Associations Between Mri Features Versus Knee Pain Severity And Progression: Data From The Vancouver Longitudinal Study Of Early Knee Osteoarthritis

ObjectiveTo determine associations between features of osteoarthritis (OA) on MRI and knee pain severity and knee pain progression.DesignBaseline, 3.3- and 7.5-year assessments were performed for 122 subjects with baseline knee pain (age 40-79), sample-weighted for population (with knee pain) representativeness. MRIs were scored for: osteophytes (0: absent to 3: large); cartilage (0: normal to 4: full thickness defect; 0/1 collapsed); subchondral sclerosis (0: none to 3:>50% of site), subchondral cyst (0: absent to 3: severe), bone marrow lesions (0: none to 3:>= 50% of site); and meniscus (0: normal to 3: maceration/resection), in 6-8 regions each. Per feature, scores were averaged across regions. Effusion/synovitis (0: absent to 3: severe) was analyzed as >= 2 vs. <2.Linear models predicted WOMAC knee pain severity (0-100), and binary models predicted 10+ (minimum perceptible clinical improvement [ MPCI]) and 20+ (minimum clinically important difference [ MCID]) increases. Models were adjusted for age, sex, BMI (and follow-up time for longitudinal models).ResultsPain severity was associated with osteophytes (7.17 per unit average; 95% CI = 3.19, 11.15) and subchondral sclerosis (11.03; 0.68, 21.39). MPCI-based pain increase was associated with osteophytes (odds ratio per unit average 3.20; 1.36, 7.55), subchondral sclerosis (5.69; 1.06, 30.44), meniscal damage (1.68; 1.08, 2.61) and effusion/synovitis >= 2 (2.25; 1.07, 4.71). MCID-based pain increase was associated with osteophytes ( 3.79; 1.41, 10.20) and cartilage defects ( 2.42; 1.24, 4.74).ConclusionsOf the features investigated, only osteophytes were consistently associated with pain cross-sectionally and longitudinally in all models. This suggests an important role of bone in early knee osteoarthritis.