Prevalence of ultrasound-detected knee synovial abnormalities in a middle-aged and older general population—the Xiangya Osteoarthritis Study

Abstract

Background There is paucity of data on the prevalence of ultrasound-detected synovial abnormalities in the general population, and the relationship between synovial changes and knee pain remains unclear. We examined the prevalence of synovial abnormalities on ultrasound and the relationship of these features with knee pain and radiographic osteoarthritis (ROA) in a community sample. Methods Participants aged 50 years or over were from the Xiangya Osteoarthritis Study, a community-based cohort study. Participants were questioned about chronic knee pain and underwent (1) ultrasonography of both knees to determine presence of synovial hypertrophy (≥ 4 mm), effusion (≥ 4 mm), and Power Doppler signal [PDS; yes/no]; and (2) standard radiographs of both knees (tibiofemoral and patellofemoral views) to determine ROA. Results There were 3755 participants (mean age 64.4 years; women 57.4%). The prevalence of synovial hypertrophy, effusion, and PDS were 18.1% (men 20.2%; women 16.5%), 46.6% (men 49.9%; women 44.2%), and 4.9% (men 4.9%; women 5.0%), respectively, and increased with age (P for trend < 0.05). Synovial abnormalities were associated with knee pain, with adjusted odds ratios (aORs) of 2.39 (95% confidence interval [CI] 2.00–2.86) for synovial hypertrophy, 1.58 (95%CI 1.39–1.80) for effusion, and 4.36 (95%CI 3.09–6.17) for PDS. Similar associations with ROA were observed, the corresponding aORs being 4.03 (95%CI 3.38–4.82), 2.01 (95%CI 1.76–2.29), and 6.49 (95%CI 4.51–9.35), respectively. The associations between synovial hypertrophy and effusion with knee pain were more pronounced among knees with ROA than those without ROA, and the corresponding P for interaction were 0.004 and 0.067, respectively. Conclusions Knee synovial hypertrophy and effusion are more common and increase with age, affecting men more than women. All three ultrasound-detected synovial abnormalities associate both with knee pain and ROA, and knee synovial hypertrophy or effusion and ROA may interact to increase the risk of knee pain.

Association Between Gut Microbiota and Elevated Serum Urate in Two Independent Cohorts

“…Study participants. The Xiangya Osteoarthritis (XO) Study (discovery cohort) is a community-based longitudinal study conducted in a rural area of China (ClinicalTrials.gov identifier: NCT04033757) (13)(14)(15). Participants in the XO Study were a randomly selected sample of subjects ages 50 years or older from rural mountainous villages of Longshan County in Hunan Province, China.…”

Knee Pain Examined under Musculoskeletal Ultrasonography: Experience from a Community-based Rheumatology Practice – A Cross-sectional Study

“…In an original work with different ethnic Malaysian people, Chia et al reported the highest knee pain prevalence in Indian ethnic Malaysians, especially in women, than other ethnic groups [17]. In another community-based cohort study, Jiang et al evaluated chronic knee pain with MSUS and documented the highest prevalence of synovial effusion, followed by synovial hypertrophy; increased synovial abnormalities were seen associated with increased knee pain [19]. The associations between synovial hypertrophy and effusion with knee pain were more pronounced with radiographic knee OA.…”

“…[18]. Community-based cohort studies further demonstrated that US-depicted synovial hypertrophy, medial osteophytes, and synovial effusion interacted with increased knee pain risk and predicted early knee OA [19,20].…”

Diagnostic Accuracy of Ultrasound for Assessment of Synovial Abnormalities Among Patients With Knee Pain: A Meta‐Analysis

“…Knee pain manifests a multidimensional nature, and synovial abnormalities have been proven to be its important causes 6–9 . Ascertaining the presence of synovial abnormalities through imaging techniques at study inclusion might improve the efficacy of antiinflammation therapy on joint pain 12–15 .…”