https://doi.org/10.4081/reumatismo.2022.1534

Magnetic resonance imaging as a structural refinement to the American College of Rheumathology clinical classification criteria for knee osteoarthritis

Vol. 74 No. 3 (2022)
Published: 29 December 2022
Osteoarthritis, magnetic resonance imaging, ACR criteria
Abstract Views: 567
PDF: 297
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Authors

G.A. Minetti
Diagnostic and Interventional Radiology Unit, S. Spirito Hospital, Casale Monferrato (AL), Italy.
M. Parodi
https://orcid.org/0000-0003-0237-7330
Department of Rheumatology, S.S. Antonio e Biagio and Cesare Arrigo Hospital, Alessandria, Italy.
S. Banderali
https://orcid.org/0000-0003-0699-8978
Radiodiagnostic Unit, Galliera Hospital, Genova, Italy.
E. Silvestri
Diagnostic Imaging, Salus-Alliance Institute, Genova, Italy.
G. Garlaschi
Imaging Diagnostics Section, Department of Experimental Medicine, University of Genova, Italy.
M.A. Cimmino
marcoamedeo.cimmino@gmail.com
https://orcid.org/0000-0002-6956-7860
Rheumatology Clinic, Department of Internal Medicine, University of Genova, Italy.

Objective: To evaluate if fulfilment of the definition of osteoarthritis (OA) based on the American College of Rheumatology (ACR) clinical criteria corresponds to pathological knee findings evaluated by magnetic resonance imaging (MRI). To evaluate if any such criteria is associated with a specific MRI pattern.
Methods: Forty-six consecutive patients aged 50 years or more referred by their general practitioners (GPs) to a radiology department because of non-traumatic knee pain underwent MRI using a dedicated low field (0.2 T) machine.
Results: MRI results were compared against the ACR criteria for knee OA. Patients with knee pain fulfilling the ACR criteria showed more severe synovial fluid effusion (OR 6.2, 95% CI 2.02 to 19.1), cartilage lesions in the medial area (OR 2.4, 95% CI 1.2 to 5) and higher mean number of osteophytes (OR 2.3, 95% CI 1.1 to 4.5). The association between single criteria and MRI features was more difficult to establish. Nonetheless, crepitus at joint movement was associated with synovial fluid effusion (p=0.02); bone enlargement was more frequent in patients with lesions of the posterior cruciate ligament (p=0.0001); no palpable warmth was associated with cartilage lesions (p=0.02), and morning stiffness shorter than 30 minutes was associated with the surface of bone edema (p=0.02).
Conclusions: The ACR clinical criteria identify patients showing the most important features of OA. The association between individual clinical ACR criteria and OA pathology depicted by MRI may be difficult to explain on the basis of anatomical changes and needs further evaluation.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

Citations

Crossref
Scopus
Google Scholar
Europe PMC
Altman R, Asch E, Bloch G, et al. Development of criteria for the classification and reporting of osteoarthritis. Classification of osteoarthritis of the knee. Arthritis Rheum. 1986; 29: 1039-49. DOI: https://doi.org/10.1002/art.1780290816
Mannoni A, Briganti MP, Di Bari M, et al. Epidemiological profile of symptomatic osteoarthritis in older adults: a population based study in Dicomano, Italy. Ann Rheum Dis. 2003; 62: 576-8. DOI: https://doi.org/10.1136/ard.62.6.576
Wang Y, Wluka AE, Cicuttini FM. The determinants of change in tibial plateau bone area in osteoarthritic knees: a cohort study. Arthritis Res Ther. 2005; 7: R687-93. Epub 2005 Mar 31. DOI: https://doi.org/10.1186/ar1726
Berthiaume MJ, Raynauld JP, Martel-Pelletier J, et al. Meniscal tear and extrusion are strongly associated with progression of symptomatic knee osteoarthritis as assessed by quantitative magnetic resonance imaging. Ann Rheum Dis. 2005; 64: 556-63. DOI: https://doi.org/10.1136/ard.2004.023796
Spector TD, Hochberg MC. Methodological problems in the epidemiological study of osteoarthritis. Ann Rheum Dis. 1994; 53: 143-6. DOI: https://doi.org/10.1136/ard.53.2.143
Recht MP, Piraino DW, Paletta GA, et al. Accuracy of fat-suppressed three-dimensional spoiled gradient-echo FLASH MR imaging in the detection of patello-femoral articular cartilage abnormalities. Radiology. 1996; 198:209-12. DOI: https://doi.org/10.1148/radiology.198.1.8539380
Hill CL, Gale DG, Chaisson CE, et al. Knee effusions, popliteal cysts, and synovial thickening: association with knee pain in osteoarthritis. J Rheumatol. 2001; 28: 1330-7.
Bañuls-Mirete M, Lombardi AF, Posis AIB, et al. Effusion-synovitis worsening mediates the association between body mass index and Kellgren-Lawrence progression in obese individuals: data from the Osteoarthritis Initiative. Osteoarthritis Cartil. 2022; 30:1278-86. DOI: https://doi.org/10.1016/j.joca.2022.05.011
Hill CL, Seo GS, Gale D, et al. Cruciate ligament integrity in osteoarthritis of the knee. Arthritis Rheum. 2005; 52: 794-9. DOI: https://doi.org/10.1002/art.20943
Felson DT, Chaisson CE, Hill CL, et al. The association of bone marrow lesions with pain in knee osteoarthritis. Ann Int Med. 2001; 134: 541-9. DOI: https://doi.org/10.7326/0003-4819-134-7-200104030-00007
Perry TA, Parkes MJ, Hodgson RJ, et al. Association between bone marrow lesions and synovitis and symptoms in symptomatic knee osteoarthritis. Osteoarthritis Cartil. 2020; 28:316-23. DOI: https://doi.org/10.1016/j.joca.2019.12.002
Ejbjerg BJ, Narvestad E, Jacobsen S, et al. Optimised, low cost, low field dedicated extremity MRI is highly specific and sensitive for synovitis and bone erosions in rheumatoid arthritis wrist and finger joints: comparison with conventional high field MRI and radiography. Ann Rheum Dis. 2005; 64: 1280-7. DOI: https://doi.org/10.1136/ard.2004.029850
Woertler K, Strothmann M, Tombach B, Reimer P. Detection of articular cartilage lesions: experimental evaluation of low- and highfield-strength MR imaging at 0.18 and 1.0 T. J Magn Reson Imaging. 2000; 11: 678-85. DOI: https://doi.org/10.1002/1522-2586(200006)11:6<678::AID-JMRI15>3.0.CO;2-Y
Qazi AA, Folkesson J, Pettersen PC, et al. Separation of healthy and early osteoarthritis by automatic quantification of cartilage homogeneity. Osteoarthritis Cartil. 2007; 15: 1199-206. DOI: https://doi.org/10.1016/j.joca.2007.03.016

How to Cite

Minetti, G., Parodi, M., Banderali, S., Silvestri, E., Garlaschi, G., & Cimmino, M. (2022). Magnetic resonance imaging as a structural refinement to the American College of Rheumathology clinical classification criteria for knee osteoarthritis. Reumatismo, 74(3). https://doi.org/10.4081/reumatismo.2022.1534
Copyright (c) 2022 the Author(s) Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Authors who publish with this journal agree to the following terms:

  1. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
  2. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
  3. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.