title: Cross-Sectional and Longitudinal Associations Between Serum Levels of High-Sensitivity C-Reactive Protein, Knee Bone Marrow Lesions, and Knee Pain in Patients With Knee Osteoarthritis.
abstract: To describe associations between serum high-sensitivity C-reactive protein (hsCRP), knee bone marrow lesions (BMLs), and knee pain, cross-sectionally and longitudinally, in patients with knee osteoarthritis (OA).
  
  
  
  Patients (n = 192) with symptomatic knee OA (mean age 63 years, range 50-79, women 53%) were assessed at baseline and after 24 months. Serum hsCRP was measured using enzyme-linked immunosorbent assay. Knee BMLs were scored using the modified Whole-Organ Magnetic Resonance Imaging (MRI) Score from T2-weighted fat-supressed fast spin-echo MRI. Knee pain was assessed using the Western Ontario and McMaster Universities Osteoarthritis Index.
  
  
  
  Quartiles of baseline serum hsCRP were associated with the presence of knee BMLs (prevalence ratio 1.07 per quartile [95% confidence interval (95% CI) 1.00, 1.15]) and total knee pain scores (β 13.66 per quartile [95% CI 2.26, 25.07]) in multivariable analyses. Longitudinally, higher baseline hsCRP was associated with an increase in BML score (risk ratio 1.37 per quartile [95% CI 1.10, 1.70]), and change in hsCRP was positively associated with change in BML score (β 0.19 [95% CI 0.05, 0.34]) in adjusted analyses. Baseline hsCRP was not associated with change in total knee pain, but change in hsCRP was positively and significantly associated with change in total knee pain (β 4.71 [95% CI 0.48, 8.94]). This became nonsignificant after adjustment for changes in BML score.
  
  
  
  In patients with knee OA, serum hsCRP is associated with knee BML scores and, to a lesser extent, pain both cross-sectionally and longitudinally, suggesting that inflammation is linked with BMLs and their associated pain.
authors.affiliation: Zhaohua Zhu, MD: Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia, and Arthritis Research Institute, Anhui Medical University, Hefei, Anhui, China.
authors.forename: Zhaohua
authors.initials: Z
authors.lastname: Zhu
authors.affiliation: Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.
authors.forename: Xingzhong
authors.initials: X
authors.lastname: Jin
authors.affiliation: Bing Wang, MD, Anita Wluka, MD, PhD, Flavia Cicuttini, MD, PhD: Monash University, Melbourne, Victoria, Australia.
authors.forename: Bing
authors.initials: B
authors.lastname: Wang
authors.affiliation: Bing Wang, MD, Anita Wluka, MD, PhD, Flavia Cicuttini, MD, PhD: Monash University, Melbourne, Victoria, Australia.
authors.forename: Anita
authors.identifier: 0000-0001-8024-9049
authors.initials: A
authors.lastname: Wluka
authors.affiliation: Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.
authors.forename: Benny
authors.initials: B
authors.lastname: Antony
authors.affiliation: Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.
authors.forename: Laura L
authors.identifier: 0000-0002-4336-0095
authors.initials: LL
authors.lastname: Laslett
authors.affiliation: Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.
authors.forename: Tania
authors.initials: T
authors.lastname: Winzenberg
authors.affiliation: Bing Wang, MD, Anita Wluka, MD, PhD, Flavia Cicuttini, MD, PhD: Monash University, Melbourne, Victoria, Australia.
authors.forename: Flavia
authors.initials: F
authors.lastname: Cicuttini
authors.affiliation: Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.
authors.forename: Graeme
authors.initials: G
authors.lastname: Jones
authors.affiliation: Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia, Arthritis Research Institute, Anhui Medical University, Hefei, Anhui, China, and Monash University, Melbourne, Victoria, Australia. changhai.ding@utas.edu.au.
authors.forename: Changhai
authors.initials: C
authors.lastname: Ding
mesh_terms: D000368:Aged; D018771:Arthralgia / Q000209:etiology / Q000473:pathology*; D001853:Bone Marrow / Q000000981:diagnostic imaging / Q000473:pathology; D001855:Bone Marrow Diseases / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology*; D002097:C-Reactive Protein / Q000032:analysis*; D003430:Cross-Sectional Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007717:Knee / Q000000981:diagnostic imaging / Q000473:pathology; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000097:blood / Q000150:complications* / Q000473:pathology
chemical_list: D002097:C-Reactive Protein