title: Meniscal extrusion or subchondral damage characterize incident accelerated osteoarthritis: Data from the Osteoarthritis Initiative.
abstract: Knee osteoarthritis (KOA) is typically a slowly progressive disorder; however, a subset of knees progress with dramatic rapidity. We aimed to describe magnetic resonance imaging (MRI) findings that are associated with accelerated KOA. We conducted a longitudinal descriptive study in the Osteoarthritis Initiative cohort. We selected participants who had no radiographic KOA at baseline with one of the following in the most severe knee: (1) accelerated KOA (progressed to end-stage KOA within 48 months), (2) common KOA, and (3) no KOA at all visits. We enriched the sample by selecting knees with a self-reported or suspected knee injury. A musculoskeletal radiologist blinded to group assignments but not to time sequence performed MRI readings for the visit before and after an injury. We assessed 38 participants (knees), 66% were female, mean age 61 (9) years, and mean body mass index 28.5 (4.9) kg/m(2). Fifteen of 20 knees with no or common KOA, had no incident findings consistent with acute damage. Among the 18 knees with accelerated KOA most had incident findings: 13 (72%) had incident medial meniscal pathology with extrusion and 5 (28%) knees had subchondral damage. Incident MRI findings that are associated with incident accelerated KOA are characterized by structural damage that compromises subchondral bone or the function of the meniscus. Recognizing meniscal extrusion and/or change in shape, lateral meniscal tear, or acute subchondral damage may be vital for identifying individuals at risk for accelerated KOA.
authors.affiliation: Division of Rheumatology, Tufts Medical Center, Boston, Massachusetts.
authors.forename: Jeffrey B
authors.identifier: http://orcid.org/0000-0001-6098-4273
authors.initials: JB
authors.lastname: Driban
authors.affiliation: Department of Radiology, Tufts Medical Center, Boston, Massachusetts.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Ward
authors.affiliation: Center for Primary Care and Prevention, Alpert Medical School of Brown University, Pawtucket, Rhode Island.
authors.forename: Charles B
authors.initials: CB
authors.lastname: Eaton
authors.affiliation: Section of Immunology, Allergy, and Rheumatology, Baylor College of Medicine, Houston, Texas.|Center for Innovations in Quality, Effectiveness and Safety Medical Care Line and Research Care Line; Michael E. DeBakey VAMC, Houston, Texas.
authors.forename: Grace H
authors.initials: GH
authors.lastname: Lo
authors.affiliation: The Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, Massachusetts.|Tufts Clinical and Translational Science Institute, Tufts University, Boston, Massachusetts.
authors.forename: Lori Lyn
authors.initials: LL
authors.lastname: Price
authors.affiliation: Division of Rheumatology, Immunology & Allergy, Brigham & Women's Hospital and Harvard Medical School, Boston, Massachusetts.
authors.forename: Bing
authors.initials: B
authors.lastname: Lu
authors.affiliation: Division of Rheumatology, Tufts Medical Center, Boston, Massachusetts.
authors.forename: Timothy E
authors.initials: TE
authors.lastname: McAlindon
mesh_terms: D000368:Aged; D002358:Cartilage, Articular / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007718:Knee Injuries / Q000175:diagnosis*; D007719:Knee Joint / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008592:Menisci, Tibial / Q000473:pathology*; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000175:diagnosis*; D012189:Retrospective Studies; D000070600:Tibial Meniscus Injuries
keywords: ligaments; magnetic resonance imaging; meniscus; osteoarthritis