OsteoarthritisImaging of Synovitis in Osteoarthritis: Current Status and Outlook
Section snippets
Methods
A comprehensive PubMed and MEDLINE search for articles published up to September 2010 was performed, using the keyword “synovitis.” Additional keywords (osteoarthritis, rheumatoid arthritis, radiography, CT, nuclear medicine, MRI, US, and pain) were then added to narrow the search. In particular, authors focused on recently published articles written in English. This search strategy yielded 9251 abstracts, which were screened for relevance. Of those, 92 were included in the current review.
Ultrasound
US is increasingly used in imaging of OA patients, thanks largely to technical advances. Modern US systems can use beam steering and compound imaging technologies to allow wider fields of view. High-resolution probes with frequencies of up to 20 MHz are being applied in routine joint assessment (37). Advantages include the lack of ionizing radiation, the multiplanar nature of the modality, and dynamic imaging in real-time (38). It is useful as a guidance tool for interventional procedures (24,
Conclusion
At present, US and CE-MRI seem to be the 2 most useful imaging modalities for evaluation of synovitis in OA. Large-scale studies led by EULAR have demonstrated a potential for US to become a powerful tool for synovial assessment in OA of the hand and the knee, including monitoring of disease progression and therapeutic effects. However, whether synovitis predicts OA patients who respond to corticosteroid injections remains to be shown. Non-CE-MRI is currently the most common modality to assess
Acknowledgments
We thank Dr Helen Keen, The University of Western Australia, Australia, for providing US images for this article (Figure 1, Figure 2, Figure 3).
References (92)
- et al.
Etiopathogenesis of osteoarthritis
Med Clin North Am
(2009) - et al.
Osteoarthritis: pathobiology-targets and ways for therapeutic intervention
Adv Drug Deliv Rev
(2006) - et al.
Targeting the synovial tissue for treating osteoarthritis (OA): where is the evidence?
Best Pract Res Clin Rheumatol
(2010) - et al.
Synovitis: a potential predictive factor of structural progression of medial tibiofemoral knee osteoarthritis—results of a 1 year longitudinal arthroscopic study in 422 patients
Osteoarthritis Cartilage
(2005) - et al.
Imaging in osteoarthritis
Rheum Dis Clin North Am
(2008) - et al.
Whole-Organ Magnetic Resonance Imaging Score (WORMS) of the knee in osteoarthritis
Osteoarthritis Cartilage
(2004) - et al.
Whole-knee synovitis semiquantitatively assessed on T1-weighted contrast-enhanced MRI is associated with radiographic tibiofemoral osteoarthritis and severe meniscal damage: The MOST Study (Abstract)
Osteoarthritis Cartilage
(2009) - et al.
Magnetic resonance imaging in osteoarthritis: which method best reflects synovial membrane inflammation?Correlations with clinical, macroscopic and microscopic features
Osteoarthritis Cartilage
(2009) - et al.
Ultrasound-detected synovitis with power Doppler signal is associated with severe radiographic damage and reduced cartilage thickness in hand osteoarthritis
Osteoarthritis Cartilage
(2010) - et al.
Ultrasonography in osteoarthritis
Radiol Clin North Am
(2009)
Guidance by ultrasound of intra-articular injections in the knee and hip joints
Osteoarthritis Cartilage
Osteoarthritis: current role of imaging
Med Clin North Am
Power Doppler ultrasound in musculoskeletal disease: A systematic review
Semin Arthritis Rheum
Synovial thickening detected by MR imaging in osteoarthritis of the knee confirmed by biopsy as synovitis
Magn Reson Imaging
A new non-invasive method to assess synovitis severity in relation to symptoms and cartilage volume loss in knee osteoarthritis patients using MRI
Osteoarthritis Cartilage
Semiquantitative assessment of synovitis in osteoarthritis on non contrast-enhanced MRI
Osteoarthritis Cartilage
The relationship between specific tissue lesions and pain severity in persons with knee osteoarthritis
Osteoarthritis Cartilage
Bone marrow lesions and joint effusion are strongly and independently associated with weight-bearing pain in knee osteoarthritis: data from the osteoarthritis initiative
Osteoarthritis Cartilage
CT arthrography, MR arthrography, PET and scintigraphy in osteoarthritis
Radiol Clin North Am
Positron emission tomography with 18F-FDG in osteoarthritic knee
Osteoarthritis Cartilage
Osteoarthritis, an inflammatory disease
Arthritis Rheum
The Role of synovial macrophages and macrophage-produced mediators in driving inflammatory and destructive responses in osteoarthritis
Arthritis Rheum
The role of cytokines as inflammatory mediators in osteoarthritis: lessons from animal models
Connect Tissue Res
Prevalence of cartilage shards in synovium and their association with synovitis in patients with early and end stage osteoarthritis
J Rheumatol
Articular responses to purified cartilage proteoglycans
Arthritis Rheum
Investigation of calcium crystals in OA knees
Rheumatol Int
Macroscopic and microscopic features of synovial membrane inflammation in the osteoarthritic knee: correlating magnetic resonance imaging findings with disease severity
Arthritis Rheum
Early lymphocyte activation in the synovial microenvironment in patients with osteoarthritis: comparison with rheumatoid arthritis patients and healthy controls
Rheumatol Int
Knee effusions, popliteal cysts, and synovial thickening: association with knee pain in osteoarthritis
J Rheumatol
Relation of synovitis to knee pain using contrast-enhanced MRIs
Ann Rheum Dis
Synovial inflammation in patients with early osteoarthritis of the knee
J Rheumatol
Synovial tissue inflammation in early and late osteoarthritis
Ann Rheum Dis
Pain in hand osteoarthritis is associated with inflammation: the value of ultrasound
Ann Rheum Dis
An ultrasonographic study of osteoarthritis of the hand: synovitis and its relationship to structural pathology and symptoms
Arthritis Rheum
Response of symptoms and synovitis to intra-muscular methylprednisolone in osteoarthritis of the hand: an ultrasonographic study
Rheumatology (Oxford)
Clinical and ultrasonographic predictors of joint replacement for knee osteoarthritis: results from a large, 3-year, prospective EULAR study
Ann Rheum Dis
Contrast-enhanced ultrasound in monitoring the efficacy of a bradykinin receptor 2 antagonist in painful knee osteoarthritis compared with MRI
Ann Rheum Dis
Knee osteoarthritisEfficacy of a new method of contrast-enhanced musculoskeletal ultrasonography in detection of synovitis in patients with knee osteoarthritis in comparison with magnetic resonance imaging
Ann Rheum Dis
Steroid injection for hip osteoarthritis: efficacy under ultrasound guidance
Rheumatology (Oxford)
Synovitis detected on magnetic resonance imaging and its relation to pain and cartilage loss in knee osteoarthritis
Ann Rheum Dis
Hoffa's Fat Pad: evaluation on unenhanced mr images as a measure of patellofemoral synovitis in osteoarthritis
AJR Am J Roentgenol
MRI assessment of knee osteoarthritis: Knee Osteoarthritis Scoring System (KOSS)—inter-observer and intra-observer reproducibility of a compartment-based scoring system
Skeletal Radiol
Correlation between synovitis detected on enhanced-magnetic resonance imaging and a histological analysis with a patient-oriented outcome measure for Japanese patients with end-stage knee osteoarthritis receiving joint replacement surgery
Clin Rheumatol
The validation of simple scoring methods for evaluating compartment-specific synovitis detected by MRI in knee osteoarthritis
Rheumatology (Oxford)
Assessment of synovitis in knee osteoarthritis on contrast-enhanced MRI using a novel comprehensive semiquantitative scoring system—The MOST Study (Abstract)
Arthritis Rheum
EULAR report on the use of ultrasonography in painful knee osteoarthritisPart 1: prevalence of inflammation in osteoarthritis
Ann Rheum Dis
Cited by (114)
Quantifying Change in Perfusion after Genicular Artery Embolization with Parametric Analysis of Intraprocedural Digital Subtraction Angiograms
2023, Journal of Vascular and Interventional RadiologyAdvanced therapeutics for targeting inflammatory arthritis
2023, Recent Developments in Anti-Inflammatory TherapyIdentification of JUN as determinant of osteoarthritis and its inhibition by the Chinese herbal formulae Zhuanggu Huoxue Tang
2022, Computers in Biology and MedicineCitation Excerpt :Osteoarthritis is the most common type of arthritis, and the knee is the most frequently affected joint [1,22]. Synovitis, which can induce cartilage damage by fibrin deposition or expression of inflammatory cytokines in early OA stages [23,24], is related to the degree and progression of joint injury [25–28]. Recent studies have begun to consider synovitis as a driving factor for OA [29].
Are contrast-enhanced and non-contrast MRI findings reflecting synovial inflammation in knee osteoarthritis: a meta-analysis of observational studies
2020, Osteoarthritis and CartilageCitation Excerpt :Prior studies have suggested that synovitis should be optimally assessed using contrast-enhanced (CE) MRI and significant correlation between histological synovitis measures and MRI-detected synovitis metrics was reported13–15. On CE-MRI, synovitis is displayed as a thickened, contrast-enhancing synovial membrane which can be differentiated from adjacent knee joint effusion and intraarticular fat tissue covered by synovial membrane3,13,15. However, in large cohort studies, which require longitudinal assessment of intra-articular structures over an extensive follow-up interval, non-contrast-enhanced (NCE) MRI is commonly used2.
Inflammation and Hypervascularization in a Large Animal Model of Knee Osteoarthritis: Imaging with Pathohistologic Correlation
2019, Journal of Vascular and Interventional Radiology