title: Associations between MRI-defined structural pathology and generalized and localized knee pain - the Oulu Knee Osteoarthritis study.
abstract: To determine the associations between multi-feature structural pathology assessed using magnetic resonance imaging (MRI) and the presence of knee pain, and to determine the associations between the locations of structural changes and different knee pain patterns.
  
  
  
  Eighty symptomatic subjects with knee pain and suspicion or diagnosis of knee OA and 63 asymptomatic subjects underwent knee MRI. Severity of structural changes was graded by MRI Osteoarthritis Knee Score (MOAKS) in separate knee locations. The associations between cartilage damage, bone marrow lesions (BMLs), osteophytes, Hoffa's synovitis, effusion-synovitis, meniscal damage and structural pathologies in ligaments, tendons and bursas and both the presence of pain and the knee pain patterns were assessed.
  
  
  
  The presence of Hoffa's synovitis (adjusted RR 1.6, 95% CI 1.2-1.3) and osteophytes in any region (2.07, 1.19-3.60) was significantly associated with the presence of pain. Any Hoffa's synovitis was associated with patellar pain (adjusted RR 4.70, 95% CI 1.19-3.60) and moderate-to-severe Hoffa's synovitis with diffuse pain (2.25, 1.13-4.50). Medial knee pain was associated with cartilage loss in the medial tibia (adjusted RR 2.66, 95% CI 1.22-5.80), osteophytes in the medial tibia (2.66, 1.17-6.07) and medial femur (2.55, 1.07-6.09), medial meniscal maceration (2.20, 1.01-4.79) and anterior meniscal extrusions (2.78, 1.14-6.75).
  
  
  
  Hoffa's synovitis and osteophytes were strongly associated with the presence of knee pain. Medial pain was associated most often with medially located structural pathologies.
authors.affiliation: Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland; Department of Physical and Rehabilitation Medicine, Kuopio University Hospital, Kuopio, Finland. Electronic address: paivi.kaukinen@kuh.fi.
authors.forename: P
authors.initials: P
authors.lastname: Kaukinen
authors.affiliation: Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland. Electronic address: Jana.Podlipska@oulu.fi.
authors.forename: J
authors.initials: J
authors.lastname: Podlipská
authors.affiliation: Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine, Boston, MA, USA. Electronic address: Ali.Guermazi@bmc.org.
authors.forename: A
authors.initials: A
authors.lastname: Guermazi
authors.affiliation: Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland; Department of Diagnostic Radiology, Oulu University Hospital and University of Oulu, Oulu, Finland. Electronic address: jaakko.niinimaki@oulu.fi.
authors.forename: J
authors.initials: J
authors.lastname: Niinimäki
authors.affiliation: Department of Anatomy, University of Oulu, Oulu, Finland; Department of Surgery, Medical Research Center, Oulu University Hospital, Oulu, Finland. Electronic address: petri.lehenkari@oulu.fi.
authors.forename: P
authors.initials: P
authors.lastname: Lehenkari
authors.affiliation: Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine, Boston, MA, USA; Department of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany. Electronic address: frank.roemer@uk-erlangen.de.
authors.forename: F W
authors.initials: FW
authors.lastname: Roemer
authors.affiliation: Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland; Medical Research Center, University of Oulu and Oulu University Hospital, Finland. Electronic address: miika.nieminen@oulu.fi.
authors.forename: M T
authors.initials: MT
authors.lastname: Nieminen
authors.affiliation: Department of Internal Medicine, Mikkeli Central Hospital, Mikkeli, Finland. Electronic address: f.koski@fimnet.fi.
authors.forename: J M
authors.initials: JM
authors.lastname: Koski
authors.affiliation: Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland; Department of Physical and Rehabilitation Medicine, Kuopio University Hospital, Kuopio, Finland. Electronic address: jari.arokoski@kuh.fi.
authors.forename: J P A
authors.initials: JP
authors.lastname: Arokoski
authors.affiliation: Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland; Department of Diagnostic Radiology, Oulu University Hospital and University of Oulu, Oulu, Finland; Medical Research Center, University of Oulu and Oulu University Hospital, Finland. Electronic address: Simo.Saarakkala@oulu.fi.
authors.forename: S
authors.initials: S
authors.lastname: Saarakkala
mesh_terms: D006801:Humans; D007717:Knee; D007719:Knee Joint; D008279:Magnetic Resonance Imaging; D020370:Osteoarthritis, Knee; D010146:Pain
keywords: Knee osteoarthritis; Magnetic resonance imaging; Pain