Synovitis and the risk of knee osteoarthritis: the MOST Study

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Created On: 11/10/2019

Synovitis and the risk of knee osteoarthritis: the MOST Study

To identify the independent relation of synovitis with incident radiographic knee osteoarthritis (OA) after adjusting for other structural factors known to cause synovitis.

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Key take away

In this study, synovitis has been called as a maverick cause of osteoarthritis (OA). This disclosure can further lead to the role of inflammation in the pathogenesis of OA. Also, synovial inflammation and effusion is associated with the later manifestation of Rheumatoid OA.

Background

To identify the independent relation of synovitis with incident radiographic knee osteoarthritis (OA) after adjusting for other structural factors known to cause synovitis.

Method

We examined MRIs from knees that developed incident radiographic OA from the Multicenter Osteoarthritis Study (MOST) and compared these case knees with controls that did not develop OA. We examined baseline MRIs for knees developing OA at any time up to 84 months’ follow-up. We scored lesions in cartilage, meniscus, bone marrow and synovitis. Synovitis scores were summed (0–9) across three regions, suprapatellar, infrapatellar and intercondylar region, each of which was scored 0–3. After bivariate analyses examining each factor's association with incidence, we carried out multivariable regression analyses adjusting for age, sex, BMI, alignment and cartilage and meniscal damage.

Result

We studied 239 case and 731 control knees. In bivariate analyses, cartilage lesions, meniscal damage, synovitis and bone marrow lesions were all risk factors for OA. After multivariable analyses, synovitis was associated with incident OA. A higher synovitis score increased the risk of incident OA (adjusted OR per unit increase 1.1; (95% CI 1.0, 1.2, P = .02)), but increased risk was associated only with synovitis scores of ≥3 (adjusted OR 1.6; 95% CI 1.2, 2.1, P = .003).