MRI findings associated with development of incident knee pain over 48 months: data from the osteoarthritis initiative

Gabby B. Joseph, Stephanie W. Hou, Lorenzo Nardo, Ursula Heilmeier, Michael C. Nevitt, Charles E. McCulloch, Thomas M. Link

Research output: Contribution to journalArticle

9 Scopus citations


Purpose: The purpose of this nested case-control study was to identify baseline, incident, and progressive MRI findings visible on standard MRI clinical sequences that were associated with development of incident knee pain in subjects at risk for OA over a period of 48 months. Methods: We analyzed 60 case knees developing incident pain (WOMACpain = 0 at baseline and WOMACpain ≥ 5 at 48 months) and 60 control knees (WOMACpain = 0 at baseline and WOMACpain = 0 at 48 months) from the Osteoarthritis Initiative. 3 T knee MRIs were analyzed using a modified WORMS score (cartilage, meniscus, bone marrow) at baseline and after 48 months. Baseline and longitudinal findings were grouped into logistic regression models and compared using likelihood-ratio tests. For each model that was significant, a stepwise elimination was used to isolate significant MRI findings. Results: One baseline MRI finding and three findings that changed from baseline to 48 months were associated with the development of pain: at baseline, the severity of a cartilage lesion in the medial tibia was associated with incident pain—(odds ratio (OR) for incident pain = 3.05; P = 0.030). Longitudinally, an incident effusion (OR = 9.78; P = 0.005), a progressive cartilage lesion of the patella (OR = 4.59; P = 0.009), and an incident medial meniscus tear (OR = 4.91; P = 0.028) were associated with the development of pain. Conclusions: Our results demonstrate that baseline abnormalities of the medial tibia cartilage as well as an incident joint effusion, progressive patella cartilage defects, and an incident medial meniscus tear over 48 months may be associated with incident knee pain. Clinically, this study helps identify MRI findings that are associated with the development of knee pain.

Original languageEnglish (US)
Pages (from-to)653-660
Number of pages8
JournalSkeletal Radiology
Issue number5
StatePublished - May 1 2016
Externally publishedYes



  • Knee
  • MRI
  • Osteoarthritis
  • Osteoarthritis initiative
  • Pain

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this