Cyst-like lesions of the knee joint and their relation to incident knee pain and development of radiographic osteoarthritis: the MOST study.
OBJECTIVE
To determine whether intra- and periarticular cyst-like lesions of the knee are associated with incident knee pain and incident radiographic knee osteoarthritis (OA).


METHODS
The Multicenter Osteoarthritis (MOST) Study is a cohort of individuals who have or are at high risk for knee OA. Using a nested case-control study design, we investigated the associations of cyst-like lesions (Baker's, meniscal and proximal tibiofibular joint (PTFJ) cysts, and prepatellar and anserine bursitides) with (1) incident pain at 15- or 30-month follow-up and (2) incident radiographic OA at 30-month follow-up. Baseline cyst-like lesions were scored semiquantitatively using the Whole Organ Magnetic Resonance Imaging Score (WORMS). Conditional logistic regression models were used to assess the relation between these lesions and the outcomes, adjusting for potential confounding factors (i.e., cartilage loss, meniscal damage, bone marrow lesions, synovitis and joint effusion, which were also scored using WORMS).


RESULTS
Incident knee pain study included 157 cases and 336 controls. Prevalence of meniscal and PTFJ cysts in the case group was twice that in the control group [9 (6%) vs 9 (3%) and 9 (6%) vs 10 (3%), respectively]. Incident radiographic OA study included 149 cases and 298 controls. Prevalence of grade 2 Baker's cysts and PTFJ cysts in the case group was approximately four times that in the control group [16(11%) vs 9 (3%) and 6 (4%) vs 3 (1%), respectively]. However, none of the cyst-like lesions was associated with incident pain or radiographic OA after fully adjusted logistic regression analyses and correction of P-values for multiple comparisons.


CONCLUSIONS
None of the analyzed lesions was an independent predictor of incident knee pain or radiographic OA. Intra- and periarticular cyst-like lesions are likely to be a secondary phenomenon seen in painful or OA-affected knees, rather than a primary trigger for incident knee pain or radiographic OA.
Guermazi
A
A
Department of Radiology, Boston University School of Medicine, 820 Harrison Avenue, Boston, MA 02118, USA. guermazi@bu.edu
Hayashi
D
D
Roemer
F W
FW
Niu
J
J
Yang
M
M
Lynch
J A
JA
Torner
J C
JC
Lewis
C E
CE
Sack
B
B
Felson
D T
DT
Nevitt
M C
MC
D000368:Aged; D001845:Bone Cysts / Q000000981:diagnostic imaging / Q000473:pathology*; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000473:pathology; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000473:pathology; D010146:Pain / Q000453:epidemiology*; D011151:Popliteal Cyst / Q000000981:diagnostic imaging / Q000473:pathology*; D011859:Radiography; D012307:Risk Factors
Knee. 2008 Dec;15(6):423-38
18559292
Arthritis Rheum. 2007 Sep;56(9):2986-92
17763427
Arthritis Rheum. 2003 Oct;48(10):2836-44
14558089
Radiology. 2006 Jun;239(3):811-7
16714463
J Rheumatol. 1988 Dec;15(12):1833-40
3068365
J Rheumatol. 2000 Apr;27(4):1096-8
10782844
Radiol Clin North Am. 2009 Jul;47(4):687-701
19631076
Ann Rheum Dis. 1957 Dec;16(4):494-502
13498604
Radiology. 1996 Oct;201(1):247-50
8816552
Skeletal Radiol. 2004 Apr;33(4):187-209
14991250
Eur Radiol. 2004 Sep;14(9):1568-73
15150666
Radiol Clin North Am. 1996 Mar;34(2):395-425, xi-xii
8633123
AJR Am J Roentgenol. 2001 Aug;177(2):409-13
11461872
Skeletal Radiol. 2003 Mar;32(3):128-32
12605275
N Engl J Med. 2008 Sep 11;359(11):1108-15
18784100
AJR Am J Roentgenol. 1994 Jul;163(1):155-61
8010203
Arthritis Rheum. 2007 Dec;56(12):4048-54
18050201
JAMA. 2001 Jul 11;286(2):188-95
11448282
Osteoarthritis Cartilage. 2004 Mar;12(3):177-90
14972335
J Clin Rheumatol. 2007 Apr;13(2):63-5
17414530
AJR Am J Roentgenol. 2003 May;180(5):1431-6
12704063
Rheumatol Int. 2008 Dec;29(2):141-6
18584176
J Rheumatol. 2001 Jun;28(6):1330-7
11409127
Radiology. 2003 Feb;226(2):373-81
12563128
Curr Probl Diagn Radiol. 2005 Jul-Aug;34(4):143-59
16012485
Osteoarthritis Cartilage. 2007;15 Suppl A:A1-56
17320422