321 research outputs found
Why radiography should no longer be considered a surrogate outcome measure for longitudinal assessment of cartilage in knee osteoarthritis
Imaging of cartilage has traditionally been achieved indirectly with conventional radiography. Loss of joint space width, or 'joint space narrowing', is considered a surrogate marker for cartilage thinning. However, radiography is severely limited by its inability to visualize cartilage, the difficulty of ascertaining the optimum and reproducible positioning of the joint in serial assessments, and the difficulty of grading joint space narrowing visually. With the availability of advanced magnetic resonance imaging (MRI) scanners, new pulse sequences, and imaging techniques, direct visualization of cartilage has become possible. MRI enables visualization not only of cartilage but also of other important features of osteoarthritis simultaneously. 'Pre-radiographic' cartilage changes depicted by MRI can be measured reliably by a semiquantitative or quantitative approach. MRI enables accurate measurement of longitudinal changes in quantitative cartilage morphology in knee osteoarthritis. Moreover, compositional MRI allows imaging of 'pre-morphologic' changes (that is, visualization of subtle intrasubstance matrix changes before any obvious morphologic alterations occur). Detection of joint space narrowing on radiography seems outdated now that it is possible to directly visualize morphologic and pre-morphologic changes of cartilage by using conventional as well as complex MRI techniques
Structural correlates of pain in joints with osteoarthritis.
Objective: To describe the insights on the epidemiology of pain-structure association and the ramifications
of these studies for clinical trials.
Design: Narrative review summarizing the pertinent literature in this area, summarizing some of the
methodologic challenges inherent and proposing some research initiatives to further understanding of
this complex science.
Results: The predominant symptom in most patients presenting with osteoarthritis (OA) is pain. Over
recent years a number of imaging based studies have narrowed the discord between structural findings
on imaging and symptoms. The interpretation of pain in OA is still enigmatic and difficult to deal with
both for clinicians and scientists.
Conclusions: We would envisage that over the next few years many of the pressing questions pertaining
to research into the structure pain relationship will continue to be addressed. With this, we can expect
clinically appropriate therapeutic advanc
Structural correlates of pain in joints with osteoarthritis.
Objective: To describe the insights on the epidemiology of pain-structure association and the ramifications of these studies for clinical trials. Design: Narrative review summarizing the pertinent literature in this area, summarizing some of the methodologic challenges inherent and proposing some research initiatives to further understanding of this complex science. Results: The predominant symptom in most patients presenting with osteoarthritis (OA) is pain. Over recent years a number of imaging based studies have narrowed the discord between structural findings on imaging and symptoms. The interpretation of pain in OA is still enigmatic and difficult to deal with both for clinicians and scientists. Conclusions: We would envisage that over the next few years many of the pressing questions pertaining to research into the structure pain relationship will continue to be addressed. With this, we can expect clinically appropriate therapeutic advanc
Quantitative Assessment of Abdominal Aortic Calcification and Disk Height Loss: The Framingham Study
Abstract Background context Vascular disease has been proposed as a risk factor for disc height loss (DHL). Purpose To examine the relationship between quantitative measures of abdominal aortic calcifications (AACs) as a marker of vascular disease, and DHL, on computed tomography (CT). Study design Cross-sectional study in a community-based population. Patient sample Four hundred thirty-five participants from the Framingham Heart Study. Outcome measures Quantitative AAC scores assessed by CT were grouped as tertiles of “no” (reference), “low,” and “high” calcification. Disc height loss was evaluated on CT reformations using a four-grade scale. For analytic purposes, DHL was dichotomized as moderate DHL of at least one level at L2–S1 versus less than moderate or no DHL. Methods We examined the association of AAC and DHL using logistic regression before and after adjusting for cardiovascular risk factors and before and after adjusting for age, sex, and body mass index (BMI). Results In crude analyses, low AAC (odds ratio [OR], 2.05 [1.27–3.30]; p=.003) and high AAC (OR, 2.24 [1.38–3.62]; p=.001) were strongly associated with DHL, when compared with the reference group of no AAC. Diabetes, hypercholesterolemia, hypertension, and smoking were not associated with DHL and did not attenuate the observed relationship between AAC and DHL. Adjustment for age, sex, and BMI markedly attenuated the associations between DHL and low AAC (OR, 1.20 [0.69–2.09]; p=.51) and high AAC (OR, 0.74 [0.36–1.53]; p=.42). Conclusions Abdominal aortic calcification was associated with DHL in this community-based population. This relationship was independent of cardiovascular risk factors. However, the association of AAC with DHL was explained by the effects of age, sex, and BMI
Presence and Extent of Severe Facet Joint Osteoarthritis Are Associated with Back Pain in Older Adults
Objective To determine whether the presence and extent of severe lumbar facet joint osteoarthritis (OA) are associated with back pain in older adults, accounting for disc height narrowing and other covariates. Design Two hundred and fifty-two older adults from the Framingham Offspring Cohort (mean age 67 years) were studied. Participants received standardized computed tomography (CT) assessments of lumbar facet joint OA and disc height narrowing at the L2–S1 interspaces using four-grade semi-quantitative scales. Severe facet joint OA was defined according to the presence and/or degree of joint space narrowing, osteophytosis, articular process hypertrophy, articular erosions, subchondral cysts, and intraarticular vacuum phenomenon. Severe disc height narrowing was defined as marked narrowing with endplates almost in contact. Back pain was defined as participant report of pain on most days or all days in the past 12 months. We used multivariable logistic regression to examine associations between severe facet joint OA and back pain, adjusting for key covariates including disc height narrowing, sociodemographics, anthropometrics, and health factors. Results Severe facet joint OA was more common in participants with back pain than those without (63.2% vs 46.7%; P = 0.03). In multivariable analyses, presence of any severe facet joint OA remained significantly associated with back pain (odds ratio (OR) 2.15 [95% confidence interval (CI) 1.13–4.08]). Each additional joint with severe OA conferred greater odds of back pain [OR per joint 1.20 (95% CI 1.02–1.41)]. Conclusions The presence and extent of severe facet joint OA on CT imaging are associated with back pain in community-based older adults, independent of sociodemographics, health factors, and disc height narrowing
Meniscus body position and its change over four years in asymptomatic adults: a cohort study using data from the Osteoarthritis Initiative (OAI).
A high degree of meniscal body extrusion on knee magnetic resonance imaging has been shown to be strongly associated with development of knee osteoarthritis. However, very little is known about meniscal position in the asymptomatic knee and its natural history. Hence our objective was to study meniscal body position and its change over 4 years in asymptomatic adults
Imaging Biomarker Validation and Qualification Report: 6th OARSI Workshop on Imaging in Osteoarthritis Combined with 3rd OA Biomarkers Workshop.
Summary The sixth Osteoarthritis Research Society International (OARSI) Workshop on Imaging in Osteoarthritis combined with the third osteoarthritis (OA) Biomarkers Workshop is the first to bring together the imaging and molecular biomarker communities to focus on clinical validation and qualification of OA biomarkers. The workshop was held in Hilton Head, SC, USA, from June 12–14, 2012; 138 attendees participated, including representatives from academia, pharmaceutical and magnetic resonance imaging (MRI) industries, Food and Drug Administration (FDA), and National Institutes of Health (NIH). Presentations and discussions raised awareness, consolidated knowledge, and identified strategies to overcome challenges for the development and application of imaging and biochemical biomarkers in OA research studies and clinical trials. Conclusion The OA research communities need to work alongside regulatory agencies across the world, to qualify and validate new chemical and imaging biomarkers for future research and clinical trials
Imaging of Osteoarthritis
Osteoarthritis (OA) is the most prevalent joint disorder in the elderly, and there is no effective treatment. Imaging is essential for evaluating the synovial joint structures (including cartilage, meniscus, subchondral bone marrow and synovium) for diagnosis, prognosis, and follow-up. This article describes the roles and limitations of both conventional radiography and magnetic resonance (MR) imaging, and considers the use of other modalities (eg, ultrasonography, nuclear medicine, computed tomography [CT], and CT/MR arthrography) in clinical practice and OA research. The emphasis throughout is on OA of the knee. This article emphasizes research developments and literature evidence published since 2008
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