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: 698
PDF: 424
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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.

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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
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