title: Quantitative Assessment of Knee Effusion-Synovitis in Older Adults: Association With Knee Structural Abnormalities.
abstract: OBJECTIVE
  To describe the natural history of quantitatively measured knee effusion-synovitis and the longitudinal associations between effusion-synovitis and knee structural factors, including cartilage defects, cartilage volume, subchondral bone marrow lesions, and meniscal pathology, in older adults.
  
  
  METHODS
  A total of 406 subjects (with a mean age of 63 years, 50% women) were randomly selected at baseline and followed up 2.7 years later. T2- or T1-weighted fat saturation magnetic resonance imaging was used to assess knee effusion-synovitis maximal area, cartilage defects, cartilage volume, bone marrow lesions, and meniscal pathology at baseline and follow-up. Multivariable generalized linear regression was performed to analyze the associations between the maximal area of effusion-synovitis and other joint structural factors after adjustment for age, sex, body mass index, tibial bone area, and/or radiographic osteoarthritis (OA).
  
  
  RESULTS
  Over 2.7 years of follow-up, the size of effusion-synovitis increased in 29%, remained stable in 50%, and decreased in 22% of the participants. Baseline effusion-synovitis maximal area was significantly associated with changes in knee cartilage defects (β = 0.18 [95% confidence interval (95% CI)] 0.07, 0.29), bone marrow lesions (β = 0.17 [95% CI 0.05, 0.30]), and cartilage volume (β = -0.40 [95% CI -0.71, -0.09]) but not with change in meniscal pathology. In contrast, baseline structural measures were not associated with change or increase in effusion-synovitis maximal area.
  
  
  CONCLUSIONS
  Our findings indicate that knee effusion-synovitis is not static in older adults. It is predictive of, but not predicted by, other structural abnormalities, suggesting a potential role in early knee OA changes.
authors.affiliation: Menzies Institute for Medical Research and University of Tasmania, Hobart, Tasmania, Australia.
authors.forename: Xia
authors.initials: X
authors.lastname: Wang
authors.affiliation: Menzies Institute for Medical Research and University of Tasmania, Hobart, Tasmania, Australia.
authors.forename: Leigh
authors.initials: L
authors.lastname: Blizzard
authors.affiliation: Menzies Institute for Medical Research and University of Tasmania, Hobart, Tasmania, Australia.
authors.forename: Xingzhong
authors.initials: X
authors.lastname: Jin
authors.affiliation: Menzies Institute for Medical Research and University of Tasmania, Hobart, Tasmania, Australia.
authors.forename: Zhongshan
authors.initials: Z
authors.lastname: Chen
authors.affiliation: Menzies Institute for Medical Research and University of Tasmania, Hobart, Tasmania, Australia.
authors.forename: Zhaohua
authors.initials: Z
authors.lastname: Zhu
authors.affiliation: Menzies Institute for Medical Research and University of Tasmania, Hobart, Tasmania, Australia.
authors.forename: Weiyu
authors.initials: W
authors.lastname: Han
authors.affiliation: Royal Hobart Hospital, Hobart, Tasmania, Australia.
authors.forename: Andrew
authors.initials: A
authors.lastname: Halliday
authors.affiliation: Monash University, Melbourne, Victoria, Australia.
authors.forename: Flavia
authors.initials: F
authors.lastname: Cicuttini
authors.affiliation: Menzies Institute for Medical Research and University of Tasmania, Hobart, Tasmania, Australia.
authors.forename: Graeme
authors.initials: G
authors.lastname: Jones
authors.affiliation: Menzies Institute for Medical Research and University of Tasmania, Hobart, Tasmania, Australia, Monash University, Melbourne, Victoria, Australia, and First Affiliated Hospital and Anhui Medical University, Hefei, China.
authors.forename: Changhai
authors.initials: C
authors.lastname: Ding
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001853:Bone Marrow / Q000473:pathology*; D002358:Cartilage, Articular / Q000473:pathology*; D018450:Disease Progression; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000473:pathology*; D016014:Linear Models; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D008592:Menisci, Tibial / Q000473:pathology*; D008875:Middle Aged; D015999:Multivariate Analysis; D009929:Organ Size; D020370:Osteoarthritis, Knee / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology*; D011859:Radiography; D013585:Synovitis / Q000150:complications / Q000473:pathology*; D013648:Tasmania