S128 Poster Presentations / Osteoarthritis and Cartilage 18, Supplement 2 (2010) S45–S256 on the outcome variables: WOMAC pain score, WOMAC physical func- tioning score, SF36 Physical Component Summary (PCS) and SF36 Mental Component Summary (MCS). Results: In CHECK 1002 participants were included, mean age of 56 years, mean BMI of 26 kg/m 2 and 79% female. 76% of participants with knee symptoms fulfilled the clinical ACR criteria for classification of OA at the start and 24% participants with early hip OA fulfilled the clinical classification criteria of hip OA. Over 67% of the total study population had comorbidity: severe or persistent disorders of neck, shoulder, elbow, wrist or hand (23%), hypertension (20%) and severe or persistent back disorders (18%) were most prevalent. The results indicate that the pain score and physical function score on the WOMAC deteriorates with about 3 and 4 points respectively with every (extra) comorbidity. The physical and mental status of the SF36 deteriorates with respectively about 2 and 1 point with every (extra) comorbidity. Results of the final model (controlling for age, gender, Kellgren & Lawrence grade) show that severe back disorders have the most negative effect on WOMAC pain, physical functioning and one of the most negative effects on physical status of SF36. The presence of this disorder increases WOMAC pain score on average with 7 points, WOMAC function score with 8 points, and SF36 PCS score with 4 points. The mental status was negatively influenced by the presence of duodenal/ulcera, thyroid disease, and migraine or regular headache. Conclusions: In the early stage of osteoarthritis the effect of the presence of especially diseases in the locomotor system have negative effect on complaints and health status. The clinical implications are that to improve the physical health of participants with early OA of knee and/or hip not only the complaints related to OA have to be treated but also the additional diseases, especially back, neck, shoulder, elbow, wrist or hand disorders or obesity. Apart from the physical status also the mental status is affected in the early stage of OA by the presence of comorbidity and this is a further reason to take comorbidity into account in the management of early OA. 286 A SYSTEMATIC REVIEW OF THE ASSOCIATION BETWEEN RADIOGRAPHIC AND CLINICAL FEATURES OF HIP AND KNEE OSTEOARTHRITIS: THE IMPORTANCE OF METHODOLOGICAL QUALITY M.B. Kinds 1,2 , P.M. Welsing 1,3 , E.P. Vignon 4 , J.W. Bijlsma 1 , M.A. Viergever 2 , A.C. Marijnissen 1 , F.P. Lafeber 1 1 Rheumatology & Clinical Immunology, Univ. Med. Ctr. Utrecht, Utrecht, Netherlands; 2 Image Sci. Inst., Univ. Med. Ctr. Utrecht, Utrecht, Netherlands; 3 Julius Ctr. for Hlth.Sci. & Primary Care, Univ. Med. Ctr. Utrecht, Utrecht, Netherlands; 4 Rheumatology, Lyon-Sud Univ. Hosp., Pierre-Bénite, France Purpose: Still there is debate on the presumed association between radio- graphic and clinical features of OA. Inconsistency in reported associations might be caused by different definitions of clinical OA, and by different protocols and scoring methods for radiographic damage. Objective of this review is to evaluate whether there is an association between radiographic OA and clinical OA of hip and knee, taking into account the importance of disease definition, radiographic protocol, and standardised outcome measures. Methods: A systematic literature search was performed and results were screened for studies describing radiographic and clinical OA. To enable comparison of study results, seven classification criteria for general study quality and for methodological quality were developed. The methodological criteria consisted of specific OA definition for inclusion, standardised radio- graphic protocols, and standardised radiographic and clinical OA outcomes. Associations were evaluated, and classified as present when significant, as absent when not significant, and as non-evident when not all performed comparisons were significant. The influence of fulfilling classification crite- ria on the association was investigated, by classifying both the number and the specific criteria fulfilled. Results: The literature search resulted in 47 studies describing associations between radiographic and clinical OA. In all studies, associations were present in 15%, absent in 19%, and non-evident in 66%. Associations were strongest in the 6 studies fulfilling all classification criteria; present in 50%, absent in 17%, and non-evident in 33% of studies. Associations diminished significantly (p<0.01) when the number of fulfilled criteria decreased (see figure). Specifically the criteria for radiographic protocol, and standardised outcomes proved of importance. Associations were present in 35%, absent in 12%, and non-evident in 53% of the 17 studies in which the radiographic protocol was adequate. In the 30 studies not fulfilling this criterion, asso- ciations were significantly (p=0.012) lower: associations were non-evident Figure 1. Frequency of associations: + (association), +/– (non-evident association), and – (no association) in 6, 8, 17, and 16 studies fulfilling 7 (all), 6, 5, and ≤4 classification criteria respectively. Linear regression analysis with number of criteria as independent variable and association + vs association +/– and – as dependent variable: p<0.01. in 74% of studies, present in only 3%, and absent in 23% of studies. Con- sidering standardised outcomes, associations were present in 26%, absent in 37%, and non-evident in 37% of studies when the criterion was fulfilled. When the criterion was not fulfilled, associations were significantly lower (p=0.002): associations were non-evident in 86% of studies, only present in 7% of studies, and absent in 7% of studies. Conclusion: Associations between radiographic and clinical OA features were more commonly present when studies fulfilled criteria for method- ological quality. Specifically the quality of radiographic protocol and standardised outcomes are important for future research. Sponsor: Dutch Arthritis Association. Disclosure Statement: No conflict of interest. 287 CORRELATION BETWEEN SYNOVITIS DETECTED ON ENHANCED-MAGNETIC RESONANCE IMAGING AND A HISTOLOGICAL ANALYSIS WITH A PATIENT-ORIENTED OUTCOME MEASURE FOR JAPANESE PATIENTS WITH END-STAGE KNEE OSTEOARTHRITIS RECEIVING JOINT REPLACEMENT SURGERY F. Ippei 1 , L. Liu 2 , M. Ishijima 1,2 , H. Kaneko 1 , M. Kubota 2 , T. Kawasaki 2 , L. Ning 2 , H. Ikeda 2 , Y. Takazawa 2 , Y. Saita 2 , Y. Kimura 2 , K. Kaneko 1,2 , H. Kurosawa 2 1 Juntendo Univ. Graduate Sch. of Med., Tokyo, Japan; 2 Juntendo Univ. Sch. of Med., Tokyo, Japan Purpose: The degeneration and destruction of articular cartilage are asso- ciated with the progression of osteoarthritis (OA). The synovitis has been revealed to be one of the potential predictive factors for both structural and symptomatic progression of the disease, indicating its crucial role in the pathophysiology of OA. Enhanced MRI using gadolinium diethylen- etriaminepentaacetic acid (Gd-MRI) has been proposed as a potentially valuable tool for evaluating synovitis in OA. The Japanese Knee Osteoarthritis Measure (JKOM) was created as an outcome measure for Japanese patients with knee OA. This measure has proven to have sufficient reliability and validity by means of statistical evaluation and comparison with the Western Ontario and McMaster Uni- versities Arthritis Index (WOMAC). The aim of this study was to examine whether synovitis in knee OA assessed by histological examinations and enhanced MRI correlated with the disability of Japanese patients with knee OA who required total knee arthroplasty (TKA) using the JKOM. Methods: Thirty-four patients who fulfilled the ACR criteria for knee OA and required TKA due to the end-stage OA knees were enrolled in this study. Clinical manifestations were evaluated by the JKOM score and a pain by a VAS score. The JKOM is a patient-based, self answering evaluation score that includes of 4 subcategories: pain and stiffness, activities of daily living, social activities, and general health conditions with 100 points as the maximum score. In addition to the JKOM, the WOMAC was also used to evaluate the clinical manifestations. For histological examination, the synovial samples were obtained during the operation from 5 regions of interest (ROIs). The paraffin sections of the samples were cut and stained with hematoxylin and eosin. Six inflammatory parameters were graded