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Abstract：
To examine whether knee subchondral cysts, measured on magnetic resonance imaging (MRI), are associated with incident knee osteoarthritis (OA) outcomes.
We used longitudinal data from the Multicenter Osteoarthritis Study, a community-based cohort of subjects with risk factors for knee OA. Participants without a history of knee surgery and/or inflammatory arthritis (i.e., rheumatoid arthritis and gout) were followed up for 84 months for the following incident outcomes: 1) radiographic knee OA (Kellgren/Lawrence grade ≥2), 2) symptomatic radiographic knee OA (radiographic knee OA and frequent knee pain), and 3) frequent knee pain (with or without radiographic knee OA). In a subset of participants, subchondral cysts were scored on baseline MRIs of 1 knee. Multiple logistic regression, with adjustment for participant characteristics and other baseline knee MRI findings, was used to assess whether subchondral cysts were predictive of incident outcomes.
Among the participants with knees eligible for analyses of outcomes over 84 months, incident radiographic knee OA occurred in 22.8% of knees with no baseline radiographic knee OA, symptomatic radiographic knee OA occurred in 17.0% of knees with no baseline symptomatic radiographic knee OA, and frequent knee pain (with or without radiographic knee OA) occurred in 28.8% of knees with no baseline radiographic knee OA and 43.7% of knees with baseline radiographic knee OA. With adjustment for age, sex, and body mass index, the presence of subchondral cysts was not associated with incident radiographic knee OA but was associated with increased odds of incident symptomatic radiographic knee OA (odds ratio 1.92 [95% confidence interval 1.16-3.19]) and increased odds of incident frequent knee pain in those who had radiographic knee OA at baseline (odds ratio 2.11 [95% confidence interval 0.87-5.12]). Stronger and significant associations were observed for outcomes based on consistent reports of frequent knee pain within ~1 month of the study visit.
Subchondral cysts are likely to be a secondary phenomenon, rather than a primary trigger, of radiographic knee OA, and may predict symptoms in knees with existing disease.
We used longitudinal data from the Multicenter Osteoarthritis Study, a community-based cohort of subjects with risk factors for knee OA. Participants without a history of knee surgery and/or inflammatory arthritis (i.e., rheumatoid arthritis and gout) were followed up for 84 months for the following incident outcomes: 1) radiographic knee OA (Kellgren/Lawrence grade ≥2), 2) symptomatic radiographic knee OA (radiographic knee OA and frequent knee pain), and 3) frequent knee pain (with or without radiographic knee OA). In a subset of participants, subchondral cysts were scored on baseline MRIs of 1 knee. Multiple logistic regression, with adjustment for participant characteristics and other baseline knee MRI findings, was used to assess whether subchondral cysts were predictive of incident outcomes.
Among the participants with knees eligible for analyses of outcomes over 84 months, incident radiographic knee OA occurred in 22.8% of knees with no baseline radiographic knee OA, symptomatic radiographic knee OA occurred in 17.0% of knees with no baseline symptomatic radiographic knee OA, and frequent knee pain (with or without radiographic knee OA) occurred in 28.8% of knees with no baseline radiographic knee OA and 43.7% of knees with baseline radiographic knee OA. With adjustment for age, sex, and body mass index, the presence of subchondral cysts was not associated with incident radiographic knee OA but was associated with increased odds of incident symptomatic radiographic knee OA (odds ratio 1.92 [95% confidence interval 1.16-3.19]) and increased odds of incident frequent knee pain in those who had radiographic knee OA at baseline (odds ratio 2.11 [95% confidence interval 0.87-5.12]). Stronger and significant associations were observed for outcomes based on consistent reports of frequent knee pain within ~1 month of the study visit.
Subchondral cysts are likely to be a secondary phenomenon, rather than a primary trigger, of radiographic knee OA, and may predict symptoms in knees with existing disease.
摘要：
检查膝关节软骨下囊肿，在磁共振成像（MRI）上测量，与膝骨关节炎（OA）的预后相关。
我们使用了多中心骨关节炎研究的纵向数据，以社区为基础的有膝关节OA危险因素的受试者队列研究.没有膝关节手术和/或炎性关节炎病史的参与者(即，类风湿关节炎和痛风）随访84个月，结果如下：1）影像学膝关节OA（Kellgren/Lawrence等级≥2），2）症状性影像学膝关节OA（影像学膝关节OA和频繁的膝关节疼痛），和3）频繁的膝关节疼痛（有或没有影像学膝关节OA）。在一部分参与者中，软骨下囊肿在1个膝关节的基线MRI上进行评分.多元逻辑回归，调整参与者特征和其他基线膝关节MRI发现，用于评估软骨下囊肿是否可预测事件结局。
在膝盖有资格接受84个月以上结果分析的参与者中，射入射线照相膝关节OA发生在没有基线射线照相膝关节OA的22.8%的膝关节中，症状性影像学膝关节OA发生在17.0%的膝关节，没有基线症状性影像学膝关节OA，和频繁的膝关节疼痛（有或没有影像学膝关节OA）发生在28.8％的没有基线影像学膝关节OA的膝盖和43.7％的基线影像学膝关节OA的膝盖。随着年龄的调整，性别,和身体质量指数,软骨下囊肿的存在与影像学膝关节OA的发生率无关,但与基线时影像学膝关节OA的发生率增加(比值比1.92[95%置信区间1.16~3.19])以及膝关节疼痛的发生率增加相关(比值比2.11[95%置信区间0.87~5.12]).基于研究访视后约1个月内频繁膝关节疼痛的一致报告，观察到结果具有更强和显著的相关性。
软骨下囊肿可能是次要现象，而不是主要的触发器，影像学膝关节OA，并可能预测存在疾病的膝盖症状。
我们使用了多中心骨关节炎研究的纵向数据，以社区为基础的有膝关节OA危险因素的受试者队列研究.没有膝关节手术和/或炎性关节炎病史的参与者(即，类风湿关节炎和痛风）随访84个月，结果如下：1）影像学膝关节OA（Kellgren/Lawrence等级≥2），2）症状性影像学膝关节OA（影像学膝关节OA和频繁的膝关节疼痛），和3）频繁的膝关节疼痛（有或没有影像学膝关节OA）。在一部分参与者中，软骨下囊肿在1个膝关节的基线MRI上进行评分.多元逻辑回归，调整参与者特征和其他基线膝关节MRI发现，用于评估软骨下囊肿是否可预测事件结局。
在膝盖有资格接受84个月以上结果分析的参与者中，射入射线照相膝关节OA发生在没有基线射线照相膝关节OA的22.8%的膝关节中，症状性影像学膝关节OA发生在17.0%的膝关节，没有基线症状性影像学膝关节OA，和频繁的膝关节疼痛（有或没有影像学膝关节OA）发生在28.8％的没有基线影像学膝关节OA的膝盖和43.7％的基线影像学膝关节OA的膝盖。随着年龄的调整，性别,和身体质量指数,软骨下囊肿的存在与影像学膝关节OA的发生率无关,但与基线时影像学膝关节OA的发生率增加(比值比1.92[95%置信区间1.16~3.19])以及膝关节疼痛的发生率增加相关(比值比2.11[95%置信区间0.87~5.12]).基于研究访视后约1个月内频繁膝关节疼痛的一致报告，观察到结果具有更强和显著的相关性。
软骨下囊肿可能是次要现象，而不是主要的触发器，影像学膝关节OA，并可能预测存在疾病的膝盖症状。
