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dc.contributor.authorMeredith, Dennis Sen_US
dc.contributor.authorLosina, Elenaen_US
dc.contributor.authorNeumann, Gesaen_US
dc.contributor.authorYoshioka, Hiroshien_US
dc.contributor.authorLang, Philipp Ken_US
dc.contributor.authorKatz, Jeffrey Nen_US
dc.date.accessioned2011-12-29T22:21:53Z
dc.date.available2011-12-29T22:21:53Z
dc.date.copyright2009en_US
dc.date.issued2009-10-29en_US
dc.identifier.citationMeredith, Dennis S, Elena Losina, Gesa Neumann, Hiroshi Yoshioka, Philipp K Lang, Jeffrey N Katz. "Empirical evaluation of the inter-relationship of articular elements involved in the pathoanatomy of knee osteoarthritis using Magnetic Resonance Imaging" BMC Musculoskeletal Disorders 10:133. (2009)en_US
dc.identifier.issn1471-2474en_US
dc.identifier.urihttp://hdl.handle.net/2144/2568
dc.description.abstractBACKGROUND: In this cross-sectional study, we conducted a comprehensive assessment of all articular elements that could be measured using knee MRI. We assessed the association of pathological change in multiple articular structures involved in the pathoanatomy of osteoarthritis. METHODS: Knee MRI scans from patients over 45 years old were assessed using a semi-quantitative knee MRI assessment form. The form included six distinct elements: cartilage, bone marrow lesions, osteophytes, subchondral sclerosis, joint effusion and synovitis. Each type of pathology was graded using an ordinal scale with a value of zero indicating no pathology and higher values indicating increasingly severe levels of pathology. The principal dependent variable for comparison was the mean cartilage disease score (CDS), which captured the aggregate extent of involvement of articular cartilage. The distribution of CDS was compared to the individual and cumulative distributions of each articular element using the Chi-squared test. The correlations between pathological change in the various articular structures were assessed in a Spearman correlation table. RESULTS: Data from 140 patients were available for review. The cohort had a median age of 61 years (range 45-89) and was 61% female. The cohort included a wide spectrum of OA severity. Our analysis showed a statistically significant trend towards pathological change involving more articular elements as CDS worsened (p-value for trend < 0.0001). Comparison of CDS to change in the severity of pathology of individual articular elements showed statistically significant trends towards more severe pathology as CDS worsened for osteophytes (p-value for trend < 0.0001), bone marrow lesions (p = 0.0003), and subchondral sclerosis (p = 0.009), but not joint effusion or synovitis. There was a moderate correlation between cartilage damage, osteophytes and BMLs as well as a moderate correlation between joint effusion and synovitis. However, cartilage damage and osteophytes were only weakly associated with synovitis or joint effusion. CONCLUSION: Our results support an inter-relationship of multiple articular elements in the pathoanatomy of knee OA. Prospective studies of OA pathogenesis in humans are needed to correlate these findings to clinically relevant outcomes such as pain and function.en_US
dc.description.sponsorshipDoris Duke Foundation; National Institutes of Health (P60 AR 47782; K24 AR 02123)en_US
dc.language.isoenen_US
dc.publisherBioMed Centralen_US
dc.rightsCopyright 2009 Meredith et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution 2.0 License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.en_US
dc.rights.urihttp://creativecommons.org/licenses/by/2.0en_US
dc.titleEmpirical Evaluation of the Inter-Relationship of Articular Elements Involved in the Pathoanatomy of Knee Osteoarthritis Using Magnetic Resonance Imagingen_US
dc.typearticleen_US
dc.identifier.doi10.1186/1471-2474-10-133en_US
dc.identifier.pubmedid19874594en_US
dc.identifier.pmcid2774678en_US


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Copyright 2009 Meredith et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution 2.0 License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Except where otherwise noted, this item's license is described as Copyright 2009 Meredith et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution 2.0 License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.