Rheumatoid Arthritis of Knee Joints: MRI-Pathological Correlation

Primary tabs

SCIENCE
Rheumatoid Arthritis of Knee Joints: MRI-Pathological Correlation
Key Take-Away: 

Rheumatoid arthritis found within the knees with various types of symptoms which were different from those of knee osteoarthritis. The following study helps to elucidate specific characteristics of knee joint destruction among patients with rheumatoid arthritis using MRI and histological examination.

The study was intended to assess the association between knee joint rheumatoid arthritis (RA) characteristics and histological examination to illustrate pathogenesis of joint injury among patients with RA.

ABSTRACT: 
Background: 

The study was intended to assess the association between knee joint rheumatoid arthritis (RA) characteristics and histological examination to illustrate pathogenesis of joint injury among patients

The study was intended to assess the association between knee joint rheumatoid arthritis (RA) characteristics and histological examination to illustrate pathogenesis of joint injury among patients with RA.

Methods: 

A total of 22 patients with 26 joints who went through total knee arthroplasty (TKA) were prospectively analyzed. The stage of the knee joints was classified using MRI by two radiologists on the basis of the articular cartilage and the menisci degree of damage, bone marrow oedema and bone erosion and synovial thickening presence.

Post‐hoc and the Mann–Whitney U‐tests were used to compare the variations in the severity of damage of the articular cartilage of the lateral and medial tibial plateaus and the medial and lateral femoral condyles, the medial and lateral menisci, and bone. The resected knee specimens were used to obtained samples of cartilage, subchondral bone, menisci, and synovium and determined semiquantitatively using immunohistochemistry and microscopy. Mann–Whitney U‐test used to evaluate the histological difference between areas of bone erosion and bone marrow oedema.
 

Results: 

For the medial and lateral tibial plateaus and the medial and lateral femoral condyles among most of the patients, the degree of articular damage was graded as grade 4 with an average damage grade of 3.6. Lateral femoral condyle was presented with the least amount of damage.

Most of the patients exhibited stage 3 knee joint damage, followed by stage four. Most severe pathological changes in cartilage noticed were hyperplasia, fibrosis, thinning and destruction. Sixty-eight areas of bone erosion and 36 areas of bone marrow oedema were identified in total 26 specimens. Among these areas, lymphocyte infiltration, fibrosis and mosaic structure of bone were the most severe changes that occurred. For both the medial and lateral meniscus, the degree of meniscus damage was graded as grade 4 with an average damage grade of 3.85. Lateral femoral condyle was presented with the lower amount of damage than the medial meniscus. Most severe pathological manifestations noticed were engulfing calcified debris and fibrosis. All 26 specimens identified with synovitis with plasma cell infiltration hyperplasia of intima cells and lymphocyte as the most severe pathological indications.

Conclusion: 

The characteristic feature of RA was the severe destruction of menisci and the articular cartilage. Bone erosion and bone marrow oedema both can be observed, but are less characteristic. The mechanism of the damage of the bone marrow, menisci, and cartilage may be the synovial infiltration. Although, further investigation is required to investigate the origin of bone marrow oedema.

 

Source:

Orthop Surg

Link to the source:

https://onlinelibrary.wiley.com/doi/full/10.1111/os.12389

Original title of article:

Rheumatoid Arthritis of Knee Joints: MRI-Pathological Correlation.

Authors:

Xiang‐hong Meng et al.

Exploratory, Rheumatoid Arthritis, Knee Joints
Log in or register to post comments