Print Email Facebook Twitter Association of pain in knee osteoarthritis with distinct patterns of synovitis Title Association of pain in knee osteoarthritis with distinct patterns of synovitis Author de Lange-Brokaar, B.J.E. Ioan-Facsinay, A. Yusuf, E. Visser, A.W. Kroon, H.M. van Osch, G.J.V.M. Zuurmond, A.M. Stojanovic-Susulic, V. Bloem, J.L. Nelissen, R.G.H.H. Huizinga, T.W. Kloppenburg, M. Publication year 2015 Abstract Objective To determine possible patterns of synovitis on contrast-enhanced magnetic resonance imaging (CE-MRI) and its relation to pain and severity in patients with radiographic knee osteoarthritis (OA). Methods In total, 86 patients (mean age 62 years, 66% women, median body mass index 29 kg/m2) with symptomatic knee OA (Kellgren/Lawrence radiographic score 3) were included. T1-weighted, gadolinium-chelate-enhanced MRI with fat suppression was used to semiquantitatively score the extent of synovitis at 11 knee sites (total score range 0-22). Self-reported pain was assessed with 3 standardized questionnaires. Principal components analysis (PCA) was used to investigate patterns (the location and severity) of synovitis. Subsequently, these patterns were assessed for associations with pain measures and radiographic severity in adjusted logistic regression models. Results Synovitis was observed in 86 patients and was found to be generally mild on CE-MRI (median total synovitis score 7, range 0-16). The median pain scores were 53 (range 0-96) on the visual analog scale for pain, 51.4 (range 2.8-97.2) on the Knee Injury and Osteoarthritis Outcome Score (KOOS) for pain, 35 (range 0-75) on the Intermittent and Constant Osteoarthritis Pain (ICOAP) score for constant pain, and 40.6 (range 0-87.5) on the ICOAP score for intermittent pain. PCA resulted in extraction of 3 components, explaining 53.4% of the variance. Component 1 was characterized by synovitis at 7 sites (mainly medial parapatellar involvement) and was associated with scores on the KOOS pain subscale and the ICOAP constant pain subscale. Component 2 was characterized by synovitis at 4 sites (mainly the site adjacent to the anterior cruciate ligament), but was not associated with pain measures or with radiographic severity. Component 3, characterized by synovitis at 3 sites (mainly at the loose body site), was associated with radiographic severity. Conclusion Different patterns of synovitis in knee OA were observed. The pattern that included several patellar sites was associated with pain, whereas other patterns showed no association, suggesting that pain perception in patients with knee OA is a localized response. Copyright © 2015 by the American College of Rheumatology. Subject LifeMHR - Metabolic Health ResearchELSS - Earth, Life and Social SciencesBiomedical InnovationBiologyHealthy LivingGadolinium chelateAdultBody massContrast enhancementDisease associationFemaleGadolinium chelate enhanced magnetic resonance imagingKnee arthroplastyKnee ligamentKnee osteoarthritisKnee painMajor clinical studyMaleNuclear magnetic resonance imagingPain assessmentPain severityPrincipal component analysisRadiographySelf reportSynovitisVisual analog scale To reference this document use: http://resolver.tudelft.nl/uuid:81355eee-325d-4b1e-b6c3-808b190e4b9c DOI https://doi.org/10.1002/art.38965 TNO identifier 524106 ISSN 2326-5191 Source Arthritis and Rheumatology, 67 (3), 733-740 Document type article Files To receive the publication files, please send an e-mail request to TNO Library.