Quantification of hip effusion-synovitis and its cross-sectional and longitudinal associations with hip pain, MRI findings and early radiographic hip OA

摘要

Background: Hip effusion-synovitis may be relevant to osteoarthritis (OA) but is of uncertain etiology. The aim ofthis study was to describe the cross-sectional and longitudinal associations of hip effusion-synovitis with clinical andstructural risk factors of OA in older adults.Methods: One hundred ninety-six subjects from the Tasmanian Older Adult Cohort (TASOAC) study with a righthip STIR (Short T1 Inversion Recovery) Magnetic Resonance Imaging (MRI) on two occasions were included. Hipeffusion-synovitis CSA (cm2) was assessed quantitatively. Hip pain was determined by WOMAC (Western Ontarioand McMaster Universities Osteoarthritis) while hip bone marrow lesions (BMLs), cartilage defects (femoral and/oracetabular) and high cartilage signal were assessed on MRI. Joint space narrowing (0–3) and osteophytes (0–3)were measured on x-ray using Altman’s atlas.Results: Of 196 subjects, 32% (n = 63) had no or a small hip effusion-synovitis while 68% (n = 133) subjects had amoderate or large hip effusion-synovitis. Both groups were similar but those with moderate or large hip effusionsynovitiswere older, had higher BMI and more hip pain. Cross-sectionally, hip effusion-synovitis at multiple siteswas associated with presence of hip pain [Prevalence ratio (PR):1.42 95%CI:1.05,1.93], but not with severity of hippain. Furthermore, hip effusion-synovitis size associated with femoral defect (βeta:0.32 95%CI:0.08,0.56).Longitudinally, and incident hip cartilage defect (PR: 2.23 95%CI:1.00, 4.97) were associated with an increase in hipeffusion-synovitis CSA. Furthermore, independent of presence of effusion-synovitis, hip BMLs predicted incident (PR:1.62 95%CI: 1.13, 2.34) and worsening of hip cartilage defects (PR: 1.50 95%CI: 1.20, 1.86). While hip cartilage defectpredicted incident (PR: 1.11 95%CI: 1.03, 1.20) and worsening hip BMLs (PR: 1.16 95%CI: 1.04, 1.30).Conclusions: Hip effusion-synovitis at multiple sites (presumably reflecting extent) may be associated with hip pain.Hip BMLs and hip cartilage defects are co-dependent and predict worsening hip effusion-synovitis, indicating causalpathways between defects, BMLs and effusion-synovitis.