Co-existing patterns of MRI lesions were differentially associated with knee pain at rest and on joint loading: a within
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RESEARCH ARTICLE
Open Access
Co-existing patterns of MRI lesions were differentially associated with knee pain at rest and on joint loading: a within-person knee-matched case-controls study Qiang Liu1,2, Nancy E. Lane3, David Hunter4, Dan Xing1, Zhikun Li1, Jianhao Lin1*
and Yuqing Zhang2*
Abstract Background: To assess the association of co-existing MRI lesions with knee pain at rest or on joint loading. Methods: We included participants from Osteoarthritis Initiative whose pain score, measured by WOMAC subscales, differed by ≥1 point at rest (in bed at night, sitting/lying down) or on joint loading (walking, stairs) between two knees. Cartilage morphology, bone marrow lesions, meniscus extrusion, meniscus morphology, Hoffa’s synovitis and synovitis-effusion were assessed using the compartment-specific MRI Osteoarthritis Knee Score. We performed latent class analyses to identify subgroups of co-existing MRI lesions and fitted a conditional logistic regression model to examine their associations with knee pain. Results: Among 130 eligible participants, we identified five subgroups of knees according to patterns of co-existing MRI lesions: I. minimal lesions; II. mild lesions; III. moderate morphological lesions; IV. moderate multiple reactive lesions; and V. severe lesions. Compared with subgroup I, the odds ratios (ORs) and 95% confidence intervals (CI) of greater pain in bed at night were 1.6 (0.3, 7.2), 2.2 (0.5, 9.5), 6.2 (1.3, 29.6) and 11.2 (2.1, 59.2) for subgroups II-V, respectively. A similar association was observed between aforementioned subgroups and pain with sitting/lying down. The ORs (95% CI) of greater pain with walking were 1.0 (reference), 1.7 (0.5, 6.1), 0.7 (0.2, 2.3), 5.0 (1.4, 18.6) and 7.9 (2.0, 31.5) for subgroup I-V, respectively. The corresponding analysis for pain on stairs showed similar results. Conclusions: Distinct patterns of co-existing MRI lesions have different implications for the pathogenesis of osteoarthritic knee pain occurring with/without joint loading. Keywords: MRI, Pattern, Pain, Joint loading, Knee, Osteoarthritis
* Correspondence: [email protected]; [email protected] 1 Peking University People’s Hospital, Arthritis Clinic and Research Center, No.11 Xizhimen South Road, Xicheng District, Beijing 100044, China 2 Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114, USA Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If materi
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