Subchondral bone in knee osteoarthritis: bystander or treatment target?
AbstractThe subchondral bone is an important structural component of the knee joint relevant for osteoarthritis (OA) incidence and progression once disease is established. Experimental studies have demonstrated that subchondral bone changes are not simply the result of altered biomechanics, i.e., pathologic loading. In fact, subchondral bone alterations have an impact on joint homeostasis leading to articular cartilage loss already early in the disease process. This narrative review aims to summarize the available and emerging imaging techniques used to evaluate knee OA-related subchondral bone changes and their potential ...
Source: Skeletal Radiology - September 20, 2023 Category: Radiology Source Type: research
Quantitative bone marrow lesion, meniscus, and synovitis measurement: current status
AbstractImaging plays a pivotal role in osteoarthritis research, particularly in epidemiological and clinical trials of knee osteoarthritis (KOA), with the ultimate goal being the development of an effective drug treatment for future prevention or cessation of disease. Imaging assessment methods can be semi-quantitative, quantitative, or a combination, with quantitative methods usually relying on software to assist. The software generally attempts image segmentation (outlining of relevant structures). New techniques using artificial intelligence (AI) or deep learning (DL) are currently a frequent topic of research. This re...
Source: Skeletal Radiology - September 20, 2023 Category: Radiology Source Type: research
Muscle strength and osteoarthritis of the knee: a systematic review and meta-analysis of longitudinal studies
ConclusionLow knee extensor and flexor strength increased the risk of worsening tibiofemoral osteoarthritis. Low knee extensor strength increased the risk of worsening patellofemoral osteoarthritis. The relationship between low knee extensor strength and worsening tibiofemoral osteoarthritis may be modified by sex/gender. (Source: Skeletal Radiology)
Source: Skeletal Radiology - September 20, 2023 Category: Radiology Source Type: research
2D versus 3D MRI of osteoarthritis in clinical practice and research
AbstractAccurately detecting and characterizing articular cartilage defects is critical in assessing patients with osteoarthritis. While radiography is the first-line imaging modality, magnetic resonance imaging (MRI) is the most accurate for the noninvasive assessment of articular cartilage. Multiple semiquantitative grading systems for cartilage lesions in MRI were developed. The Outerbridge and modified Noyes grading systems are commonly used in clinical practice and for research. Other useful grading systems were developed for research, many of which are joint-specific. Both two-dimensional (2D) and three-dimensional (...
Source: Skeletal Radiology - September 20, 2023 Category: Radiology Source Type: research
A clinician ’s perspective on the role of imaging in knee osteoarthritis in clinical practice
AbstractKnee osteoarthritis (OA) is a highly prevalent and disabling disease. Most persons age 45 and over with chronic knee pain have OA and with characteristic history and physical findings, diagnostic imaging is usually not necessary. Further, treatment of chronic knee pain with or without evidence of OA is similar, so imaging does not usually alter therapy. The exception is atypical presentations, such as sudden onset of pain perhaps after trauma or evidence of arthritis in atypical locations elsewhere in the body. Imaging is also unnecessary to follow patients. Given the absence of treatments that slow progression, th...
Source: Skeletal Radiology - September 20, 2023 Category: Radiology Source Type: research
Osteoarthritis of the hip: is radiography still needed?
Abstract
Diagnosis of hip osteoarthritis (OA) is based on clinical arguments, and medical imaging is obtained to confirm the diagnosis and rule out other possible sources of pain. Conventional radiographs are recommended as the first line imaging modality to investigate chronic hip pain. They should be obtained in a rigorous technique that includes an antero-posterior (AP) radiograph of the pelvis. The choice of the appropriate lateral view depends on the clinical indication, Lequesne ’s false profile being valuable in the assessment of OA. Magnetic resonance imaging (MRI) is more sensitive to detect joint effusion/sy...
Source: Skeletal Radiology - September 20, 2023 Category: Radiology Source Type: research
Quantitative measurement of cartilage morphology in osteoarthritis: current knowledge and future directions
The objective of this narrative review is to summarize the current status of cartilage morphometry in OA research, to provide insights into aspects relevant for the design of future studies and clinical trials, and to give an outlook on fu ture developments. It covers the aspects related to the acquisition of MRIs suitable for cartilage morphometry, the analysis techniques needed for deriving quantitative measures from the MRIs, the quality assurance required for providing reliable cartilage measures, and the appropriate participant r ecruitment criteria for the enrichment of study cohorts with knees likely to show structu...
Source: Skeletal Radiology - September 20, 2023 Category: Radiology Source Type: research
Imaging of osteoarthritis from the ankle through the midfoot
AbstractAnkle, hindfoot, and midfoot osteoarthritis (OA) is most commonly posttraumatic and tends to become symptomatic in younger patients. It often results from instability due to insufficiency of supportive soft tissue structures, such as ligaments and tendons. Diagnostic imaging can be helpful to detect and characterize the distribution of OA, and to assess the integrity of these supportive structures, which helps determine prognosis and guide treatment. However, the imaging findings associated with OA and instability may be subtle and unrecognized until the process is advanced, which may ultimately limit therapeutic o...
Source: Skeletal Radiology - September 20, 2023 Category: Radiology Source Type: research
MRI-based T1rho and T2 cartilage compositional imaging in osteoarthritis: what have we learned and what is needed to apply it clinically and in a trial setting?
AbstractCartilage MRI-based T1rho and T2 compositional measurements have been developed to characterize cartilage matrix quality and diagnose cartilage damage before irreversible defects are found, allowing intervention at an early, potentially reversible disease stage. Over the last 2 decades, this technology was investigated in numerous studies and was validated using specimen studies and arthroscopy; and longitudinal studies documented its ability to predict progression of degenerative disease and radiographic osteoarthritis (OA). While T1rho and T2 measurements have shown promise in early disease stages, several hurdle...
Source: Skeletal Radiology - September 20, 2023 Category: Radiology Source Type: research
Crystal arthropathies and osteoarthritis —where is the link?
AbstractOsteoarthritis (OA) is one of the leading causes of disability worldwide. As our understanding of OA progressively has moved from a purely mechanical “wear and tear” concept toward a complex multi-tissue condition in which inflammation plays a central role, the possible role of crystal-induced inflammation in OA incidence and progression may be relevant. In addition to gout, which affects 4% of the US population, basic calcium phosphate and c alcium pyrophosphate deposition both may induce joint inflammation and may play a role in pain in OA. This narrative review article discusses the possible mechanisms under...
Source: Skeletal Radiology - September 20, 2023 Category: Radiology Source Type: research
Imaging of early-stage osteoarthritis: the needs and challenges for diagnosis and classification
AbstractIn an effort to boost the development of new management strategies for OA, there is currently a shift in focus towards the diagnosis and treatment of early-stage OA. It is important to distinguish diagnosis from classification of early-stage OA. Diagnosis takes place in clinical practice, whereas classification is a process to stratify participants with OA in clinical research. For both purposes, there is an important opportunity for imaging, especially with MRI. The needs and challenges differ for early-stage OA diagnosis versus classification. Although it fulfils the need of high sensitivity and specificity for m...
Source: Skeletal Radiology - September 20, 2023 Category: Radiology Source Type: research
Deep learning applications in osteoarthritis imaging
This article will provide a review of current applications of DL in osteoarthritis (OA) imaging, including methods used for cartilage lesion detection, OA diagnosis, cartilage segmentation, and OA risk assessment. DL techniques have been shown to have similar diagnostic performance as human readers for detecting and grading cartilage lesions within the knee on MRI. A variety of DL methods have been developed for detecting and grading the severity of knee OA and various features of knee OA on X-rays using standardized classification systems with diagnostic performance similar to human readers. Multiple DL approaches have be...
Source: Skeletal Radiology - September 20, 2023 Category: Radiology Source Type: research
Glenohumeral osteoarthritis: what the surgeon needs from the radiologist
This article reviews the above concepts and details what a surgeon needs from a radiologist and could benefit from accurate reporting of preoperative imaging studies. (Source: Skeletal Radiology)
Source: Skeletal Radiology - September 20, 2023 Category: Radiology Source Type: research
Morphological assessment of cartilage and osteoarthritis in clinical practice and research: Intermediate-weighted fat-suppressed sequences and beyond
AbstractMagnetic resonance imaging (MRI) is widely regarded as the primary modality for the morphological assessment of cartilage and all other joint tissues involved in osteoarthritis. 2D fast spin echo fat-suppressed intermediate-weighted (FSE FS IW) sequences with a TE between 30 and 40ms have stood the test of time and are considered the cornerstone of MRI protocols for clinical practice and trials. These sequences offer a good balance between sensitivity and specificity and provide appropriate contrast and signal within the cartilage as well as between cartilage, articular fluid, and subchondral bone. Additionally, FS...
Source: Skeletal Radiology - September 20, 2023 Category: Radiology Source Type: research
Biomarkers in osteoarthritis: current status and outlook — the FNIH Biomarkers Consortium PROGRESS OA study
AbstractCurrently, no disease-modifying therapies are approved for osteoarthritis (OA) use. One obstacle to trial success in this field has been our existing endpoints ’ limited validity and responsiveness. To overcome this impasse, the Foundation for the NIH OA Biomarkers Consortium is focused on investigating biomarkers for a prognostic context of use for subsequent qualification through regulatory agencies. This narrative review describes this activity and th e work underway, focusing on the PROGRESS OA study. (Source: Skeletal Radiology)
Source: Skeletal Radiology - September 20, 2023 Category: Radiology Source Type: research
