Cross-sectional and Longitudinal Associations between Knee Joint Effusion Synovitis and Knee Pain in Older Adults

Abstract

Knee joint effusion synovitis has independent associations with knee pain in older adults. Suprapatellar pouch effusion synovitis is associated with nonweight-bearing and weight-bearing knee pain, while posterior femoral recess and central portion effusion synovitis are only associated with nonweight-bearing pain.

Associations of Symptomatic Knee Osteoarthritis With Histopathologic Features in Subchondral Bone

“…Our findings here suggest that subchondral pathology can define a subgroup of patients with symptomatic chondropathy, only partially overlapping with those whose OA pain is driven by synovitis. MRI evidence of cartilage defects , bone marrow lesions , and synovitis can also discretely predict OA pain. We extended these findings to identify NGF‐immunoreactive osteochondral channels and subchondral osteoclast densities as key pathologic features that make discrete contributions to OA symptoms.…”

“…However, the mechanisms by which subchondral pathology contributes to OA pain are incompletely understood. Synovitis has also been associated with OA pain . Synovial and subchondral pathology can occur together within the same joint, but it is unknown whether these represent discrete painful pathologies that could be separate targets for therapeutic intervention.…”

Osteoarthritis year in review 2016: imaging

“…Using data from approximately 900 participants in the MOST study it was shown that higher WORMS scores of synovitis and Hoffa synovitis were predictive of incident radiographic KOA 65 . Two other community based studies of more than 900 KOA patients followed over 2.6 years showed an association between knee joint effusion-synovitis and knee cartilage defects in both cross-sectional and longitudinal analyses, suggesting a potential causal relationship 66,67 .…”

KARAOKE: Krill oil versus placebo in the treatment of knee osteoarthritis: protocol for a randomised controlled trial

“…Inclusion criteria are as follows: males and females aged ≥ 40 years old; with significant knee pain on most days (defined as a pain score ≥ 40 mm on a 100-mm VAS); and meeting the American College of Rheumatology (ACR) criteria for symptomatic knee OA [37], assessed by a physician, and any effusion-synovitis present on MRI (defined as ≥grade 1 according to modified WORMS scoring [18,38] ;…”

“…Pro-inflammatory cytokines, including interleukin (IL)-1β, tumour necrosis factor-α (TNF-α) , and IL-6 are produced by synovium and chondrocytes, and contribute to the progression of cartilage degradation [8]. Localised inflammation presents as effusion (excess synovial fluid within the joint space) and / or synovitis (thickening of the synovium); these predict pain [15][16][17][18], including new and worsening pain over 2.6 years [18]. Effusion-synovitis also predicts structural changes: predicting cartilage defects, bone marrow lesions (BMLs) and increased cartilage loss over 2.6 years [19] and predicts joint replacement [20].…”