ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 204

Ultrasonographic Predictors for Clinical and Radiological Progression in Knee Osteoarthritis after 2 Years Follow up

Karen Bevers1, Johanna E. Vriezekolk2, J.W.J. Bijlsma3, Els van den Ende4 and Alfons A. den Broeder2, 1Rheumatology, St Maartenskliniek, Nijmegen, Netherlands, 2Rheumatology, Sint Maartenskliniek, Nijmegen, Netherlands, 3Rheumatology & Clinical Immunology, University Medical Center Utrecht, Utrecht, Netherlands, 4Department of Rheumatology, Sint Maartenskliniek, Nijmegen, Netherlands

Meeting: 2014 ACR/ARHP Annual Meeting

Keywords: ,

Session Information

Title: Osteoarthritis - Clinical Aspects: Imaging and Biomechanics

Session Type: Abstract Submissions (ACR)

Background/Purpose

Pathophysiology of osteoarthritis (OA) is not completely understood. Identifying patients with progression might help to direct future research on therapeutic interventions. As OA is known to affect the entire joint including soft tissue structures, structural changes in these tissues, visualised by ultrasound (US),  might predict progression. The aim of this study was to investigate the association between a set of US features and radiographic and clinical progression of knee OA after two years of follow up.

Methods

A total of 125 patients  fulfilling American College of Rheumatology clinical criteria for knee OA1 underwent US examination of the most symptomatic knee. The US protocol included assessment of synovial hypertrophy, joint effusion, infrapatellar bursitis,  Baker’s cyst, medial meniscus protrusion and cartilage thickness. Clinical progression was defined using  the inverse OARSI responder criteria 2or progression to total knee replacement. A 2-point or more increase in Altman score or progression to total knee replacement was considered radiologic progression. Regression analyses were performed with US features as independent variables and progression (two separate models for clinical progression and radiographic progression) as dependent variable. 

Results

A total of 31 (25%) patients fulfilled the criteria of clinical progression and 60 (48%) patients fulfilled the criteria of radiologic progression. Presence of Baker’s cyst showed a statistically significant association with clinical (OR: 3.07; 95% CI: 1.21 – 7.78) as well as radiological (OR: 2.84; 95% CI: 1.17 – 6.90) progression. Synovial hypertrophy showed a weaker but consistent association with clinical- as well as radiologic progression (OR: 2.11; 95% CI: 0.80 – 5.57)

Conclusion

We demonstrated a longitudinal association between Baker’s cyst (and to a lesser extent synovial hypertrophy) at baseline and radiological and clinical progression after two years. When confirmed, these inflammatory variables might be candidate features to help define knee OA patients with worse prognosis.

Reference List

  (1)   Altman R, Asch E, Bloch D et al. Development of criteria for the classification and reporting of osteoarthritis. Classification of osteoarthritis of the knee. Diagnostic and Therapeutic Criteria Committee of the American Rheumatism Association. Arthritis Rheum 1986;29(8):1039-1049.

  (2)   Pham T, van der Heijde D, Altman RD et al. OMERACT-OARSI initiative: Osteoarthritis Research Society International set of responder criteria for osteoarthritis clinical trials revisited. Osteoarthritis Cartilage 2004;12(5):389-399.

Disclosure:

K. Bevers,
None;

J. E. Vriezekolk,
None;

J. W. J. Bijlsma,
None;

E. van den Ende,
None;

A. A. den Broeder,
None.

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