MRI软骨下骨髓水肿与早期膝骨关节炎临床表现的相关性研究?

目的：探讨早期膝骨关节炎(KOA)MRI 软骨下骨髓水肿的程度,并探究骨髓水肿与 KOA 夜间休息痛、关节肿胀程度和骨关节炎功能(the western Ontario and McMaster Universities osteoarthritis index,WOMAC)评分的相关性。方法本研究按纳排标准收集了早期 KOA 病例60例,其中伴骨髓水肿改变30例,设为观察组,不伴骨髓水肿改变30例,设为对照组。观察骨髓水肿程度评分、夜间休息痛视觉模拟(visular analogue scale, VAS)评分、关节肿胀程度及 WOMAC 功能评分情况。结果1)两组患者在夜间休息痛 VAS 评分、关节肿胀程度和 WOMAC 评分上比较,差异有统计学意义(P <0.05)；2)观察组骨髓水肿程度越重,夜间休息痛 VAS 评分与WOMAC 评分越高；3)观察组骨髓水肿和夜间休息痛情况的相关系数 r =0.933(r >0)(P <0.05),二者呈正相关性；骨髓水肿与 WOMAC 评分的相关系数 r=0.555(r>0)(P <0.05),二者呈正相关性；骨髓水肿同关节肿胀程度相关系数 r=0.148(r>0)(P >0.05),二者间无明显相关性。结论MRI 软骨下骨髓水肿样改变与早期 KOA 夜间休息痛、WOMAC 评分具有正相关性；与关节肿胀情况无相关性。

Correlation Between the MRI Features of Subchondral Bone Marrow Edema and the Early Clinical Manifestations of Knee Osteoarthritis

Objective To investigate the MRI features of subchondral bone marrow edema in the patients with early knee osteoarthritis and explore whether the bone marrow edema is correlated with the knee osteoarthritis rest pain at night,the joint swelling and the WOMAC score respectively.Methods 60 cases of early knee osteoarthritis were collected according to the inclusive and exclusive criteria and divided into two groups.30 cases of them were with the change of bone marrow edema and divided into the observation group,and the other 30 cases were without that and divided into the control group.The data were collected by observing and grading the bone marrow edema, the knee osteoarthritis rest pain at night,the joint swelling and the WOMAC respectively.Results There were significant differences in the scores of the knee osteoarthritis rest pain at night,the degree of the joint swelling and the WOMAC scores between the two groups (P <0.05).In the observation group,the growing levels of the joint swelling resulted in the higher VAS and WOMAC scores.There was a positive correlation between the bone marrow edema and the knee osteoarthritis rest pain at night (r=0.933,P <0.05)and between the bone marrow edema and the WOMAC score (r=0.555,P <0.05),but there was no significant correlation between the bone marrow edema and the joint swelling (r=0.148,P >0.05).Conclusion The MRI features of subchondral bone marrow edema in the patients with early knee osteoarthritis are positively correlated with the knee osteoarthritis rest pain at night and the WOMAC score,but they are not significantly correlated with the levels of the joint swelling.