Patients with intra-articular mineralization have twice the odds of frequent knee pain
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Key takeaways:
- Patients with intra-articular mineralization had greater odds of demonstrating frequent and worsening knee pain.
- Developing and testing therapies targeted toward crystal deposition could help improve knee osteoarthritis symptoms.
Patients with intra-articular mineralization demonstrate a two-times higher likelihood of having frequent knee pain, as well as more intermittent or constant pain, according to data published in Arthritis & Rheumatology.
“Intra-articular (IA) crystal deposition is common in knee [osteoarthritis (OA)], yet its clinical significance remains unclear,” Jean W. Liew, MD, assistant professor of medicine and rheumatologist at Boston University, and colleagues wrote. “Crystals that can deposit intra-articularly in OA include calcium pyrophosphate (CPP) and basic calcium phosphate (BCP); each of these crystals can be associated with painful clinical conditions characterized often by acute flares.”
To investigate the relation between CT-detectable intra-articular mineralization and knee pain, Liew and colleagues analyzed data from the Multicenter Osteoarthritis Study of patients aged 50 to 79 years with, or who were at risk for, knee OA. Patients’ 12-year visits were used to discern baseline status, including patient-answered surveys regarding pain. All participants underwent knee radiographs and bilateral knee CT scans. Patients were evaluated for pain scores every 8 months for 2 years.
The researchers used three pain outcome measures — frequent knee pain, intermittent or constant pain, and worsening pain. Liew and colleagues accounted for confounding variables including age, sex and race of patient, as well as the site of their trial evaluations of BMI and Kellgren-Lawrence grades.
The analysis included 2,093 patients, of whom 10.2% demonstrated intra-articular mineralization detectable by CT. According to the researchers, patients with any kind of mineralization in the knee cartilage had twice the odds of experiencing frequent knee pain (95% CI, 1.38-2.78) and were 1.86 times more likely to have intermittent or constant knee pain (95% CI, 1.2-2.78). The researchers noted similar results when mineralization was found in the meniscus or joint capsule.
“IA knee mineralization was associated with an increased risk of developing frequent knee pain, more intermittent or constant pain, and greater knee pain severity over two years,” Liew and colleagues wrote. “These findings implicate calcium crystal deposition in changing pain patterns over time in knee OA. These insights also raise the potential for developing and testing therapies directed towards crystal deposition and downstream mediators to improve knee OA symptoms.”
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