PMID- 25278070
OWN - NLM
STAT- MEDLINE
DCOM- 20150611
LR  - 20161018
IS  - 1522-9653 (Electronic)
IS  - 1063-4584 (Linking)
VI  - 22
IP  - 10
DP  - 2014 Oct
TI  - The responsiveness of novel, dynamic, contrast-enhanced magnetic resonance 
      measures of total knee synovitis after intra-articular corticosteroid for painful 
      osteoarthritis.
PG  - 1614-8
LID - S1063-4584(14)01106-6 [pii]
LID - 10.1016/j.joca.2014.05.024 [doi]
AB  - OBJECTIVE: Sensitive biomarkers are needed to understand synovial response to 
      therapy in osteoarthritis (OA). Dynamic, contrast-enhanced magnetic resonance 
      imaging (DCE MRI) provides quantitative, novel measures of synovial inflammation. 
      This exploratory study examined DCE-assessed synovial response to intra-articular 
      corticosteroid (IACS). METHODS: People with ACR clinical criteria OA knee 
      underwent 3 T MRI pre- and 2 weeks post-IACS. Five MRI variables were assessed 
      blindly: total synovial volume (semi-automated computer program), early 
      enhancement rate (EER) and late enhancement ratio of the entire knee, synovial 
      volume x late enhancement and a semi-quantitative (SQ) score (six sites scored 
      0-3). Clinical symptoms were assessed using pain visual analogue score (VAS) and 
      WOMAC. RESULTS: 13 participants (5 male, mean age 63, mean pain VAS 66 mm mean 
      body mass index (BMI) 31.3 kg/m(2)) were included. The majority of MRIs 
      demonstrated no change in SQ score although the DCE variables changed to some 
      extent in all. There was generally a reduction in synovial volume ((Wilcoxon 
      test) median (interquartile range (IQR)) reduction 14 cm(3) (-1, 29)), EER (0.2% 
      (-0.3, 0.6)) and late enhancement ratio (8% (-0.5, 41)). Synovial volume x late 
      enhancement ratio demonstrated a substantive reduction (2250 (-930, 5630)) as 
      well as the largest effect size, r = 0.45. There was a median 26% reduction in 
      EER in participants with good symptomatic response to IACS, contrasting with a 
      23% increase in those who responded poorly. CONCLUSIONS: DCE MRI may be more 
      sensitive than a SQ score at detecting post-therapy synovial changes. The 
      association between EER and symptomatic response to IACS may reflect a closer 
      relation of this biomarker to synovial inflammation than with volumetric 
      assessment.
CI  - Copyright (c) 2014 Osteoarthritis Research Society International. Published by 
      Elsevier Ltd. All rights reserved.
FAU - Wenham, C Y J
AU  - Wenham CY
AD  - Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, 
      UK; NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK. Electronic 
      address: c.y.j.wenham@leeds.ac.uk.
FAU - Balamoody, S
AU  - Balamoody S
AD  - NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK.
FAU - Grainger, A J
AU  - Grainger AJ
AD  - NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK.
FAU - Hensor, E M A
AU  - Hensor EM
AD  - Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, 
      UK; NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK.
FAU - Draycott, S
AU  - Draycott S
AD  - Leeds Teaching Hospitals NHS Trust, Leeds, UK.
FAU - Hodgson, R
AU  - Hodgson R
AD  - NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK.
FAU - Conaghan, P G
AU  - Conaghan PG
AD  - Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, 
      UK; NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK.
LA  - eng
PT  - Journal Article
PL  - England
TA  - Osteoarthritis Cartilage
JT  - Osteoarthritis and cartilage
JID - 9305697
RN  - 0 (Adrenal Cortex Hormones)
RN  - 0 (Contrast Media)
SB  - IM
MH  - Adrenal Cortex Hormones/*therapeutic use
MH  - Aged
MH  - Arthralgia/*drug therapy/etiology
MH  - Contrast Media
MH  - Female
MH  - Humans
MH  - Injections, Intra-Articular
MH  - Knee Joint/*pathology
MH  - Magnetic Resonance Imaging
MH  - Male
MH  - Middle Aged
MH  - Osteoarthritis, Knee/complications/drug therapy/*pathology
MH  - Synovitis/drug therapy/etiology/*pathology
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Biomarker
OT  - Dynamic magnetic resonance imaging
OT  - Intra-articular corticosteroid
OT  - Knee
OT  - Osteoarthritis
OT  - Synovium
EDAT- 2014/10/04 06:00
MHDA- 2015/06/13 06:00
CRDT- 2014/10/04 06:00
PHST- 2014/01/04 00:00 [received]
PHST- 2014/05/23 00:00 [revised]
PHST- 2014/05/30 00:00 [accepted]
PHST- 2014/10/04 06:00 [entrez]
PHST- 2014/10/04 06:00 [pubmed]
PHST- 2015/06/13 06:00 [medline]
AID - S1063-4584(14)01106-6 [pii]
AID - 10.1016/j.joca.2014.05.024 [doi]
PST - ppublish
SO  - Osteoarthritis Cartilage. 2014 Oct;22(10):1614-8. doi: 
      10.1016/j.joca.2014.05.024.