title: Biomechanical factors and physical examination findings in osteoarthritis of the knee: associations with tissue abnormalities assessed by conventional radiography and high-resolution 3.0 Tesla magnetic resonance imaging.
abstract: BACKGROUND
  We aimed to explore the associations between knee osteoarthritis (OA)-related tissue abnormalities assessed by conventional radiography (CR) and by high-resolution 3.0 Tesla magnetic resonance imaging (MRI), as well as biomechanical factors and findings from physical examination in patients with knee OA.
  
  
  METHODS
  This was an explorative cross-sectional study of 105 patients with knee OA. Index knees were imaged using CR and MRI. Multiple features from CR and MRI (cartilage, osteophytes, bone marrow lesions, effusion and synovitis) were related to biomechanical factors (quadriceps and hamstrings muscle strength, proprioceptive accuracy and varus-valgus laxity) and physical examination findings (bony tenderness, crepitus, bony enlargement and palpable warmth), using multivariable regression analyses.
  
  
  RESULTS
  Quadriceps weakness was associated with cartilage integrity, effusion, synovitis (all detected by MRI) and CR-detected joint space narrowing. Knee joint laxity was associated with MRI-detected cartilage integrity, CR-detected joint space narrowing and osteophyte formation. Multiple tissue abnormalities including cartilage integrity, osteophytes and effusion, but only those detected by MRI, were found to be associated with physical examination findings such as crepitus.
  
  
  CONCLUSIONS
  We observed clinically relevant findings, including a significant association between quadriceps weakness and both effusion and synovitis, detected by MRI. Inflammation was detected in over one-third of the participants, emphasizing the inflammatory component of OA and a possible important role for anti-inflammatory therapies in knee OA. In general, OA-related tissue abnormalities of the knee, even those detected by MRI, were found to be discordant with biomechanical and physical examination features.
authors.forename: Jesper
authors.initials: J
authors.lastname: Knoop
authors.forename: Joost
authors.initials: J
authors.lastname: Dekker
authors.forename: Jan-Paul
authors.initials: JP
authors.lastname: Klein
authors.forename: Marike
authors.initials: M
authors.lastname: van der Leeden
authors.forename: Martin
authors.initials: M
authors.lastname: van der Esch
authors.forename: Dick
authors.initials: D
authors.lastname: Reiding
authors.forename: Ramon E
authors.initials: RE
authors.lastname: Voorneman
authors.forename: Martijn
authors.initials: M
authors.lastname: Gerritsen
authors.forename: Leo D
authors.initials: LD
authors.lastname: Roorda
authors.forename: Martijn P M
authors.initials: MP
authors.lastname: Steultjens
authors.forename: Willem F
authors.initials: WF
authors.lastname: Lems
mesh_terms: D000328:Adult; D000368:Aged; D018771:Arthralgia / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology; D001175:Arthrography; D001696:Biomechanical Phenomena / Q000502:physiology; D002356:Cartilage / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D015994:Incidence; D007593:Joint Instability / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology; D007719:Knee Joint / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength / Q000502:physiology; D020370:Osteoarthritis, Knee / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000503:physiopathology; D010808:Physical Examination; D012044:Regression Analysis