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Evaluating the patellofemoral joint in addition to the tibiofemoral joint alone has contributed to explaining this structure\u2013pain discordance, hence justifying a more comprehensive evaluation of whole\u2010knee OA and pain. The present study, therefore, was undertaken to evaluate the association between patellofemoral and tibiofemoral OA features with localized anterior knee pain (AKP) using 2 study designs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using cross\u2010sectional data from the Multicenter Osteoarthritis Study, our first approach was a within\u2010person, knee\u2010matched design in which we identified participants with unilateral AKP. We then assessed magnetic resonance imaging (MRI)\u2013derived OA features (cartilage damage, bone marrow lesions [BMLs], osteophytes, and inflammation) in both knees and evaluated the association of patellofemoral and tibiofemoral OA features to unilateral AKP. In our second approach, MRIs from 1 knee per person were scored, and we evaluated the association of OA features to AKP in participants with AKP and participants with no frequent knee pain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Using the first approach (n\u00a0=\u00a071, 66% women, mean\u2009\u00b1\u2009SD age 69\u2009\u00b1\u20098\u2009years), lateral patellofemoral osteophytes (odds ratio [OR] 5.0 [95% confidence interval (95% CI) 1.7\u201314.6]), whole\u2010knee joint effusion\u2010synovitis (OR 4.7 [95% CI 1.3\u201316.2]), and infrapatellar synovitis (OR 2.8 [95% CI 1.0\u20137.8]) were associated with AKP. Using the second approach (n\u00a0=\u00a0882, 59% women, mean\u2009\u00b1\u2009SD age 69\u2009\u00b1\u20097\u2009years), lateral and medial patellofemoral cartilage damage (prevalence ratio [PR] 2.3 [95% CI 1.3\u20134.0] and PR 1.9 [95% CI 1.1\u20133.3], respectively) and lateral patellofemoral BMLs (PR 2.6 [95% CI 1.5\u20134.7]) were associated with AKP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Patellofemoral but not tibiofemoral joint OA features and inflammation were associated with AKP.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acr.24604","type":"journal-article","created":{"date-parts":[[2021,3,26]],"date-time":"2021-03-26T02:42:17Z","timestamp":1616726537000},"page":"1533-1540","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Magnetic Resonance Imaging\u2013Defined Osteoarthritis Features and Anterior Knee Pain in Individuals With, or at Risk for, Knee Osteoarthritis: A Multicenter Study on Osteoarthritis"],"prefix":"10.1002","volume":"74","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2798-6052","authenticated-orcid":false,"given":"Erin M.","family":"Macri","sequence":"first","affiliation":[{"name":"Erasmus MC, Rotterdam, The Netherlands, and University of Delaware  Newark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9515-1711","authenticated-orcid":false,"given":"Tuhina","family":"Neogi","sequence":"additional","affiliation":[{"name":"Boston University and Boston Imaging Core Lab  Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Jarraya","sequence":"additional","affiliation":[{"name":"Mercy Catholic Medical Center  Darby Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Guermazi","sequence":"additional","affiliation":[{"name":"Boston University and Boston Imaging Core Lab  Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9238-7350","authenticated-orcid":false,"given":"Frank","family":"Roemer","sequence":"additional","affiliation":[{"name":"Boston University, Boston, Massachusetts, and Friedrich\u2010Alexander University Erlangen\u2010Nuremberg  Erlangen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cora E.","family":"Lewis","sequence":"additional","affiliation":[{"name":"University of Alabama at Birmingham"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James C.","family":"Torner","sequence":"additional","affiliation":[{"name":"University of Iowa  Iowa City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John A.","family":"Lynch","sequence":"additional","affiliation":[{"name":"University of California  San Francisco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irina","family":"Tolstykh","sequence":"additional","affiliation":[{"name":"University of California  San Francisco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1099-9175","authenticated-orcid":false,"given":"S. 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