Bone marrow lesions and synovitis on MRI associate with radiographic progression after 2 years in hand osteoarthritis.
OBJECTIVE
To study the association of magnetic resonance (MR) features with radiographic progression of hand osteoarthritis over 2 years.


METHODS
Of 87 primary patients with hand osteoarthritis (82% women, mean age 59 years), baseline distal and proximal interphalangeal joint contrast-enhanced MR images were scored 0-3 for bone marrow lesions (BMLs) and synovitis following the Oslo score. Baseline and 2-year follow-up radiographs were scored following Kellgren-Lawrence (KL) (0-4) and OsteoArthritis Research Society International (OARSI) scoring methods (0-3 osteophytes, joint space narrowing (JSN)). Increase ≥1 defined progression. Associations between MR features and radiographic progression were explored on joint and on patient level, adjusting for age, sex, body mass index, synovitis and BML. Joints in end-stage were excluded.


RESULTS
Of 696 analysed joints, 324 had baseline KL=0, 28 KL=4 and after 2 years 78 joints progressed. BML grade 2/3 was associated with KL progression (2/3 vs 0: adjusted risk ratio (RR) (95% CI) 3.3 (2.1 to 5.3)) and with osteophyte or JSN progression, as was synovitis. Summated scores were associated with radiographic progression on patient level (RR crude BML 1.08 (1.01 to 1.2), synovitis 1.09 (1.04 to 1.1), adjusted synovitis 1.08 (1.03 to 1.1)).


CONCLUSIONS
BMLs, next to synovitis, show, already after 2 years, graded associations with radiographic progression, suggesting that both joint tissues could be important targets for therapy.
Department of Rheumatology, Leiden University Medical Center (LUMC), Leiden, The Netherlands.
W
W
Damman
Department of Rheumatology, Leiden University Medical Center (LUMC), Leiden, The Netherlands.
R
R
Liu
Department of Radiology, Leiden University Medical Center (LUMC), Leiden, The Netherlands.
J L
JL
Bloem
Department of Clinical Epidemiology, Leiden University Medical Center (LUMC), Leiden, The Netherlands.
F R
FR
Rosendaal
Department of Radiology, Leiden University Medical Center (LUMC), Leiden, The Netherlands.
M
M
Reijnierse
Department of Rheumatology, Leiden University Medical Center (LUMC), Leiden, The Netherlands.
M
M
Kloppenburg
D015992:Body Mass Index; D001855:Bone Marrow Diseases / Q000000981:diagnostic imaging / Q000209:etiology*; D018450:Disease Progression; D005260:Female; D005384:Finger Joint / Q000000981:diagnostic imaging; D005500:Follow-Up Studies; D050823:Hand Joints / Q000000981:diagnostic imaging*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000150:complications* / Q000000981:diagnostic imaging; D011859:Radiography; D012720:Severity of Illness Index; D013585:Synovitis / Q000000981:diagnostic imaging / Q000209:etiology*
Hand Osteoarthritis; Inflammation; Magnetic Resonance Imaging; Outcomes research; Synovitis