Associations between clinical evidence of inflammation and synovitis in symptomatic knee osteoarthritis: a substudy of the VIDEO trial

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Title: Associations between clinical evidence of inflammation and synovitis in symptomatic knee osteoarthritis: a substudy of the VIDEO trial
Authors: Wallace, G
Cro, S
Doré, C
King, L
Kluzek, S
Price, A
Roemer, F
Guermazi, A
Keen, R
Arden, N
Item Type: Journal Article
Abstract: Objective Painful knee osteoarthritis (KOA) has been associated with joint inflammation. There is however little literature correlating signs of localised inflammation with Contrast-enhanced (CE) Magnetic resonance imaging (MRI) of synovium. This study examined the relationship between clinical and functional markers of localised knee inflammation and CE MRI based synovial scores. Methods Patients with symptomatic KOA were enrolled into the randomised, double-blind, Vitamin D Evaluation in Osteoarthritis (VIDEO) trial. In this cross-sectional substudy, associations between validated MRI based semi-quantitative synovial scores of the knee and the following markers of inflammation were investigated; self-reported pain and stiffness, effusion, warmth, joint line tenderness, erythrocyte sedimentation rate, radiographic severity and functional ability tests. Results 107 patients satisfied the inclusion criteria of complete data and were included in the analysis. Significant associations were found between the number of regions affected by synovitis and WOMAC pain, effusion and joint line tenderness. Each additional region affected by synovitis was associated with an increase in WOMAC pain (1.82; 95% CI 0.05-3.58; p=0.04) and the association with extent of medial synovitis was particularly strong (3.21; 95% CI 0.43-5.99; p=0.02). Extent of synovitis was positively associated with effusion (OR=1.69; 95% CI 1.37-2.08, p<0.01), and negatively associated with joint line tenderness (RR= 0.87; 95% CI 0.84-0.90; p<0.01). Conclusion There is a strong positive association between synovitis, and self-reported patient pain and clinically detectable effusion. Non-operative treatments directed at management of inflammation and future trials targeting the synovial tissue for treating KOA should consider these two factors as potential inclusion criteria.
Issue Date: 14-Aug-2017
Date of Acceptance: 29-Nov-2016
URI: http://hdl.handle.net/10044/1/44693
DOI: https://dx.doi.org/10.1002/acr.23162
ISSN: 2151-464X
Publisher: Wiley
Start Page: 1340
End Page: 1348
Journal / Book Title: Arthritis Care & Research
Volume: 69
Issue: 9
Copyright Statement: © 2016, American College of Rheumatology. This is the accepted version of the following article, which has been published in final form at http://dx.doi.org/10.1002/acr.23162
Keywords: Science & Technology
Life Sciences & Biomedicine
Rheumatology
CONTRAST-ENHANCED MRI
RHEUMATOID-ARTHRITIS
RADIOGRAPHIC SEVERITY
MICROSCOPIC FEATURES
IMAGING FINDINGS
PAIN
MEMBRANE
EFFUSION
HISTOLOGY
RISK
Aged
Arthralgia
Blood Sedimentation
Cross-Sectional Studies
Disability Evaluation
Double-Blind Method
Female
Humans
Knee Joint
Magnetic Resonance Imaging
Male
Middle Aged
Osteoarthritis, Knee
Severity of Illness Index
Synovial Membrane
Synovitis
Synovial Membrane
Knee Joint
Humans
Arthralgia
Osteoarthritis, Knee
Synovitis
Magnetic Resonance Imaging
Disability Evaluation
Blood Sedimentation
Severity of Illness Index
Cross-Sectional Studies
Double-Blind Method
Aged
Middle Aged
Female
Male
1103 Clinical Sciences
1701 Psychology
Publication Status: Published
Appears in Collections:Faculty of Medicine
Epidemiology, Public Health and Primary Care



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