Ultrasound assessment of response to intra-articular therapy in osteoarthritis of the knee

Helen Keen, E.M.A. Hensor, R.J. Wakefield, P.J. Mease, C.O. Bingham, P.G. Conaghan

    Research output: Contribution to journalArticle

    19 Citations (Scopus)

    Abstract

    © The Author 2015. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. Objective. Assessment of the synovium in patients with knee OA is of great potential value for clinical trials. Ultrasonography could provide this but few data exist on its ability to assess synovial response to therapies. The aim of this study was to examine whether US can detect synovial response to IA corticosteroid (IACS) therapy and to explore associations between synovial characteristics and symptoms. Methods. A total of 35 people with ACR radiographic knee OA were included, including those who required an injection of 80 mg of IA methylprednisolone. All participants completed a visual analogue scale for pain and underwent US of the knee at baseline, 1 and 4 weeks. Minimum clinically important improvement (MCII) in pain was ≥20 mm. Results. One week of data were available for 33 patients (19 received IACS and 14 others). Synovial thickness (ST) decreased in 16 IACS patients and 2 others [mean between-group difference 4.7mm (95% CI 1.1, 8.2), P = 0.012]. Absolute reduction was not associated with absolute reduction in pain (r = 0.20, P = 0.289), but decreased ST was substantively associated with reduction in pain greater than or equal to the MCII (52.9% vs 23.1%, P = 0.098, ϕ = 0.30). The power Doppler score decreased in 13 IACS patients and 3 others {median change in IACS patients -1.0 [interquartile range (IQR) -5.0-0.0], others 0.0 [-0.3-1.3], P = 0.004}. Absolute changes in pain and power Doppler score were weakly associated (r = 0.36, P = 0.049) and a decreased power Doppler score was associated with reduction in pain greater than or equal to the MCII (64.3% vs 18.8%, P = 0.011, ' = 0.46). Conclusion. Ultrasonography can detect short-term synovial response in knee OA. In particular, power Doppler score may be both responsive to and associated with pain, warranting further investigation.
    Original languageEnglish
    Pages (from-to)1385-1391
    JournalRheumatology
    Volume54
    Issue number8
    DOIs
    Publication statusPublished - 2015

    Fingerprint Dive into the research topics of 'Ultrasound assessment of response to intra-articular therapy in osteoarthritis of the knee'. Together they form a unique fingerprint.

    Cite this