Longitudinal assessment of cyst-like lesions of the knee and their relation to radiographic osteoarthritis and MRI-detected effusion and synovitis in patients with knee pain.

Summary of "Longitudinal assessment of cyst-like lesions of the knee and their relation to radiographic osteoarthritis and MRI-detected effusion and synovitis in patients with knee pain."

ABSTRACT:

INTRODUCTION:
The purpose of this study was (i) To determine the prevalence of cystic lesions and cyst-like bursitides in subjects with frequent knee pain and to assess their relation to radiographic osteoarthritis (OA) severity; (ii) to describe bilaterality and size fluctuation of the lesions over 6 months; and (iii) to assess relations between the prevalence of synovium-lined lesions communicating with the joint capsule and severity of magnetic resonance imaging (MRI)-detected effusion and synovitis.
METHODS:
One hundred and sixty three subjects (total 319 knees) aged 35-65 with chronic, frequent knee pain were included. Imaging with 3T MRI was performed at baseline and 6-month follow-up with the same protocols as those used in the osteoarthritis initiative. Severity of radiographic OA was assessed using Kellgren Lawrence grade (0-4). Severity of effusion and synovitis was graded 0-3 based on whole organ magnetic resonance imaging score (WORMS) system. The associations of cysts and cyst-like bursitides and severity of radiographic OA, MRI-detected effusion and synovitis were analyzed using logistic regression controlling for clustering by person. Wilcoxon signed rank test was used to determine if there was a significant change in the size of lesions between baseline and follow-up.
RESULTS:
At least one lesion (any type) was present in 222 (70%) knees. The most prevalent lesions were popliteal cysts (40%, 128/319), followed by subgastrocnemius bursitis (15%, 49/319) and proximal tibiofibular joint cysts (8%, 26/319). Bilateral lesions were seen in 49% of the subjects. Only popliteal cysts and subgastrocnemius bursitis showed a significant change in size (P<0.001). No trend was observed between prevalence of any of the cyst-like lesions analyzed and the increasing radiographic OA severity. Increasing prevalence of subgastrocnemius bursitis was associated with increasing severity of effusion (P=0.0072) and synovitis (P=0.0033).
CONCLUSIONS:
None of the cyst-like lesions analyzed seems to be a marker of radiographic OA severity in knees with chronic frequent pain. Subgastrocnemius bursitis may be used as a marker of effusion/synovitis severity. Bilateral cyst-like lesions are relatively commonly observed in people with chronic knee pain.

Affiliation

Journal Details

This article was published in the following journal.

Name: Arthritis research & therapy
ISSN: 1478-6362
Pages: R172

Links

• PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/20843319
• DOI: http://dx.doi.org/10.1186/ar3132