title: Patterns of Coexisting Lesions Detected on Magnetic Resonance Imaging and Relationship to Incident Knee Osteoarthritis: The Multicenter Osteoarthritis Study.
abstract: OBJECTIVE
  To identify patterns of coexisting lesions seen on magnetic resonance imaging (MRI) in knees that are free of radiographic osteoarthritis (OA) and to examine the relationship of these MRI-detected lesions to incident OA.
  
  
  METHODS
  Study subjects were individuals enrolled in the Multicenter Osteoarthritis Study, a prospective cohort study. In each subject, 1 knee in which radiographic OA was absent in both the tibiofemoral and patellofemoral joints at baseline was selected for study, with followup for 84 months. We used a novel approach, latent class analysis, to group the constellation of MRI lesions in each joint, i.e., cartilage damage, bone marrow lesion, meniscal tear, meniscal extrusion, synovitis, and effusion, into a manageable number of subgroups. The association of these subgroups with incident radiographic OA in the same joint was assessed using logistic regression.
  
  
  RESULTS
  Among 885 eligible knees (203 with incident disease in the tibiofemoral joint, 64 with incident disease in the patellofemoral joint), 4 latent subgroups in the tibiofemoral joint were identified (described briefly as minimal lesions, mild lesions, moderate lesions [but limited meniscal lesions], and severe lesions). The odds ratios of incident tibiofemoral joint OA in the latter 3 subgroups (compared to the knees with minimal lesions as the referent) were 5.6, 1.8, and 5.0, respectively. A similar set of 4 subgroups in the patellofemoral joint was identified, except that the fourth subgroup had limited meniscal lesions. The odds ratios of incident disease in the patellofemoral joint were 3.8, 5.1, and 13.7 in the subgroups with mild lesions, moderate lesions, and severe lesions, respectively.
  
  
  CONCLUSIONS
  Different patterns of coexisting MRI lesions, which have different implications with regard to risk of knee OA, were identified. Meniscal damage seemed to play a different role in the development of incident disease in tibiofemoral versus patellofemoral joints.
authors.affiliation: Boston University School of Medicine, Boston, Massachusetts.
authors.forename: Jingbo
authors.initials: J
authors.lastname: Niu
authors.affiliation: Boston University School of Medicine, Boston, Massachusetts, and University of Manchester, Manchester, UK.
authors.forename: David T
authors.initials: DT
authors.lastname: Felson
authors.affiliation: Boston University School of Medicine, Boston, Massachusetts.
authors.forename: Tuhina
authors.initials: T
authors.lastname: Neogi
authors.affiliation: University of California, San Francisco.
authors.forename: Michael C
authors.initials: MC
authors.lastname: Nevitt
authors.affiliation: Boston University School of Medicine and Boston Core Imaging Lab, LLC, Boston, Massachusetts.
authors.forename: Ali
authors.initials: A
authors.lastname: Guermazi
authors.affiliation: Boston University School of Medicine and Boston Core Imaging Lab, LLC, Boston, Massachusetts, and University of Erlangen-Nuremberg, Erlangen, Germany.
authors.forename: Frank
authors.initials: F
authors.lastname: Roemer
authors.affiliation: University of Alabama School of Medicine, Birmingham.
authors.forename: Cora E
authors.initials: CE
authors.lastname: Lewis
authors.affiliation: University of Iowa, Iowa City.
authors.forename: James
authors.initials: J
authors.lastname: Torner
authors.affiliation: Boston University School of Medicine, Boston, Massachusetts.
authors.forename: Yuqing
authors.initials: Y
authors.lastname: Zhang
mesh_terms: D000368:Aged; D001853:Bone Marrow / Q000473:pathology*; D002358:Cartilage, Articular / Q000473:pathology*; D015331:Cohort Studies; D018450:Disease Progression; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000473:pathology; D016015:Logistic Models; D008279:Magnetic Resonance Imaging; D008297:Male; D008592:Menisci, Tibial / Q000473:pathology*; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000000981:diagnostic imaging / Q000473:pathology*; D057071:Patellofemoral Joint / Q000473:pathology*; D011446:Prospective Studies; D011859:Radiography; D013585:Synovitis / Q000473:pathology*