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Empirical evaluation of the inter-relationship of articular elements involved in the pathoanatomy of knee osteoarthritis using Magnetic Resonance Imaging
BMC Musculoskeletal Disorders, 10/30/09

Meredith DS et al. – These results support an inter-relationship of multiple articular elements in the pathoanatomy of knee OA.

• Cross-sectional study
• Knee MRI scans from patients over 45 years old assessed using semi-quantitative knee MRI assessment form
• Form included 6 distinct elements: cartilage, bone marrow lesions, osteophytes, subchondral sclerosis, joint effusion and synovitis
• Each type of pathology graded using ordinal scale with value of zero indicating no pathology and higher values indicating increasingly severe levels of pathology
• Principal dependent variable for comparison was mean cartilage disease score (CDS), which captured aggregate extent of involvement of articular cartilage
• Distribution of CDS compared to individual and cumulative distributions of each articular element using Chi-squared test
• Correlations between pathological change in various articular structures were assessed in Spearman correlation table

• Data from 140 patients were available for review
• Cohort had median age of 61 years (range 45-89)
• 61% female
• Cohort included wide spectrum of OA severity
• Our analysis showed statistically significant trend towards pathological change involving more articular elements as CDS worsened
• Comparison of CDS to change in severity of pathology of individual articular elements showed statistically significant trends towards more severe pathology as CDS worsened for osteophytes , bone marrow lesions , and subchondral sclerosis , but not joint effusion or synovitis

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