Journal Article

Prevalence of abnormalities in knees detected by MRI in adults without knee osteoarthritis: population based observational study (Framingham Osteoarthritis Study)

Guermazi, Ali, Niu, Jingbo, Hayashi, Daichi, Roemer, Frank W, McLennan, Christine E, Englund, Martin, Aliabadi, Piran, Felson, David T, Neogi, Tuhina

2012

Overview

Objective To examine use of magnetic resonance imaging (MRI) of knees with no radiographic evidence of osteoarthritis to determine the prevalence of structural lesions associated with osteoarthritis and their relation to age, sex, and obesity.Design Population based observational study.Setting Community cohort in Framingham, MA, United States (Framingham osteoarthritis study).Participants 710 people aged >50 who had no radiographic evidence of knee osteoarthritis (Kellgren-Lawrence grade 0) and who underwent MRI of the knee.Main outcome measures Prevalence of MRI findings that are suggestive of knee osteoarthritis (osteophytes, cartilage damage, bone marrow lesions, subchondral cysts, meniscal lesions, synovitis, attrition, and ligamentous lesions) in all participants and after stratification by age, sex, body mass index (BMI), and the presence or absence of knee pain. Pain was assessed by three different questions and also by WOMAC questionnaire.Results Of the 710 participants, 393 (55%) were women, 660 (93%) were white, and 206 (29%) had knee pain in the past month. The mean age was 62.3 years and mean BMI was 27.9. Prevalence of “any abnormality” was 89% (631/710) overall. Osteophytes were the most common abnormality among all participants (74%, 524/710), followed by cartilage damage (69%, 492/710) and bone marrow lesions (52%, 371/710). The higher the age, the higher the prevalence of all types of abnormalities detectable by MRI. There were no significant differences in the prevalence of any of the features between BMI groups. The prevalence of at least one type of pathology (“any abnormality”) was high in both painful (90-97%, depending on pain definition) and painless (86-88%) knees.Conclusions MRI shows lesions in the tibiofemoral joint in most middle aged and elderly people in whom knee radiographs do not show any features of osteoarthritis, regardless of pain.

• Publisher: British Medical Journal Publishing Group,BMJ Publishing Group,BMJ Publishing Group LTD,BMJ Publishing Group Ltd
• Subject: Age / Age Distribution / Arthritis / Body mass / Body Mass Index / Bone Cysts - pathology / Bone marrow / Bone Marrow - abnormalities / Calcium and Bone / Cartilage diseases / Clinical Diagnostic Tests / Clinical Medicine / Cohort Studies / Cysts / Degenerative Joint Disease / Female / Geriatrics / Health Education / Health Promotion / Humans / Immunology (Including Allergy) / Klinisk medicin / Knee / Knee - abnormalities / Knee joint / Knee osteoarthritis / Knees / Lesions / Ligaments, Articular - abnormalities / Magnetic Resonance Imaging / Male / Massachusetts - epidemiology / Medical and Health Sciences / Medicin och hälsovetenskap / Menisci, Tibial - abnormalities / Meniscus / Middle Aged / Musculoskeletal Syndromes / NMR / Nuclear magnetic resonance / Obesity (Nutrition) / Obesity (Public Health) / Obesity - complications / Observational studies / Orthopaedics / Ortopedi / Osteoarthritis / Osteoarthritis, Knee - diagnosis / Osteophyte - pathology / Osteophytes / Pain / Pain (Neurology) / Pain Measurement / Patella - abnormalities / Population / Population studies / Population-based studies / Predictive Value of Tests / Prevalence / Radiography / Radiology / Radiology (Diagnostics) / Risk Factors / Sensitivity and Specificity / Sex Distribution / Subchondral bone / Synovitis / Synovitis - pathology