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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.
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

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

Ludmila E. Valkova – the Assistant of the Department of Radiation Diagnosis, Radiotherapy and Oncology Russian Federation

A. S. Revchuk

Arkhangelsk Regional Clinical Oncology Center

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

Andrey V. Agapitov – Radiologist the Department of Ct and Mri n> Russian Federation

I. A. Chernykh

First City Clinical Hospital EE Volosevich

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


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

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


  1. Алексеева Л.И., Остеоартроз: диагностика и лечение (национальные рекомендации по диагностике и лечению остеоартроза). М.; 2015. 26 с.
  2. Бадокин В.В., Ревматология. Клинические лекции. М.; 2014. 592 с.
  3. Беневоленская Л.И., Бржезовский М.М. Эпидемиология ревматических болезней. М.; 2012. 237 с.
  4. Гржибовский А.М. Анализ номинальных данных (независимые наблюдения). Экология человека. 2008;(6):58-68.
  5. Гржибовский А.М. Корреляционный анализ. Экология человека. 2008;(9):50-60.
  6. Гржибовский А.М., Иванов С.В., Горбатова М.А., Дюсупов А.А. Использование псевдорандомизации (propensity score matching) для устранения систематических различий сравниваемых групп в обсервационных исследованиях c дихотомическим исходом. Экология человека. 2016;(5):50-64.
  7. Кашеварова Н.Г., Алексеева Л.И. Факторы риска прогрессирования остеоартроза коленных суставов. Научно-практическая ревматология. 2014;52(5):553-561. doi: 10.14412/1995-4484-2014-553-561.
  8. Насонов Е.Л., Насонова В.А. Ревматология: национальное руководство. М.; 2014. 720 с.
  9. Наумов А.В., Алексеева Л.И., Верткин А.Л. Ведение больных с остеоартритом и коморбидностью в общей врачебной практике. Клинические рекомендации консенсуса экспертов Российской Федерации. М.; 2015. 38 с.
  10. Олюнин Ю.А. Хронический синовит в ревматологии. Оценка активности и тактика лечения. Русский медицинский журнал. 2013;(21):304-309.
  11. Холматова К.К., Харькова О.А., Гржибовский А.М. Классификация научных исследований в здравоохранении. Экология человека. 2016;(1):57-64.
  12. Холматова К.К., Харькова О.А., Гржибовский А.М. Особенности применения когортных исследований в медицине и общественном здравоохранении. Экология человека. 2016;(4):56-64.
  13. Altman R., Alarcón G., Appelrouth D., Bloch D., Borenstein D., Brandt K., Brown C., Cooke T.D., Daniel W., Gray R. The American College of Rheumatology criteria for the classification and reporting of osteoarthritis of the hip. Arthritis Rheum.1991;(34):505-514.
  14. Ayral X., Pickering E.H., Woodworth T.G., Mackillop N., Dougados M. 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;(13):361-367.
  15. Biswal S., Hastie T., Andriacchi T.P., Bergman G.A., Dillingham M.F., Lang P. Risk factors for progressive cartilage loss in the knee: a longitudinal magnetic resonance imaging study in forty-three patients. Arthritis Rheum. 2002;46(11):2884-2892.
  16. Claire Y.J., Wenham and Philip G. Conaghan The role of synovitis in osteoarthritis. Therapeutic Advances in Musculoskeletal Disease. 2010;2(6):349-359. doi: 10.1177/1759720X10378373.
  17. Ding M., Danielsen C.C., Hvid I. Bone density does not reflect mechanical properties in early-stage arthrosis. Acta Orthop Scand. 2001;72(2):181-185.
  18. Felson D.T., Lynch J., Guermazi A., Roemer F.W., Niu J, McAlindon T., Nevitt M.C. Comparison of BLOKS and WORMS scoring systems part II. Longitudinal assessment of knee MRIs for osteoarthritis and suggested approach based on their performance: data from the Osteoarthritis Initiative. Osteoarthritis Cartilage. 2010;18(11):1402-1407. doi: 10.1016/j.joca.2010.06.016.
  19. Hill C.L., Hunter D.J., Niu J., Clancy M., Guermazi A., Genant H., Gale D., Grainger A., Conaghan P., Felson D.T. Synovitis detected on magnetic resonance imaging and its relation to pain and cartilage loss in лnee osteoarthritis. Ann Rheum Dis. 2007;66(12):1599-1603.
  20. Hunter D.J., Zhang Y.Q., Niu J.B., Tu X., Amin S., Clancy M., Guermazi A., Grigorian M., Gale D., Felson D.T. The association of meniscal pathologic changes with cartilage loss in symptomatic knee osteoarthritis. Arthritis Rheum. 2006;(4):795-801.
  21. Ledingham J., Regan M., Jones A., Doherty M. Factors affecting radiographic progression of knee osteoarthritis. Ann Rheum Dis. 1995;54(1):53-58.
  22. Pelletier J.P., Raynauld J.P., Berthiaume M.J., Abram F., Choquette D., Haraoui B., Beary J.F., Cline G.A., Meyer J.M., Martel-Pelletier J. Risk factors associated with the loss of cartilage volume on weight-bearing areas in knee osteoarthritis patients assessed by quantitative magnetic resonance imaging: a longitudinal study. Arthritis Res Ther. 2007;9(4):R74.
  23. Pessis E., Drape J.L., Ravaud P., Chevrot A., Ayral M.D.X. Assessment of progression in knee osteoarthritis: results of a 1 year study comparing arthroscopy and MRI. Osteoarthritis Cartilage. 2003;11(5):361-369.
  24. Peterfy C.G., Guermazi A., Zaim S., Tirman P.F.J, Miaux Y., White D., Kothari M., Lu Y., Fye K., Zhao S., Genant H.K. Whole-Organ Magnetic Resonance Imaging Score (WORMS) of the knee in osteoarthritis. Osteoarthritis Cartilage. 2004; 12(3):177-190.

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