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Rheumatology Advance Access originally published online on September 27, 2005
Rheumatology 2005 44(12):1569-1573; doi:10.1093/rheumatology/kei094
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Published by Oxford University Press on behalf of the British Society for Rheumatology 2005.

The validation of simple scoring methods for evaluating compartment-specific synovitis detected by MRI in knee osteoarthritis

L. A. Rhodes, A. J. Grainger1, A.-M. Keenan2, C. Thomas2, P. Emery2 and P. G. Conaghan2

Academic Unit of Medical Physics, University of Leeds, Wellcome Wing, Leeds General Infirmary, 1 Department of Radiology, Leeds General Infirmary and 2 Academic Unit of Musculoskeletal Disease, University of Leeds and Leeds General Infirmary, Leeds, UK.

Correspondence to: L. A. Rhodes, Academic Unit of Medical Physics, University of Leeds, Wellcome Wing, Leeds General Infirmary, Great George Street, Leeds LS1 3EX, UK. E-mail: lar{at}medphysics.leeds.ac.uk

Objectives. Synovitis is common in osteoarthritis (OA) of the knee. In order to evaluate its importance, valid and reliable quantification methods are required. The aim of this study was to compare simple, semiquantitative synovitis scores with detailed volume assessments in subjects with knee OA using magnetic resonance imaging (MRI) as the investigative tool.

Methods. Thirty-five subjects with clinically diagnosed OA of the knee were assessed for synovitis using gadolinium-enhanced MRI. The volume measurement of synovitis was assessed at four sites (medial and lateral parapatellar recesses, intercondylar notch and suprapatellar pouch). The semiquantitative scoring of synovitis was scored on a 0–3 scale. Establishment of a correlative relationship was undertaken using Spearman's {rho} for the individual site-specific measurements. Ordinal regression modelling was undertaken in order to establish the capacity of the synovitis scoring to predict the volume measurement.

Results. A total of 140 sites were assessed. There were good correlations between the semiquantitative scores and the volume measurements, ranging from {rho} = 0.86 (P<0.00) for the medial parapatellar recess to {rho} = 0.71 (P<0.00) for the lateral parapatellar recess. The ordinal regression suggested that, while the synovitis scores predicted between 50 and 70% (R2 = 0.53, P<0.00 to R2 = 0.71, P<0.00) of the volume measurements, there was some minor overlap, particularly in the mid-range synovitis scores.

Conclusions. These results suggest that semiquantitative synovitis scores are valid and will enable feasible evaluation of the synovium in OA cohorts.

KEY WORDS: Osteoarthritis, Synovitis, MRI, Synovial volume, Knee


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