Prevalence of MRI-detected mediopatellar plica in subjects with knee pain and the association with MRI-detected patellofemoral cartilage damage and bone marrow lesions: data from the Joints On Glucosamine study

Daichi Hayashi; Li Xu; Ali Guermazi; C Kent Kwoh; Michael J Hannon; Mohamed Jarraya; Stephanie M Green; John M Jakicic; Carolyn E Moore; Frank W Roemer

doi:10.1186/1471-2474-14-292

Prevalence of MRI-detected mediopatellar plica in subjects with knee pain and the association with MRI-detected patellofemoral cartilage damage and bone marrow lesions: data from the Joints On Glucosamine study

BMC Musculoskelet Disord. 2013 Oct 12:14:292. doi: 10.1186/1471-2474-14-292.

Authors

Daichi Hayashi¹, Li Xu, Ali Guermazi, C Kent Kwoh, Michael J Hannon, Mohamed Jarraya, Stephanie M Green, John M Jakicic, Carolyn E Moore, Frank W Roemer

Affiliation

¹ Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine, FGH Building 3rd Floor, 820 Harrison Avenue, Boston, MA 02118, USA. dhayashi@bu.edu.

Abstract

Background: The mediopatellar plica is a synovial fold representing an embryonic remnant from the developmental process of the synovial cavity formation in the knee. We aimed to examine the frequency of MRI-detected mediopatellar plica and its cross-sectional association with MRI-detected cartilage damage and bone marrow lesions (BMLs) in the patellofemoral joint (PFJ) in a cohort of subjects with knee pain.

Methods: 342 knees with chronic frequent knee pain were evaluated for MRI-detected mediopatellar plica (type A, B or C according to the modified Sakakibara classification). Cartilage damage (scored 0 to 6) and BMLs (scored 0 to 3) were semiquantitatively assessed in four subregions of the PFJ on MRI. Hoffa-synovitis and effusion-synovitis were graded 0 to 3. Patellar length ratio (PLR), lateral patellar tilt angle (LPTA), bisect offset (BO), and sulcus angle (SA) were measured on MRI. The presence of mediopatellar plica and its association with cartilage damage and BMLs in the PFJ was assessed using logistic regression after adjusting for age, gender, body mass index, PLR, LPTA, BO, SA, and Hoffa- and effusion-synovitis.

Results: 163 (47.7%) knees exhibited mediopatellar plica (76 (22.2%) type A, 69 (20.2%) type B, and 18 (5.3%) type C) on MRI. Significant cross-sectional associations of MRI-detected mediopatellar plica and cartilage damage were observed for the medial patella (adjusted odds ratio (aOR) 2.12, 95% CI 1.23-3.64 for all types combined, and aOR 4.20, 95% CI 1.92-9.19 for type B lesion), but not for the anterior medial femur or the lateral PFJ. No associations were found between the presence of MRI-detected mediopatellar plica and BMLs in any patellofemoral subregion.

Conclusion: On MRI, types A and B mediopatellar plicae were commonly observed in this cohort of subjects with knee pain. MRI-detected mediopatellar plica was cross-sectionally associated with higher likelihood of the presence of MRI-detected medial patellar cartilage damage after adjustment for confounders.

Trial registration: ClinicalTrials.gov NCT00277286.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Arthralgia / diagnosis*
Arthralgia / pathology
Bone Marrow / pathology*
Cartilage, Articular / pathology*
Chronic Pain / diagnosis*
Chronic Pain / pathology
Confounding Factors, Epidemiologic
Cross-Sectional Studies
Double-Blind Method
Female
Humans
Logistic Models
Magnetic Resonance Imaging*
Male
Middle Aged
Odds Ratio
Pain Measurement
Patellofemoral Joint / pathology*
Pennsylvania
Predictive Value of Tests
Risk Factors
Severity of Illness Index
Synovial Membrane / pathology*
Synovitis / diagnosis
Synovitis / pathology

Associated data

ClinicalTrials.gov/NCT00277286