# The frequency and severity of ultrasound-detected osteoarthritis features in the knees and their associations with pain: Cross-sectional analyses of the Nor-Hand study

## TL;DR

This study found that ultrasound-detected osteophytes are common in people with knee osteoarthritis and are linked to pain, suggesting they may be early signs of the condition.

## Contribution

The study provides new evidence on the association between ultrasound-detected osteophytes and knee pain in individuals with and without diagnosed osteoarthritis.

## Key findings

- Osteophytes were more common in people with knee OA compared to those without.
- Osteophyte sum score was associated with higher WOMAC pain scores.
- Severe synovitis was linked to a higher odds of knee pain.

## Abstract

To investigate the frequency and severity of ultrasound-detected osteophytes and synovitis in people with and without knee osteoarthritis (OA), and to explore the association between these ultrasound features and pain.

In the Nor-Hand study, both knees were assessed for osteophytes (0–3 scale, four locations per knee) and grey-scale synovitis (0–3 scale). The frequency and severity of the ultrasound-detected features were compared in individuals with and without knee OA defined by the American College of Rheumatology criteria. Pain was self-reported in each knee (yes/no) and by the Western/Ontario McMaster University index (WOMAC). The associations between ultrasound-detected features and pain were examined by regression analyses adjusted for age, sex, and body mass index.

We analyzed 286 participants. Osteophytes of all sizes were more common in participants with knee OA compared to those without (65.9 ​% vs. 40.8 ​%, p ​< ​0.001). No between-group difference was found for the frequency of any grey-scale synovitis (45.5 ​% vs. 44.7 ​%, p ​= ​0.67), while severe synovitis was more common in those with knee OA. Ultrasound-detected osteophyte sum score, but not synovitis, was associated with WOMAC pain (B ​= ​0.18, 95 ​% CI 0.03–0.32). Osteophytes of all sizes were associated with pain in the same knee with odds ratio (OR, 95 ​% CI) ranging from 1.85 (1.20–2.84) to 9.02 (4.04–20.10). Statistically significant association was found for severe synovitis only (OR ​= ​6.63, 95 ​% CI 2.26–19.43).

Ultrasound-detected osteophytes were prevalent in people with knee OA and were associated with pain. OA pathology in individuals without fulfilling the knee OA criteria may reflect early or subclinical OA.