| 1. |
- Englund, Martin, et al.
(författare)
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Effect of meniscal damage on the development of frequent knee pain, aching, or stiffness
- 2007
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Ingår i: Arthritis and Rheumatism. - : Wiley. - 1529-0131 .- 0004-3591. ; 56:12, s. 4048-4054
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To evaluate the effect of meniscal damage on the development of frequent knee pain, aching, or stiffness in middle-aged and older adults. METHODS: The Multicenter Osteoarthritis Study is a prospective study of 3,026 individuals 50 years of age or older who have or are at high risk of developing knee osteoarthritis (OA). We investigated knees at baseline and at 15 months. Case knees (n = 110) were those with no pain, aching, or stiffness on most days at baseline, but that had developed frequent pain, aching, or stiffness at 15 months. Control knees (n = 220) were drawn randomly from knees with no frequent symptoms at baseline that did not become case knees. Using 1.0T magnetic resonance imaging performed at baseline and at followup, 2 musculoskeletal radiologists blinded to the case-control status assessed the meniscal damage using the following scale: 0 = intact, 1 = minor tear, 2 = nondisplaced tear or prior surgical repair, and 3 = displaced tear, resection, maceration, or destruction. The effect of meniscal damage was analyzed by contingency tables and logistic regression. RESULTS: Meniscal damage was common at baseline both in case knees (38%) and in control knees (29%). Although there was a modest association between the meniscal damage score (range 0-3) and the development of frequent knee pain, aching, or stiffness (odds ratio [OR] 1.21, 95% confidence interval [95% CI] 0.96-1.51, adjusted for age, sex, and body mass index), meniscal damage was mostly present in knees with OA. When considering the co-occurrence of OA, we found no independent association between meniscal damage and the development of frequent knee symptoms (OR 1.05, 95% CI 0.80-1.37). CONCLUSION: In middle-aged and older adults, any association between meniscal damage and the development of frequent knee pain seems to be present because both pain and meniscal damage are related to OA and not because of a direct link between the two.
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| 2. |
- Roemer, F. W., et al.
(författare)
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MRI-detected subchondral bone marrow signal alterations of the knee joint: terminology, imaging appearance, relevance and radiological differential diagnosis
- 2009
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Ingår i: Osteoarthritis and Cartilage. - : Elsevier BV. - 1063-4584. ; 17:9, s. 1115-1131
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Forskningsöversikt (refereegranskat)abstract
- Objective: To discuss terminology, radiological differential diagnoses and significance of magnetic resonance imaging (MRI)-detected subchondral bone marrow lesions (BMLs) of the knee joint. Methods: An overview of the published literature is presented. In addition, the radiological appearance and differential diagnosis of subchondral signal alterations of the knee joint are discussed based on expert consensus. A recommendation for terminology is provided and the relevance of these imaging findings for osteoarthritis (OA) research is emphasized. Results: A multitude of differential diagnoses of subchondral BMLs may present with a similar aspect and signal characteristics. For this reason it is crucial to clearly and specifically define the type of BML that is being assessed and to use terminology that is appropriate to the condition and the pathology. In light of the currently used terminology, supported by histology, it seems appropriate to apply the widely used term "bone marrow lesion" to the different entities of subchondral signal alterations and in addition to specifically and precisely define the analyzed type of BML. Water sensitive sequences such as fat suppressed T2-weighted, proton density-weighted, intermediate-weighted fast spin echo or short tau inversion recovery (STIR) sequences should be applied to assess non-cystic BMLs as only these sequences depict the lesions to their maximum extent. Assessment of subchondral non-cystic ill-defined BMLs on gradient echo-type sequences should be avoided as they will underestimate the size of the lesion. Differential diagnoses of CA related BMLs include traumatic bone contusions and fractures with or without disruption of the articular surface. Osteonecrosis and bone infarcts, inflammation, tumor, transient idiopathic bone marrow edema, red marrow and post-surgical alterations should also be considered. Conclusion: Different entities of subchondral BMLs that are of relevance in the context of OA research may be distinguished by specific imaging findings, patient characteristics, symptoms, and history and are discussed in this review. (C) 2009 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.
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| 3. |
- Roemer, F. W., et al.
(författare)
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The association of meniscal damage with joint effusion in persons without radiographic osteoarthritis: the Framingham and MOST osteoarthritis studies
- 2009
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Ingår i: Osteoarthritis and Cartilage. - : Elsevier BV. - 1063-4584. ; 17:6, s. 748-753
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To assess the cross-sectional association between meniscal status and joint effusion on magnetic resonance imaging (MRI) in knees without radiographic osteoarthritis (OA). Design: Knees without OA (Kellgren/Lawrence grade 0) from the Framingham and MOST studies were examined by MRI. Meniscal status was assessed with a score of 0-4 in the anterior horn/body/posterior horn of the medial/lateral meniscus and effusion was assessed using a score of 0-3. The odds ratios (ORs) of joint effusion in those with meniscal damage were estimated using a logistic regression model. A sub-analysis was performed for knees without MRI-detected cartilage damage. Results: Of 1368 knees, 296 (21.6%) showed meniscal pathology in at least one subregion. Effusion was present in 133 (44.9%) of knees with meniscal damage vs 328 (30.6%) in those without meniscal damage. The adjusted OR of effusion in a knee with meniscal damage was 1.8, 95% confidence intervals (CI) [1.4, 2.4]. The OR of effusion for the group with meniscal pathology in two compartments was 5.4, 95% CI [2.1, 14.3]. For knees without any cartilage lesions but with meniscal damage in any compartment the OR was 2.3, 95% CI [1.1, 4.5]. Conclusions: Knees without OA but with meniscal pathology exhibit joint effusion to a significantly higher degree than knees without meniscal damage. The association persists for knees without cartilage damage. The prevalence of effusion is further increased when present in two compartments. Concomitant occurrence of synovial activation and meniscal damage contributes to understanding the pathophysiology of early degenerative joint disease. (C) 2008 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.
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