Effusion attenuates the effect of synovitis on radiographic progression in patients with hand osteoarthritis: a longitud
- PDF / 359,216 Bytes
- 5 Pages / 595.276 x 790.866 pts Page_size
- 15 Downloads / 202 Views
BRIEF REPORT
Effusion attenuates the effect of synovitis on radiographic progression in patients with hand osteoarthritis: a longitudinal magnetic resonance imaging study W. Damman 1
&
R. Liu 1 & M. Reijnierse 2 & F. R. Rosendaal 3 & J. L. Bloem 2 & M. Kloppenburg 1,3
Received: 26 April 2020 / Revised: 27 July 2020 / Accepted: 9 August 2020 # The Author(s) 2020
Abstract An exploratory study to determine the role of effusion, i.e., fluid in the joint, in pain, and radiographic progression in patients with hand osteoarthritis. Distal and proximal interphalangeal joints (87 patients, 82% women, mean age 59 years) were assessed for pain. T2-weighted and Gd-chelate contrast-enhanced T1-weighted magnetic resonance images were scored for enhanced synovial thickening (EST, i.e., synovitis), effusion (EST and T2-high signal intensity [hsi]) and bone marrow lesions (BMLs). Effusion was defined as follows: (1) T2-hsi > 0 and EST = 0; or 2) T2-hsi = EST but in different joint locations. Baseline and 2-year follow-up radiographs were scored following Kellgren-Lawrence, increase ≥ 1 defined progression. Associations between the presence of effusion and pain and radiographic progression, taking into account EST and BML presence, were explored on the joint level. Effusion was present in 17% (120/691) of joints, with (63/120) and without (57/120) EST. Effusion on itself was not associated with pain or progression. The association with pain and progression, taking in account other known risk factors, was stronger in the absence of effusion (OR [95% CI] 1.7 [1.0–2.9] and 3.2 [1.7–5.8]) than in its presence (1.6 [0.8–3.0] and 1.3 [0.5–3.1]). Effusion can be assessed on MR images and seems not to be associated with pain or radiographic progression but attenuates the association between synovitis and progression. Key Points • Effusion is present apart from synovitis in interphalangeal joints in patients with hand OA. • Effusion in finger joints can be assessed as a separate feature on MR images. • Effusion seems to be of importance for its attenuating effect on the association between synovitis and radiographic progression.
Keywords Effusion . Hand osteoarthritis . Magnetic resonance imaging . Synovitis
Introduction Where OA was formerly considered a purely mechanical disorder, nowadays the consensus is that in OA also low-grade inflammation is implicated [1]. Imaging studies with
* W. Damman [email protected] 1
Department of Rheumatology, Leiden University Medical Center, C1-R, PO Box 9600, 2300, RC Leiden, The Netherlands
2
Radiology, Leiden University Medical Center (LUMC), Leiden, The Netherlands
3
Clinical Epidemiology, Leiden University Medical Center (LUMC), Leiden, The Netherlands
ultrasound and magnetic resonance (MR) have shown that synovitis and bone marrow lesions (BMLs) play a role in the pathogenesis of hand osteoarthritis (OA), since these inflammatory features are associated with pain and radiographic progression [2–6]. However, their precise role remains unclear since treatments with anti-inflammatory drugs
Data Loading...
