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Abstract
IntroductionWe aimed to explore the associations between knee osteoarthritis (OA)-related tissue abnormalities assessed by conventional radiography (CR) and by high-resolution 3.0 Tesla magnetic resonance imaging (MRI), as well as biomechanical factors and findings from physical examination in patients with knee OA.MethodsThis was an explorative cross-sectional study of 105 patients with knee OA. Index knees were imaged using CR and MRI. Multiple features from CR and MRI (cartilage, osteophytes, bone marrow lesions, effusion and synovitis) were related to biomechanical factors (quadriceps and hamstrings muscle strength, proprioceptive accuracy and varus-valgus laxity) and physical examination findings (bony tenderness, crepitus, bony enlargement and palpable warmth), using multivariable regression analyses.ResultsQuadriceps weakness was associated with cartilage integrity, effusion, synovitis (all detected by MRI) and CR-detected joint space narrowing. Knee joint laxity was associated with MRI-detected cartilage integrity, CR-detected joint space narrowing and osteophyte formation. Multiple tissue abnormalities including cartilage integrity, osteophytes and effusion, but only those detected by MRI, were found to be associated with physical examination findings such as crepitus.ConclusionWe observed clinically relevant findings, including a significant association between quadriceps weakness and both effusion and synovitis, detected by MRI. Inflammation was detected in over one-third of the participants, emphasizing the inflammatory component of OA and a possible important role for anti-inflammatory therapies in knee OA. In general, OA-related tissue abnormalities of the knee, even those detected by MRI, were found to be discordant with biomechanical and physical examination features.
Highlights
We aimed to explore the associations between knee osteoarthritis (OA)-related tissue abnormalities assessed by conventional radiography (CR) and by high-resolution 3.0 Tesla magnetic resonance imaging (MRI), as well as biomechanical factors and findings from physical examination in patients with knee OA
Three CR features were related to varus-valgus laxity; namely, joint space width (JSW) (b = 0.26, P = 0.004) and osteophytes (b = 0.26, P = 0.005) in the lateral tibiofemoral (LTF) compartment related to higher laxity, and JSW in the medial tibiofemoral (MTF) compartment related to lower laxity (b = -0.22, P = 0.016)
Three MRI features were significantly associated with lower quadriceps strength - namely, cartilage integrity in
Summary
We aimed to explore the associations between knee osteoarthritis (OA)-related tissue abnormalities assessed by conventional radiography (CR) and by high-resolution 3.0 Tesla magnetic resonance imaging (MRI), as well as biomechanical factors and findings from physical examination in patients with knee OA. Physical examination may reveal clinical signs such as joint crepitus, swelling, deformities or increased warmth of the joint [2]. Biomechanical factors such as lower limb muscle strength, proprioceptive accuracy of the knee joint and varus-valgus knee joint laxity, which are considered essential factors for knee stabilization [3,4,5], have frequently been found to be impaired in knee OA patients [6,7,8].
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