TRANSITION PREDICTORS OF X-RAY 0 STAGE FOR KNEE OSTEOARTHRITIS INTO THE 1ST STAGE (BASED ON THE COMPLEX EVALUATION OF THE KNEE JOINT BY MRI WORMS)

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Abstract

Background. Osteoarthritis (OA) is the most common disease among all rheumatological diseases. Approximately 70-80% of all OA cases of are gonarthritis. Routine X-ray examination is not informative to assess non-bone structures. Magnetic resonance imaging (MRI) allows visualizing all the structural elements of a joint, such as articular soft tissue structures and subcortical parts. To achieve objective data, the researcher needs to adhere a protocol allowing to assess of all joint parts, the so-called method of evaluation of the whole body (Whole Organ Magnetic Resonance Imaging Score –WORMS). Aim. to determine predictors of OA progression for X-ray 0 stage on the basis of the knee MRI procedure byWORMS.

Methods. A cohort study. The sample consisted of patients with gonarthritis in all hospitals inArkhangelsk,Northwest Russia. The main inclusion criterion was clinically confirmed with knee OA by Altman 1991 without X-ray pathological changes. X-ray examinations of the knee joints were performed during the initial diagnosis and after one year. After the first X-ray examination patients underwent an MRI provided by machines with a magnetic field strength of 1.5 Tesla. The study included 76 patients, 22 patients were lost to follow up. Altogether, 54 (71.1%) patients completed the study. MRI evaluation of the data was carried out byWORMS protocol.

Results. The progression of X-ray 0 stage into the first stage by Kellgren-Lawrence after one year has occurred in 45 (8.3%) patients of the 54 patients. Clinically significant predictors of progression of OA of the knee based on MRI were: degeneration of the medial meniscus (OR = 5.0, 95% CI: 1.1-22.5), and synovitis (OR = 7.0, 95% CI: 1.5-33.1), degeneration of the medial meniscus and synovitis were included Regression model. Regression model revealed the most significant predictor of progression of knee OA was synovitis (OR = 5.49, 95% CI: 1.13-26.72). The sensitivity of model was 95,1% (95% CI: 85.8-94.9), specificity was 71,4% (95% CI: 33.3-94.4), positive predictive value was 5,6% (95% CI: 89.6-99.1), negative predictive value was 55,6% (95% CI: 25,9-73,4).

The findings of this study revealed the only significant MRI predictor of the transition X-ray 0 stage into the first stage was synovitis which increased the risk of the progression in 5.5 times during one year.

About the authors

М. V. Makarova

Northern State Medical University;
Arkhangelsk Regional Clinical Hospital

Author for correspondence.
Email: mtim10@gmail.com
Maria V. Makarova – Cand. Sci. (Med.), the Assistant of the Department of Radiation Diagnosis, Radiotherapy and Oncology, Northern State Medical University; Head of the Radiology Department N 1 the First City Clinical Hospital of E.E. Volosevich Russian Federation

M. Yu. Valkov

Northern State Medical University

Email: fake@neicon.ru
Mikhail Yu. Valkov – Dr. Sci. (Med.), Professor, the Head of the Department of Radiation Diagnosis, Radiotherapy and Oncology Russian Federation

L. E. Valkova

Northern State Medical University

Email: fake@neicon.ru
Ludmila E. Valkova – the Assistant of the Department of Radiation Diagnosis, Radiotherapy and Oncology Russian Federation

A. S. Revchuk

Arkhangelsk Regional Clinical Oncology Center

Email: fake@neicon.ru
Alexander S. Revchuk – the Assistant of the Department of Radiation Diagnosis, Radiotherapy and Oncology, Northern State Medical University; Radiologist, Arkhangelsk Regional Oncological Center Russian Federation

A. V. Agapitov

Arkhangelsk Regional Clinical Hospital;
First City Clinical Hospital EE Volosevich

Email: fake@neicon.ru
Andrey V. Agapitov – Radiologist the Department of Ct and Mri n> Russian Federation

I. A. Chernykh

First City Clinical Hospital EE Volosevich

Email: fake@neicon.ru
Igor’ A. Chernyh – Head of the Department of Ct and Mri, theFirstCity ClinicalHospital ofE.E. Volosevich Russian Federation

A. R. Parfenova

Arkhangelsk Regional Clinical Oncology Center

Email: fake@neicon.ru

Anastasia R. Parfenova – the Head of the Department of the Radio-Nuclear Diagnosis

Russian Federation

A. M. Grjibovski

Northern State Medical University;
Norwegian Institute of Public Health;
International Kazakh-Turkish University

Email: fake@neicon.ru
Andrej M. Grjibovski – Dr. Sci. (Med.), Professor, Senior Advisor of Norwegian Institute of Public Health; Professor of Yasavi International Kazakh-Turkish University; Research Advisor and Head of Research Practice in Northern State Medical University Russian Federation

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