المؤلفون: MacFarlane, Lindsey A., Arant, Kaetlyn R., Kostic, Aleksandra M., Mass, Hanna, Jones, Morgan H., Collins, Jamie E., Losina, Elena, Katz, Jeffrey N.

المصدر: Arthritis Care & Research; Aug2023, Vol. 75 Issue 8, p1783-1787, 5p

مصطلحات موضوعية: LEUKOCYTE count, SYNOVITIS, SYNOVIAL fluid, KNEE pain, MAGNETIC resonance imaging, KNEE osteoarthritis, INFLAMMATION

مستخلص: Objective: Inflammation is a potential pain generator and treatment target in knee osteoarthritis (OA). Inflammation can be detected on magnetic resonance imaging (MRI) and by synovial fluid white blood cell count (WBC). However, the performance characteristics of synovial fluid WBC for the detection of synovitis have not been established. This study was undertaken to determine the sensitivity and specificity of synovial fluid WBC in identifying inflammation in knee OA using MRI effusion‐synovitis as the gold standard. Methods: We identified records of patients seen at an academic center with a diagnosis code for knee OA, a procedural code for knee aspiration, and a laboratory order for synovial fluid WBC in the same encounter, as well as an MRI within 12 months of the aspiration. MRIs were read for effusion‐synovitis using the MRI OA Knee Score (MOAKS). We dichotomized effusion‐synovitis as 1) none or small, or 2) medium or large. We calculated the sensitivity and specificity of synovial fluid WBC using MRI effusion‐synovitis (medium/large) as the gold standard. We used the Youden index to identify the best cut point. Results: We included 75 patients. Mean ± SD age was 63 ± 12 years, and 69% were female. The synovial fluid WBC was higher in the medium/large effusion‐synovitis group (median 335 [interquartile range (IQR) 312]) than in the none/small group (median 194 [IQR 272]). The optimal cut point was 242, yielding a sensitivity of 71% (95% confidence interval [95% CI] 56–83%) and specificity of 63% (95% CI 41–81%). Conclusion: The sensitivity and specificity of synovial fluid WBC in identifying effusion‐synovitis on MRI were limited. Further research is needed to better understand the association between MRI and effusion‐synovitis measured by synovial fluid and to determine which measure more strongly relates to synovial histopathology and patient outcomes. [ABSTRACT FROM AUTHOR]

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المؤلفون: Katz, Jeffrey N., Collins, Jamie E., Jones, Morgan, Spindler, Kurt P., Marx, Robert G., Mandl, Lisa A., Levy, Bruce A., Wright, Rick, Jarraya, Mohamed, Guermazi, Ali, MacFarlane, Lindsey A., Losina, Elena, Chang, Yuchiao

المصدر: Arthritis Care & Research; Feb2023, Vol. 75 Issue 2, p340-347, 8p

مصطلحات موضوعية: KNEE pain, MENISCUS injuries, KNEE osteoarthritis, SYMPTOMS, MAGNETIC resonance imaging, KNEE injuries

مستخلص: Objective: Middle‐aged subjects with meniscal tear treated with arthroscopic partial meniscectomy (APM) experience greater progression of damage to joint structures on imaging than subjects treated nonoperatively. It is unclear whether these changes are clinically relevant. The goal of this study was to assess whether worsening in magnetic resonance imaging (MRI)–assessed tissue damage over 18 months leads to subsequent worsening in knee pain over the subsequent 3.5 years. Methods: We used data from the Meniscal Tear in Osteoarthritis Research (MeTeOR) trial of APM versus physical therapy for subjects ages ≥45 years with knee pain, cartilage damage, and meniscal tear. We assessed whether change in cartilage surface area damage score (and other structural measures) from baseline to 18 months, assessed on MRI with the MRI Osteoarthritis Knee Score (MOAKS) system, was associated with change in Knee Injury and Osteoarthritis Outcome Score (KOOS) pain score (range 0–100; 100 = worst) from 18 to 60 months. Results: The primary analysis included 168 subjects with complete MRI data at baseline and 18 months and KOOS data at 18 and 60 months. We did not observe clinically important associations between change in cartilage surface area score between baseline and 18 months and change in pain scores from 18 to 60 months. Pain scores in the worst tertile for cartilage surface area damage score progression worsened by 0.45 points more than in the best tertile (95% confidence interval –4.45, 5.35). Similarly, we did not observe clinically important associations between changes in bone marrow lesions, osteophytes, or synovitis and subsequent pain. Conclusion: We did not observe clinically important associations between early changes in cartilage damage and other structural measures and worsening in pain over the subsequent 3.5 years. Further follow‐up is required to assess this association over a longer follow‐up period. [ABSTRACT FROM AUTHOR]

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المؤلفون: Santana, Daniel C., Oak, Sameer R., Jin, Yuxuan, Rothy, Alex, Lee, Ling-Ling, Katz, Jeffrey N., Winalski, Carl S., Duryea, Jeff, Jones, Morgan H.

المصدر: American Journal of Sports Medicine; Jul2022, Vol. 50 Issue 8, p2075-2082, 8p

مصطلحات موضوعية: KNEE radiography, SURGICAL complication risk factors, KNEE osteoarthritis, ARTHROSCOPY, MENISCECTOMY, CASE-control method, MAGNETIC resonance imaging, RISK assessment, COMPARATIVE studies, DESCRIPTIVE statistics, ARTICULAR cartilage, DATA analysis software, MENISCUS injuries, DISEASE risk factors

مستخلص: Background: Arthroscopic partial meniscectomy (APM) is widely performed and remains an important therapeutic option for patients with a meniscal tear. However, it is debated whether or not APM accelerates the progression of osteoarthritis (OA) in the long term. Purpose/Hypothesis: The purpose was to compare the progression of OA measured by the change in tibiofemoral joint space width (JSW)—a quantitative measure of OA radiographic severity—across 3 groups with a midterm follow-up: (1) patients undergoing APM; (2) those with a meniscal tear treated nonoperatively; and (3) those without a tear. We hypothesized that the reduction in JSW would be greatest in patients undergoing APM and least in those patients without a tear. Study Design: Cohort study; Level of evidence, 3. Methods: Using the Osteoarthritis Initiative cohort, a total of 144 patients were identified that underwent APM with at least 12 months of follow up and without previous knee surgery. Those with a meniscal tear who did not have APM (n = 144) and those without a tear (n = 144) were matched to patients who had APM by sex, age, Kellgren-Lawrence (KL) grade, and follow up time. Participants underwent magnetic resonance imaging at baseline. Knee radiographs to assess JSW were collected annually or biannually. The change in minimum medial compartment JSW was calculated using a validated automated method. A piecewise linear mixed effects model was constructed to examine the relationship between JSW decline over time and treatment group—adjusting for age, body mass index, smoking status, KL grade, and baseline JSW. Results: All groups had comparable baseline JSW—ranging from 4.33 mm to 4.38 mm. The APM group had a rate of JSW decline of −0.083 mm/mo in the first 12 months and −0.014 mm/mo between 12 and 72 months. The rate of JSW decline in the APM group was approximately 27 times greater in the first 12 months than that in the nonsurgical group (−0.003 mm/mo) and 5 times greater than that in the no tear group (−0.015 mm/mo); however, there was no significant difference between groups for 12 to 72 months (nonsurgical group: −0.009 mm/mo; no tear group: −0.010 mm/mo). The adjusted JSW in the APM group was 4.38 mm at baseline and decreased to 2.57 mm at 72 months; the JSW in the nonsurgical group declined from 4.31 mm to 3.73 mm, and in the no tear group it declined from 4.33 mm to 3.54 mm. There was a statistically significant difference in JSW change between baseline and 72 months for the APM group compared with the other groups (P <.001), but not between the nonsurgical and no tear groups (P =.12). Conclusion: In the first postoperative year, APM results in a faster rate of joint space narrowing compared with knees undergoing nonsurgical management of meniscal tears. Thereafter, there are comparable rates of OA progression regardless of the chosen management. APM results in a persistent decrease in JSW over at least 72 months. An untreated meniscal tear does not contribute to radiographic progression—assessed by JSW—as compared with an intact meniscus. [ABSTRACT FROM AUTHOR]

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المؤلفون: Hunter, David J., Deveza, Leticia A., Collins, Jamie E., Losina, Elena, Katz, Jeffrey N., Nevitt, Michael C., Lynch, John A., Roemer, Frank W., Guermazi, Ali, Bowes, Michael A., Dam, Erik B., Eckstein, Felix, Kwoh, C. Kent, Hoffmann, Steve, Kraus, Virginia B.

المصدر: Arthritis Care & Research; Jul2022, Vol. 74 Issue 7, p1142-1153, 12p

مصطلحات موضوعية: PATELLOFEMORAL joint, BONE spurs, KNEE pain, BIOMARKERS, MAGNETIC resonance imaging, OSTEOARTHRITIS, CANCELLOUS bone, PARSIMONIOUS models

الشركة/الكيان: NATIONAL Institutes of Health (U.S.)

مستخلص: Objective: To determine the optimal combination of imaging and biochemical biomarkers for use in the prediction of knee osteoarthritis (OA) progression. Methods: The present study was a nested case–control trial from the Foundation of the National Institutes of Health OA Biomarkers Consortium that assessed study participants with a Kellgren/Lawrence grade of 1–3 who had complete biomarker data available (n = 539 to 550). Cases were participants' knees that had radiographic and pain progression between 24 and 48 months compared to baseline. Radiographic progression only was assessed in secondary analyses. Biomarkers (baseline and 24‐month changes) that had a P value of <0.10 in univariate analysis were selected, including quantitative cartilage thickness and volume on magnetic resonance imaging (MRI), semiquantitative MRI markers, bone shape and area, quantitative meniscal volume, radiographic progression (trabecular bone texture [TBT]), and serum and/or urine biochemical markers. Multivariable logistic regression models were built using 3 different stepwise selection methods (complex models versus parsimonious models). Results: Among baseline biomarkers, the number of locations affected by osteophytes (semiquantitative), quantitative central medial femoral and central lateral femoral cartilage thickness, patellar bone shape, and semiquantitative Hoffa‐synovitis predicted OA progression in most models (C statistic 0.641–0.671). In most models, 24‐month changes in semiquantitative MRI markers (effusion‐synovitis, meniscal morphologic changes, and cartilage damage), quantitative central medial femoral cartilage thickness, quantitative medial tibial cartilage volume, quantitative lateral patellofemoral bone area, horizontal TBT (intercept term), and urine N‐telopeptide of type I collagen predicted OA progression (C statistic 0.680–0.724). A different combination of imaging and biochemical biomarkers (baseline and 24‐month change) predicted radiographic progression only, which had a higher C statistic of 0.716–0.832. Conclusion: The present study highlights the combination of biomarkers with potential prognostic utility in OA disease‐modifying trials. Properly qualified, these biomarkers could be used to enrich future trials with participants likely to experience progression of knee OA. [ABSTRACT FROM AUTHOR]

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المؤلفون: Katz, Jeffrey N.^1,2,3, Arant, Kaetlyn R.¹, Loeser, Richard F.⁴

المصدر: JAMA: Journal of the American Medical Association. 2/9/2021, Vol. 325 Issue 6, p568-578. 11p.

مصطلحات موضوعية: *HIP joint diseases diagnosis, *OSTEOARTHRITIS treatment, *OSTEOARTHRITIS diagnosis, *KNEE diseases, *HIP joint diseases, *DISEASE progression, *ADRENOCORTICAL hormones, *NONSTEROIDAL anti-inflammatory agents, *SELF-evaluation, *MAGNETIC resonance imaging, *ARTIFICIAL joints, *OSTEOARTHRITIS, *WEIGHT loss, *INTRA-articular injections, *EXERCISE, *MENTAL health surveys, *RESEARCH funding, *HEALTH self-care

مستخلص: Importance: Osteoarthritis (OA) is the most common joint disease, affecting an estimated more than 240 million people worldwide, including an estimated more than 32 million in the US. Osteoarthritis is the most frequent reason for activity limitation in adults. This Review focuses on hip and knee OA.Observations: Osteoarthritis can involve almost any joint but typically affects the hands, knees, hips, and feet. It is characterized by pathologic changes in cartilage, bone, synovium, ligament, muscle, and periarticular fat, leading to joint dysfunction, pain, stiffness, functional limitation, and loss of valued activities, such as walking for exercise and dancing. Risk factors include age (33% of individuals older than 75 years have symptomatic and radiographic knee OA), female sex, obesity, genetics, and major joint injury. Persons with OA have more comorbidities and are more sedentary than those without OA. The reduced physical activity leads to a 20% higher age-adjusted mortality. Several physical examination findings are useful diagnostically, including bony enlargement in knee OA and pain elicited with internal hip rotation in hip OA. Radiographic indicators include marginal osteophytes and joint space narrowing. The cornerstones of OA management include exercises, weight loss if appropriate, and education-complemented by topical or oral nonsteroidal anti-inflammatory drugs (NSAIDs) in those without contraindications. Intra-articular steroid injections provide short-term pain relief and duloxetine has demonstrated efficacy. Opiates should be avoided. Clinical trials have shown promising results for compounds that arrest structural progression (eg, cathepsin K inhibitors, Wnt inhibitors, anabolic growth factors) or reduce OA pain (eg, nerve growth factor inhibitors). Persons with advanced symptoms and structural damage are candidates for total joint replacement. Racial and ethnic disparities persist in the use and outcomes of joint replacement.Conclusions and Relevance: Hip and knee OA are highly prevalent and disabling. Education, exercise and weight loss are cornerstones of management, complemented by NSAIDs (for patients who are candidates), corticosteroid injections, and several adjunctive medications. For persons with advanced symptoms and structural damage, total joint replacement effectively relieves pain. [ABSTRACT FROM AUTHOR]

المؤلفون: MacFarlane, Lindsey A., Yang, Heidi, Collins, Jamie E., Guermazi, Ali, Jones, Morgan H., Spindler, Kurt P., Winter, Amelia R., Losina, Elena, Katz, Jeffrey N., Brophy, Robert H., Cole, Brian J., Levy, Bruce A., Mandl, Lisa A., Martin, Scott, Marx, Robert G., Matava, Mathew, Safran-Norton, Clare, Stuart, Michael, Wright, Rick

المصدر: American Journal of Sports Medicine; Mar2019, Vol. 47 Issue 3, p612-619, 8p

مصطلحات موضوعية: OSTEOARTHRITIS treatment, MENISCUS injuries, KNEE diseases, ARTHROSCOPY, LONGITUDINAL method, MAGNETIC resonance imaging, MENISCECTOMY, PHYSICAL therapy, REGRESSION analysis, BODY mass index, KNEE pain, DESCRIPTIVE statistics, THERAPEUTICS

مستخلص: Background: Arthroscopic partial meniscectomy (APM) is used to treat meniscal tears, although its efficacy is controversial. Purpose: This study used magnetic resonance imaging (MRI) to determine characteristics that lead to greater benefit from APM and physical therapy (PT) than from PT alone among patients with meniscal tear and knee osteoarthritis. Study Design: Cohort study; Level of evidence, 2. Methods: Using data from the Meniscal Tear in Osteoarthritis Research (MeTeOR) trial, the authors first assessed whether the effect of treatment on pain scores at 6 months differed according to baseline MRI features (bone marrow lesions, cartilage and meniscal damage). Second, the authors summed MRI features associated with differential pain relief between APM and PT to create a "damage score," which included bone marrow lesion number and cartilage damage size with possible values of 0 (least damage), 1 (moderate), and 2 (greatest). The authors used linear models to determine whether the association between damage score and pain relief at 6 months differed for APM versus PT. Results: The study included 220 participants: 13%, had the least damage; 52%, moderate; and 34%, greatest. Although treatment type did not significantly modify the association of damage score and change in pain (P interaction = .13), those with the least damage and moderate damage had greater improvement with APM than with PT in Knee injury and Osteoarthritis Outcome Score pain subscale—by 15 and 7 points, respectively. Those with the greatest damage had a similar improvement with APM and PT. Conclusion: Among patients with osteoarthritis and meniscal tear, those with less intra-articular damage on MRI may have greater improvement in pain with APM and PT than with PT alone. However, these results should be interpreted cautiously owing to the limited sample size. [ABSTRACT FROM AUTHOR]

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المؤلفون: MacFarlane, Lindsey A., Yang, Heidi, Collins, Jamie E., Jarraya, Mohamed, Guermazi, Ali, Mandl, Lisa A., Martin, Scott D., Wright, John, Losina, Elena, Katz, Jeffrey N., Brophy, Robert H., Levy, Bruce A., Marx, Robert G., Matava, Mathew, Safran‐Norton, Clare, Spindler, Kurt P., Stuart, Michael, Dahm, Diane L., Wright, Rick

المصدر: Arthritis & Rheumatology; Jan2019, Vol. 71 Issue 1, p73-81, 9p

مصطلحات موضوعية: CARTILAGE diseases, CONFIDENCE intervals, KNEE diseases, MAGNETIC resonance imaging, MENISCUS injuries, OSTEOARTHRITIS, PHYSICAL therapy, POISSON distribution, REGRESSION analysis, RELATIVE medical risk, SYNOVITIS, DISEASE progression, DISEASE complications, DISEASE risk factors, DIAGNOSIS, THERAPEUTICS

مستخلص: Objective: Synovitis is a feature of knee osteoarthritis (OA) and meniscal tear and has been associated with articular cartilage damage. This study was undertaken to examine the associations of baseline effusion‐synovitis and changes in effusion‐synovitis with changes in cartilage damage in a cohort with OA and meniscal tear. Methods: We analyzed data from the Meniscal Tear in Osteoarthritis Research (MeTeOR) trial of surgery versus physical therapy for treatment of meniscal tear. We performed semiquantitative grading of effusion‐synovitis and cartilage damage on magnetic resonance imaging, and dichotomized effusion‐synovitis as none/small (minimal) and medium/large (extensive). We assessed the association of baseline effusion‐synovitis and changes in effusion‐synovitis with changes in cartilage damage size and depth over 18 months, using Poisson regression models. Analyses were adjusted for patient demographic characteristics, treatment, and baseline cartilage damage. Results: We analyzed 221 participants. Over 18 months, effusion‐synovitis was persistently minimal in 45.3% and persistently extensive in 21.3% of the patients. The remaining 33.5% of the patients had minimal synovitis on one occasion and extensive synovitis on the other. In adjusted analyses, patients with extensive effusion‐synovitis at baseline had a relative risk (RR) of progression of cartilage damage depth of 1.7 (95% confidence interval [95% CI] 1.0–2.7). Compared to those with persistently minimal effusion‐synovitis, those with persistently extensive effusion‐synovitis had a significantly increased risk of progression of cartilage damage depth (RR 2.0 [95% CI 1.1–3.4]). Conclusion: Our findings indicate that the presence of extensive effusion‐synovitis is associated with subsequent progression of cartilage damage over 18 months. The persistence of extensive effusion‐synovitis over time is associated with the greatest risk of concurrent cartilage damage progression. [ABSTRACT FROM AUTHOR]

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المؤلفون: Barbhaiya, Medha, Yan Dong, Sparks, Jeffrey A., Losina, Elena, Costenbader, Karen H., Katz, Jeffrey N., Dong, Yan

المصدر: BMC Musculoskeletal Disorders; 6/19/2017, Vol. 18, p1-6, 6p, 3 Charts

مصطلحات موضوعية: OSTEONECROSIS, OSTEORADIOGRAPHY, MAGNETIC resonance imaging, EPIDEMIOLOGY, ALGORITHMS, ARM, COMPARATIVE studies, LEG, RESEARCH methodology, MEDICAL cooperation, NOSOLOGY, RESEARCH, RESEARCH funding, EVALUATION research

مستخلص: Background: Studies of the epidemiology and outcomes of avascular necrosis (AVN) require accurate case-finding methods. The aim of this study was to evaluate performance characteristics of a claims-based algorithm designed to identify AVN cases in administrative data.Methods: Using a centralized patient registry from a US academic medical center, we identified all adults aged ≥18 years who underwent magnetic resonance imaging (MRI) of an upper/lower extremity joint during the 1.5 year study period. A radiologist report confirming AVN on MRI served as the gold standard. We examined the sensitivity, specificity, positive predictive value (PPV) and positive likelihood ratio (LR+) of four algorithms (A-D) using International Classification of Diseases, 9th edition (ICD-9) codes for AVN. The algorithms ranged from least stringent (Algorithm A, requiring ≥1 ICD-9 code for AVN [733.4X]) to most stringent (Algorithm D, requiring ≥3 ICD-9 codes, each at least 30 days apart).Results: Among 8200 patients who underwent MRI, 83 (1.0% [95% CI 0.78-1.22]) had AVN by gold standard. Algorithm A yielded the highest sensitivity (81.9%, 95% CI 72.0-89.5), with PPV of 66.0% (95% CI 56.0-75.1). The PPV of algorithm D increased to 82.2% (95% CI 67.9-92.0), although sensitivity decreased to 44.6% (95% CI 33.7-55.9). All four algorithms had specificities >99%.Conclusion: An algorithm that uses a single billing code to screen for AVN among those who had MRI has the highest sensitivity and is best suited for studies in which further medical record review confirming AVN is feasible. Algorithms using multiple billing codes are recommended for use in administrative databases when further AVN validation is not feasible. [ABSTRACT FROM AUTHOR]

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المؤلفون: Roemer, Frank W., Guermazi, Ali, Collins, Jamie E., Losina, Elena, Nevitt, Michael C., Lynch, John A., Katz, Jeffrey N., Kwoh, C. Kent, Kraus, Virginia B., Hunter, David J.

المصدر: BMC Musculoskeletal Disorders; 11/10/2016, Vol. 17, p1-17, 17p, 2 Black and White Photographs, 10 Charts

مصطلحات موضوعية: OSTEOARTHRITIS, MAGNETIC resonance imaging, DISEASE progression, KNEE diseases, CROSS-sectional method, DIAGNOSIS

مستخلص: Background: To describe the scoring methodology and MRI assessments used to evaluate the cross-sectional features observed in cases and controls, to define change over time for different MRI features, and to report the extent of changes over a 24-month period in the Foundation for National Institutes of Health Osteoarthritis Biomarkers Consortium study nested within the larger Osteoarthritis Initiative (OAI) Study. Methods: We conducted a nested case-control study. Cases (n = 406) were knees having both radiographic and pain progression. Controls (n = 194) were knee osteoarthritis subjects who did not meet the case definition. Groups were matched for Kellgren-Lawrence grade and body mass index. MRIs were acquired using 3 T MRI systems and assessed using the semi-quantitative MOAKS system. MRIs were read at baseline and 24 months for cartilage damage, bone marrow lesions (BML), osteophytes, meniscal damage and extrusion, and Hoffa- and effusion-synovitis. We provide the definition and distribution of change in these biomarkers over time. Results: Seventy-three percent of the cases had subregions with BML worsening (vs. 66 % in controls) (p = 0.102). Little change in osteophytes was seen over 24 months. Twenty-eight percent of cases and 10 % of controls had worsening in meniscal scores in at least one subregion (p < 0.001). Seventy-three percent of cases and 53 % of controls had at least one area with worsening in cartilage surface area (p < 0.001). More cases experienced worsening in Hoffa- and effusion synovitis than controls (17 % vs. 6 % (p < 0.001); 41 % vs. 18 % (p < 0.001), respectively). Conclusions: A wide range of MRI-detected structural pathologies was present in the FNIH cohort. More severe changes, especially for BMLs, cartilage and meniscal damage, were detected primarily among the case group suggesting that early changes in multiple structural domains are associated with radiographic worsening and symptomatic progression. [ABSTRACT FROM AUTHOR]

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المؤلفون: Collins, Jamie E., Losina, Elena, Nevitt, Michael C., Roemer, Frank W., Guermazi, Ali, Lynch, John A., Katz, Jeffrey N., Kent Kwoh, C., Kraus, Virginia B., Hunter, David J.

المصدر: Arthritis & Rheumatology; Oct2016, Vol. 68 Issue 10, p2422-2431, 10p

مصطلحات موضوعية: ARTICULAR cartilage, BIOMARKERS, CONFIDENCE intervals, KNEE, KNEE diseases, MAGNETIC resonance imaging, MATHEMATICAL models, MENISCUS (Anatomy), OSTEOARTHRITIS, PAIN, PROBABILITY theory, RESEARCH funding, SYNOVIAL membranes, TIME, LOGISTIC regression analysis, THEORY, MULTIPLE regression analysis, PAIN measurement, CASE-control method, DISEASE progression, DATA analysis software, ODDS ratio

مستخلص: Objective To determine the association between changes in semiquantitative magnetic resonance imaging (MRI) biomarkers over 24 months and radiographic and pain progression over 48 months in knees with mild-to-moderate osteoarthritis (OA). Methods We undertook a nested case-control study as part of the Foundation for the National Institutes of Health Biomarkers Consortium Project. We used multivariable logistic regression models to examine the association between change over 24 months in semiquantitative MRI markers and radiographic and pain progression in knee OA. MRIs were read according to the MRI OA Knee Score system. We focused on changes in cartilage, osteophytes, meniscus, bone marrow lesions, Hoffa-synovitis, and effusion-synovitis. Results The most parsimonious model included changes in cartilage thickness and surface area, effusion-synovitis, Hoffa-synovitis, and meniscal morphology (C statistic 0.740). Compared with no worsening, worsening in cartilage thickness in ≥3 subregions was associated with 2.8-fold (95% confidence interval [95% CI] 1.3-5.9) greater odds of being a case, and worsening in cartilage surface area in ≥3 subregions was associated with 2.4-fold (95% CI 1.3-4.4) greater odds of being a case. Worsening of meniscal morphology in any region was associated with 2.2-fold (95% CI 1.3-3.8) greater odds of being a case. Worsening effusion-synovitis and Hoffa-synovitis were also associated with a greater odds of being a case (odds ratios 2.7 and 2.0, respectively). Conclusion Twenty-four-month changes in cartilage thickness, cartilage surface area, effusion-synovitis, Hoffa-synovitis, and meniscal morphology were independently associated with OA progression, suggesting that these factors may serve as efficacy biomarkers in clinical trials of disease-modifying interventions for knee OA. [ABSTRACT FROM AUTHOR]

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