Quantitative magnetic resonance imaging evidence of synovial proliferation is associated with radiographic severity of knee osteoarthritis

Abstract

Objective To evaluate the relationships of quantitative and semi-quantitative (SQ) assessments of synovium with knee OA severity by radiographic and 3T MRI findings. Methods 58 knee OA patients underwent non-fluoroscopic fixed-flexion knee radiographs. Dynamic contrast-enhanced (CE) 3T MRI was performed pre-/post-gadolinium administration to quantify synovial volume (qSV). SQ synovial outcomes were assessed on CE and unenhanced images. Two radiologists scored X-rays using the OARSI atlas; inter-reader agreement was assessed using Kappas and concordance correlation coefficients. Multiple linear and logistic regression analysis was used to assess associations among variables while controlling the effects of age, BMI, gender and meniscal extrusion. Results KL grade, diseased compartment joint space width (dcJSW) and diseased compartment joint space narrowing (dcJSN) were significantly associated with synovial proliferation, measured as CE qSV (β = 0.78, p = 0.0001; β = -0.22, p = 0.0003; β = 0.53, p = 0.0001, respectively). Furthermore, qSV strongly correlated with total subchondral BML volume (β = 0.22, p = 0.0003). KL grade, dcJSW, and dcJSN were significantly associated with BLOKS SQ infrapatellar synovitis (OR [95%CI]: 9.05, [1.94,42.3]; 0.75 [0.54,1.03]; 2.22 [1.15,4.31], respectively) and effusion (OR [95%CI]: 5.75, [1.23,26.8]; 0.70, [0.50,0.98]; 1.96, [1.02,3.74], respectively). CE SQ synovitis also significantly associated with KL and dcJSN (β = 0.036, p = 0.0040; β = 0.015, p=0.0266, respectively), and BLOKS synovitis. Conclusion Synovitis is a characteristic feature of advancing knee OA stages, and is significantly associated with KL, JSW, JSN, and BMLs. BLOKS synovitis scoring on unenhanced MRI is associated with CE synovitis measures.

Systemic biochemical markers of joint metabolism and inflammation in relation to radiographic parameters and pain of the knee: data from CHECK, a cohort of early-osteoarthritis subjects

“…ESR and hsCRP levels showed negative associations with minimum JSW, that only persisted for ESR after adjustment for concurrent patellofemoral and hip OA features. Assuming that ESR and hsCRP reflect synovitis in the current context, this confirms the notion that synovitis plays a role in cartilage damage 41 . This hypothesis contradicts the negative association of ESR with OP area, since also osteophyte growth may be driven by synovitis.…”

Raised serum IL 6 and CRP in Radiographic Knee Osteoarthritis in Eastern India

“…The gradual changes in the cartilage matrix turnover might be detected by several potential molecular biomarkers which accounts for synovitis and knee pain in patients with an earlystage knee OA [27] . Severe chronic synovitis was visualised in the advanced stage of knee OA which was correlated with the pain severity and the level of disability than that in the early stage [28,29] . However, an increased degree of mononuclear cell infiltration and an overproduction of proinflammatory cytokines were more frequently observed in the early-stage of knee OA [26] .…”

Brucella abortus Invasion of Synoviocytes Inhibits Apoptosis and Induces Bone Resorption through RANKL Expression

“…Notwithstanding, at present it has not been investigated whether Brucella-infected synoviocytes are involved in the pathological increase in numbers of osteoclasts (cells involved in bone resorption) and whether Brucella infection alters synoviocyte survival. In addition, considering the relevance of macrophages and neutrophils as infiltrating cells in inflammatory tissues and taking into account that synoviocytes secrete monocyte chemoattractant protein 1 (MCP-1) and interleukin-8 (IL-8) in response to Brucella infection (22), we also decided to investigate the role of these cells as modulators of synoviocyte survival, which has been associated with osteoarticular damage (23).…”