Relationship between knee pain and the presence, location, size and phenotype offemorotibial denuded areas of subchondral bone as visualized by MRI

S. Cotofana, B. T. Wyman, O. Benichou, D. Dreher, M. Nevitt, J. Gardiner, W. Wirth, W. Hitzl, Chian K Kwoh, F. Eckstein, R. B. Frobell

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Objective: Conflicting associations between imaging biomarkers and pain in knee osteoarthritis (OA) have been reported. A relation between pain and denuded areas of subchondral bone (dABs) has been suggested and this study explores this relationship further by relating the presence, phenotype, location and size of dABs to different measures of knee pain. Methods: 633 right knees from the Osteoarthritis Initiative (OAI) (250 men, age 61.7±9.6yrs, BMI 29.4±4.7kg/m2) were included. Manual segmentation of the femorotibial cartilage plates was performed on 3T coronal fast low angle shot with water excitation (FLASHwe) images. dABs were defined as areas where the subchondral bone was uncovered by cartilage. The following measures of pain were used: weightbearing-, non-weightbearing-, moderate-to-severe-, infrequent- and frequent knee pain. Results: Using pain measures from subjects without dABs as a reference, those with at least one dAB hada 1.64-fold higher prevalence ratio [PR, 95% confidence interval (CI) 1.24-2.18] to have frequent and 1.45-fold higher for moderate-to-severe knee pain (95% CI 1.13-1.85). Subjects with dABs in central subregions had a 1.53-fold increased prevalence of having weightbearing pain (95% CI 1.20-1.97), especially when the central subregion was moderately (>10%) denuded (PR 1.81, 95% CI 1.35-2.42). Individuals with cartilage-loss-type dABs had a slightly higher prevalence (PR 1.13, 95% CI 1.00-1.27) of having frequent knee pain compared to individuals with intra-chondral-osteophyte-type dABs. Conclusion: This study supports a positive relation between femorotibial dABs and knee pain, especially when the dABs are located centrally (i.e., in weightbearing regions) or when the respective central subregion is moderately denuded.

Original languageEnglish (US)
Pages (from-to)1214-1222
Number of pages9
JournalOsteoarthritis and Cartilage
Volume21
Issue number9
DOIs
StatePublished - Sep 2013
Externally publishedYes

Fingerprint

Magnetic resonance imaging
Knee
Bone
Phenotype
Bone and Bones
Pain
Cartilage
Confidence Intervals
Weight-Bearing
Knee Osteoarthritis
Osteophyte
Biomarkers
Imaging techniques
Water

Keywords

  • Cartilage
  • Denuded area of subchondral bone
  • MRI
  • Pain

ASJC Scopus subject areas

  • Biomedical Engineering
  • Orthopedics and Sports Medicine
  • Rheumatology

Cite this

Relationship between knee pain and the presence, location, size and phenotype offemorotibial denuded areas of subchondral bone as visualized by MRI. / Cotofana, S.; Wyman, B. T.; Benichou, O.; Dreher, D.; Nevitt, M.; Gardiner, J.; Wirth, W.; Hitzl, W.; Kwoh, Chian K; Eckstein, F.; Frobell, R. B.

In: Osteoarthritis and Cartilage, Vol. 21, No. 9, 09.2013, p. 1214-1222.

Research output: Contribution to journalArticle

Cotofana, S, Wyman, BT, Benichou, O, Dreher, D, Nevitt, M, Gardiner, J, Wirth, W, Hitzl, W, Kwoh, CK, Eckstein, F & Frobell, RB 2013, 'Relationship between knee pain and the presence, location, size and phenotype offemorotibial denuded areas of subchondral bone as visualized by MRI', Osteoarthritis and Cartilage, vol. 21, no. 9, pp. 1214-1222. https://doi.org/10.1016/j.joca.2013.04.001
Cotofana, S. ; Wyman, B. T. ; Benichou, O. ; Dreher, D. ; Nevitt, M. ; Gardiner, J. ; Wirth, W. ; Hitzl, W. ; Kwoh, Chian K ; Eckstein, F. ; Frobell, R. B. / Relationship between knee pain and the presence, location, size and phenotype offemorotibial denuded areas of subchondral bone as visualized by MRI. In: Osteoarthritis and Cartilage. 2013 ; Vol. 21, No. 9. pp. 1214-1222.
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abstract = "Objective: Conflicting associations between imaging biomarkers and pain in knee osteoarthritis (OA) have been reported. A relation between pain and denuded areas of subchondral bone (dABs) has been suggested and this study explores this relationship further by relating the presence, phenotype, location and size of dABs to different measures of knee pain. Methods: 633 right knees from the Osteoarthritis Initiative (OAI) (250 men, age 61.7±9.6yrs, BMI 29.4±4.7kg/m2) were included. Manual segmentation of the femorotibial cartilage plates was performed on 3T coronal fast low angle shot with water excitation (FLASHwe) images. dABs were defined as areas where the subchondral bone was uncovered by cartilage. The following measures of pain were used: weightbearing-, non-weightbearing-, moderate-to-severe-, infrequent- and frequent knee pain. Results: Using pain measures from subjects without dABs as a reference, those with at least one dAB hada 1.64-fold higher prevalence ratio [PR, 95{\%} confidence interval (CI) 1.24-2.18] to have frequent and 1.45-fold higher for moderate-to-severe knee pain (95{\%} CI 1.13-1.85). Subjects with dABs in central subregions had a 1.53-fold increased prevalence of having weightbearing pain (95{\%} CI 1.20-1.97), especially when the central subregion was moderately (>10{\%}) denuded (PR 1.81, 95{\%} CI 1.35-2.42). Individuals with cartilage-loss-type dABs had a slightly higher prevalence (PR 1.13, 95{\%} CI 1.00-1.27) of having frequent knee pain compared to individuals with intra-chondral-osteophyte-type dABs. Conclusion: This study supports a positive relation between femorotibial dABs and knee pain, especially when the dABs are located centrally (i.e., in weightbearing regions) or when the respective central subregion is moderately denuded.",
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T1 - Relationship between knee pain and the presence, location, size and phenotype offemorotibial denuded areas of subchondral bone as visualized by MRI

AU - Cotofana, S.

AU - Wyman, B. T.

AU - Benichou, O.

AU - Dreher, D.

AU - Nevitt, M.

AU - Gardiner, J.

AU - Wirth, W.

AU - Hitzl, W.

AU - Kwoh, Chian K

AU - Eckstein, F.

AU - Frobell, R. B.

PY - 2013/9

Y1 - 2013/9

N2 - Objective: Conflicting associations between imaging biomarkers and pain in knee osteoarthritis (OA) have been reported. A relation between pain and denuded areas of subchondral bone (dABs) has been suggested and this study explores this relationship further by relating the presence, phenotype, location and size of dABs to different measures of knee pain. Methods: 633 right knees from the Osteoarthritis Initiative (OAI) (250 men, age 61.7±9.6yrs, BMI 29.4±4.7kg/m2) were included. Manual segmentation of the femorotibial cartilage plates was performed on 3T coronal fast low angle shot with water excitation (FLASHwe) images. dABs were defined as areas where the subchondral bone was uncovered by cartilage. The following measures of pain were used: weightbearing-, non-weightbearing-, moderate-to-severe-, infrequent- and frequent knee pain. Results: Using pain measures from subjects without dABs as a reference, those with at least one dAB hada 1.64-fold higher prevalence ratio [PR, 95% confidence interval (CI) 1.24-2.18] to have frequent and 1.45-fold higher for moderate-to-severe knee pain (95% CI 1.13-1.85). Subjects with dABs in central subregions had a 1.53-fold increased prevalence of having weightbearing pain (95% CI 1.20-1.97), especially when the central subregion was moderately (>10%) denuded (PR 1.81, 95% CI 1.35-2.42). Individuals with cartilage-loss-type dABs had a slightly higher prevalence (PR 1.13, 95% CI 1.00-1.27) of having frequent knee pain compared to individuals with intra-chondral-osteophyte-type dABs. Conclusion: This study supports a positive relation between femorotibial dABs and knee pain, especially when the dABs are located centrally (i.e., in weightbearing regions) or when the respective central subregion is moderately denuded.

AB - Objective: Conflicting associations between imaging biomarkers and pain in knee osteoarthritis (OA) have been reported. A relation between pain and denuded areas of subchondral bone (dABs) has been suggested and this study explores this relationship further by relating the presence, phenotype, location and size of dABs to different measures of knee pain. Methods: 633 right knees from the Osteoarthritis Initiative (OAI) (250 men, age 61.7±9.6yrs, BMI 29.4±4.7kg/m2) were included. Manual segmentation of the femorotibial cartilage plates was performed on 3T coronal fast low angle shot with water excitation (FLASHwe) images. dABs were defined as areas where the subchondral bone was uncovered by cartilage. The following measures of pain were used: weightbearing-, non-weightbearing-, moderate-to-severe-, infrequent- and frequent knee pain. Results: Using pain measures from subjects without dABs as a reference, those with at least one dAB hada 1.64-fold higher prevalence ratio [PR, 95% confidence interval (CI) 1.24-2.18] to have frequent and 1.45-fold higher for moderate-to-severe knee pain (95% CI 1.13-1.85). Subjects with dABs in central subregions had a 1.53-fold increased prevalence of having weightbearing pain (95% CI 1.20-1.97), especially when the central subregion was moderately (>10%) denuded (PR 1.81, 95% CI 1.35-2.42). Individuals with cartilage-loss-type dABs had a slightly higher prevalence (PR 1.13, 95% CI 1.00-1.27) of having frequent knee pain compared to individuals with intra-chondral-osteophyte-type dABs. Conclusion: This study supports a positive relation between femorotibial dABs and knee pain, especially when the dABs are located centrally (i.e., in weightbearing regions) or when the respective central subregion is moderately denuded.

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KW - Denuded area of subchondral bone

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KW - Pain

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