Biomechanical factors and physical examination findings in osteoarthritis of the knee: associations with tissue abnormalities assessed by conventional radiography and high-resolution 3.0 Tesla magnetic resonance imaging

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.

Is the Severity of Knee Osteoarthritis on Magnetic Resonance Imaging Associated With Outcome of Exercise Therapy?

“…Major strengths of this study are the use of 3.0T MRIs, which were systematically assessed according to the BLOKS scoring system (), a low dropout rate (4%), and high patient adherence. Study limitations include the absence of a “no exercise” control group, the large number of analyzed associations (n = 32), and the lack of contrast used for assessing effusion/synovitis.…”

“…Detailed information on MRI assessment is included in our previous publication (). In summary, 3.0T MRI scans (General Electric Medical Systems, 5 sequences) of the most affected knee (index knee) were obtained at baseline (i.e., 1–3 weeks prior to the start of the intervention).…”

Factors associated with upper leg muscle strength in knee osteoarthritis: A scoping review

“…Joint degeneration. Several cross-sectional studies reported that radiographic OA (ROA) was associated with lower muscle strength in knee OA (21,24,26,28,31,(57)(58)(59)(60)(61). Although in all joint compartments the presence of ROA was associated with quadriceps weakness, the strongest relation was found when a combination of tibiofemoral (TF) and patellofemoral (PF) ROA was present (57,58).…”

Clinical and Translational Potential of MRI Evaluation in Knee Osteoarthritis

“…Therefore, for synovitis evaluation by use of non-enhanced MRI (NEMRI), T2 hyperintensity within the Hoffa fat pad is used as a surrogate marker. Using NEMRI and a semiquantitative approach, Knoop et al revealed that quadriceps weakness was associated with synovitis for patients with knee OA [51]. Zhang et al revealed that change in synovitis is associated with fluctuations of knee pain for patients with knee OA [49].…”