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- DOI: 10.1002/art.30148
- PMID: 21080361
- UKPMCID: 21080361
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Fluctuation of knee pain and changes in bone marrow lesions, effusions and synovitis on MRI: The most study.
Zhang, Yuqing; Nevitt, Michael; Niu, Jingbo; Lewis, Cora; Torner, James; Guermazi, Ali; Roemer, Frank; McCulloch, Charles; Felson, David
Arthritis and rheumatism. 2011;63(3):691-699.
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Full-text held externally
- DOI: 10.1002/art.30148
- PMID: 21080361
- UKPMCID: 21080361
Abstract
OBJECTIVE: Fluctuations in pain among persons with knee osteoarthritis are both common and risk factors for pain fluctuation are poorly understood. To best identify structural causes of fluctuations, multiple assessments of pain status and structural lesions are needed. Therapeutic evidence may be best gleaned if pain resolution is accompanied by diminution of lesions. METHODS: Subjects in the Multicenter Osteoarthritis Study were queried about their knee pain by interview and had knee magnetic resonance imaging at baseline, 15-month, and 30-month clinic visits. Among the knees experiencing pain fluctuation over three clinic visits we examined the relation of bone marrow lesions (BMLs), synovitis, and effusion to frequent knee pain and pain severity using conditional logistic regression. RESULTS: Included in the analysis were 570 subjects (651 knees). When the BML score changed from 0 to 1, 2, 3, 4, 5-6 and 7-18, the odds ratios (OR) for frequent knee pain were 1.2, 1.2, 1.5, 2.2, 2.4, and 2.5, respectively (P for trend=0.006). The corresponding ORs were 1.5, 1.5, and 2.4 when synovitis score changed from 0 to 1, 2, and 3-6 (P for trend=0.045). No significant association was found between effusion and frequent knee pain. Diminishing size of BMLs was associated with resolution of knee pain (P=0.007). Similar associations were also observed between these structural lesions and knee pain severity. CONCLUSION: Changes of BMLs and synovitis are associated with the fluctuation of knee pain. Pain resolution occurs more frequently when BMLs become smaller.