The responsiveness of novel, dynamic, contrast-enhanced magnetic resonance measures of total knee synovitis after intra-articular corticosteroid for painful osteoarthritis
| Autor: | Claire Y J Wenham, Sharon Balamoody, Richard Hodgson, P.G. Conaghan, Elizabeth M A Hensor, S. Draycott, Andrew J. Grainger |
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| Rok vydání: | 2014 |
| Předmět: |
Male
Dynamic magnetic resonance imaging medicine.medical_specialty WOMAC Knee Joint medicine.drug_class Biomedical Engineering Contrast Media Osteoarthritis Injections Intra-Articular Rheumatology Adrenal Cortex Hormones Interquartile range Synovitis Synovium medicine Humans Knee Orthopedics and Sports Medicine Aged Intra-articular corticosteroid medicine.diagnostic_test business.industry Magnetic resonance imaging Biomarker Middle Aged Osteoarthritis Knee medicine.disease Arthralgia Magnetic Resonance Imaging Surgery Treatment Outcome Corticosteroid Biomarker (medicine) Female Nuclear medicine business Body mass index |
| Zdroj: | Osteoarthritis and Cartilage. 22:1614-1618 |
| ISSN: | 1063-4584 |
| DOI: | 10.1016/j.joca.2014.05.024 |
| Popis: | Summary Objective Sensitive biomarkers are needed to understand synovial response to therapy in osteoarthritis (OA). Dynamic, contrast-enhanced magnetic resonance imaging (DCE MRI) provides quantitative, novel measures of synovial inflammation. This exploratory study examined DCE-assessed synovial response to intra-articular corticosteroid (IACS). Methods People with ACR clinical criteria OA knee underwent 3 T MRI pre- and 2 weeks post-IACS. Five MRI variables were assessed blindly: total synovial volume (semi-automated computer program), early enhancement rate (EER) and late enhancement ratio of the entire knee, synovial volume × late enhancement and a semi-quantitative (SQ) score (six sites scored 0–3). Clinical symptoms were assessed using pain visual analogue score (VAS) and WOMAC. Results 13 participants (5 male, mean age 63, mean pain VAS 66 mm mean body mass index (BMI) 31.3 kg/m2) were included. The majority of MRIs demonstrated no change in SQ score although the DCE variables changed to some extent in all. There was generally a reduction in synovial volume ((Wilcoxon test) median (interquartile range (IQR)) reduction 14 cm3 (−1, 29)), EER (0.2% (−0.3, 0.6)) and late enhancement ratio (8% (−0.5, 41)). Synovial volume × late enhancement ratio demonstrated a substantive reduction (2250 (−930, 5630)) as well as the largest effect size, r = 0.45. There was a median 26% reduction in EER in participants with good symptomatic response to IACS, contrasting with a 23% increase in those who responded poorly. Conclusions DCE MRI may be more sensitive than a SQ score at detecting post-therapy synovial changes. The association between EER and symptomatic response to IACS may reflect a closer relation of this biomarker to synovial inflammation than with volumetric assessment. |
| Databáze: | OpenAIRE |
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