcomes (odds ratio ranged from 2.14 to 2.21).
CT-detected IA mineralization was associated with risk of having more frequent, persistent, and worsening knee pain over 2 years. Targeting IA mineralization may have therapeutic potential for pain improvement in knee OA.
关节内（IA）钙晶体沉积在膝骨关节炎（OA）中很常见，但意义尚不清楚。可能是低水平的晶体相关炎症可能导致膝关节疼痛。我们检查了 CT 检测到的 IA 矿化与膝关节疼痛发展之间的纵向关系。
我们使用了美国国立卫生研究院资助的纵向多中心骨关节炎研究的数据。参与者在基线时接受了膝关节 X 光和双侧膝关节 CT 检查，并在 2 年内每 8 个月进行一次疼痛评估。使用波士顿大学钙膝关节评分对 CT 图像进行评分。我们使用广义线性混合效应模型纵向检查 CT 检测到的 IA 矿化与频繁膝关节疼痛（FKP）、间歇性或持续性膝关节疼痛恶化以及疼痛严重程度恶化的风险之间的关系。
我们纳入了 2093 名参与者（平均年龄 61 岁，57%为女性，平均 BMI 为 28.8kg/m²）。总体而言，10.2%的膝关节存在 IA 矿化。软骨中存在任何 IA 矿化与 FKP 的几率增加 2.0 倍（95%置信区间 [CI] 1.38-2.78）和间歇性或持续性疼痛更频繁的几率增加 1.86 倍（95% CI 1.20-2.78），在半月板或关节囊中存在任何 IA 矿化也有类似的结果。膝关节内任何部位的 IA 矿化负担增加与所有疼痛结局的几率增加相关（比值比范围为 2.14 至 2.21）。
CT 检测到的 IA 矿化与 2 年内更频繁、持续和恶化的膝关节疼痛风险相关。针对 IA 矿化可能具有改善膝骨关节炎疼痛的治疗潜力。
