Volume index as a new measure of cartilage loss: a retrospective MRI-based study of chondral injury patterns in adult patients with knee pain

2021 ◽  
Author(s):  
Arjun Naik ◽  
Saseendar Shanmugasundaram ◽  
Kavya Mahadev ◽  
Asode Ananthram Shetty ◽  
Seok Jung Kim
Keyword(s):  
Knee Pain ◽  
Adult Patients ◽  
Cartilage Loss ◽  
Volume Index ◽  
Injury Patterns ◽  
Chondral Injury

scholarly journals Does cartilage loss cause pain in osteoarthritis and if so, how much?

2020 ◽  
Vol 79 (8) ◽  
pp. 1105-1110 ◽  
Author(s):  
Kathryn Bacon ◽  
Michael P LaValley ◽  
S Reza Jafarzadeh ◽  
David Felson
Keyword(s):  
Knee Pain ◽  
Linear Models ◽  
Structural Features ◽  
Pain Scale ◽  
Small Degree ◽  
Cartilage Thickness ◽  
Cartilage Loss ◽  
Womac Pain ◽  
Womac Pain Score ◽  
Thickness Loss

ObjectivesAlthough treatment development in osteoarthritis (OA) focuses on chondroprotection, it is unclear how much preventing cartilage loss reduces joint pain. It is also unclear how nociceptive tissues may be involved.MethodsUsing data from the Osteoarthritis Initiative, we quantified the relation between cartilage loss and worsening knee pain after adjusting for bone marrow lesions (BMLs) and synovitis, and examined how much these factors mediated this association. 600 knee MRIs were scored at baseline, 12 months and 24 months for quantitative and semiquantitative measures of OA structural features. We focused on change in medial cartilage thickness using an amount similar to that seen in recent trials. Linear models calculated mean change in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain score with cartilage loss, adjusted for baseline BMLs, synovitis and covariates. Mediation analysis tested whether change in synovitis or BMLs mediated the cartilage loss–pain association. We carried out a subanalysis for knees with non-zero baseline WOMAC pain scores and another for non-valgus knees.ResultsCartilage thickness loss was significantly associated with a small degree of worsening in pain over 24 months. For example, a loss of 0.1 mm of cartilage thickness over 2 years was associated with a 0.32 increase in WOMAC pain (scale 0–20). The association of cartilage thickness loss with pain was mediated by synovitis change but not by BML change. Subanalysis results were similar.ConclusionsCartilage thickness loss is associated with only a small amount of worsening knee pain, an association mediated in part by worsening synovitis. Demonstrating that chondroprotection reduces knee pain will be extremely challenging and is perhaps unachievable.

scholarly journals Impact of Right Ventricular Dilatation in Patients with Atrial Septal Defect

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Rie Nakayama ◽  
Yoichi Takaya ◽  
Teiji Akagi ◽  
Koji Nakagawa ◽  
Nobuhisa Watanabe ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Atrial Septal Defect ◽  
Exercise Capacity ◽  
Septal Defect ◽  
Adult Patients ◽  
Volume Index ◽  
End Diastolic Volume ◽  
The Mean ◽  
Asd Closure ◽  
The Relationship

Objective. The aim of this study was to examine the relationship between right ventricular (RV) volume and exercise capacity in adult patients with atrial septal defect (ASD) and to determine the degree of RV dilatation for transcatheter ASD closure. Background. RV dilatation is an indication of transcatheter ASD closure; however, few studies have reported the clinical significance of RV dilatation. Methods. We enrolled 82 consecutive patients (mean age, 49 ± 18 years; female, 68%) who underwent cardiac magnetic resonance imaging and symptom-limited cardiopulmonary exercise test before ASD closure. The relationship between RV volume and peak oxygen uptake (VO2) was evaluated. Results. The mean RV end-diastolic volume index was 108 ± 27 ml/m2 (range, 46 to 180 ml/m2). The mean peak VO2 was 24 ± 7 ml/min/kg (range, 14 to 48 ml/min/kg), and the mean predicted peak VO2 was 90 ± 23%. There were significant negative relationships of RV end-diastolic volume index with peak VO2 (r = −0.28, p<0.01) and predicted peak VO2 (r = −0.29, p<0.01). The cutoff value of RV end-diastolic volume index <80% of predicted peak VO2 was 120 ml/m2, with the sensitivity of 49% and the specificity of 89%. Conclusions. There was a relationship between RV dilatation and exercise capacity in adult patients with ASD. RV end-diastolic volume index ≥120 ml/m2 was related to the reduction in peak VO2. This criterion of RV dilatation may be valuable for the indication of transcatheter ASD closure.

scholarly journals Alterations in cartilage quantification before and after injections of mesenchymal stem cells into osteoarthritic knees

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ichiro Sekiya ◽  
Hisako Katano ◽  
Mitsuru Mizuno ◽  
Hideyuki Koga ◽  
Jun Masumoto ◽  
...  
Keyword(s):  
Stem Cells ◽  
Knee Pain ◽  
Rating Scale ◽  
Area Ratio ◽  
Cartilage Loss ◽  
Osteoarthritis Of The Knee ◽  
Knee Score ◽  
3D Mri ◽  
Lysholm Knee Score ◽  
Significant Difference

AbstractSeveral studies have reported improvement in knee pain following mesenchymal stem cell (MSC) injections for knee osteoarthritis (OA). We developed a novel 3D magnetic resonance imaging (MRI) analysis software program that provides “projected cartilage area ratios” for automatic detection of changes in cartilage amounts. The primary objective of this prospective interventional study was to compare alterations in the projected cartilage area ratio (thickness ≥ 1.5 mm) at the femoral posteromedial region between 30 weeks before and 30 weeks after synovial MSC injections. Secondary objectives were to assess the clinical scores and safety of MSC injections. Patients with OA who complained of knee pain underwent autologous synovial MSC injections into the knee at time 0 and again 15 weeks later. MRI examinations were performed at − 30, − 15, − 1, and 30 weeks. Patients showing < 3% decreases in the projected cartilage area ratio (thickness ≥ 1.5 mm) at the femoral the posteromedial region from − 30 weeks to − 15 weeks were excluded from the study. The Lysholm Knee Score, Knee Injury and Osteoarthritis Outcome Scale (KOOS), and Numerical Rating Scale (NRS) scores were evaluated at − 30, − 15, − 5, − 2, 0, 5, 10, 15, 20, 25, and 30 weeks. Five patients were excluded because 3D MRI analysis showed no cartilage loss at − 15 weeks. Ultimately, eight OA patients underwent MSC injections. The projected cartilage area ratio significantly decreased by 0.07 in the 30 weeks before MSC injections (p = 0.01), but no further decreases occurred in the 30 weeks after MSC injections. The projected cartilage area ratio at the femoral posteromedial region showed a significant difference between 30 weeks before and 30 weeks after MSC injections. The Lysholm Knee Score, KOOS, and NRS values improved significantly after the injections. MSC injection could not be ruled out as the cause of two adverse events: transient knee pain and itching in both hands. Fully automatic 3D MRI analysis showed that synovial MSC injections suppressed cartilage loss in patients with progressive OA.Trial registration: Intraarticular injections of synovial stem cells for osteoarthritis of the knee (Number UMIN 000026732). Date of registration; June 1, 2017. https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000029967.

scholarly journals The association of MRI-detected subchondral bone marrow sclerosis with cartilage loss in a cohort of subjects with knee pain

2012 ◽  
Vol 20 ◽  
pp. S207-S208 ◽  
Author(s):  
M.D. Crema ◽  
J. Cibere ◽  
E.C. Sayre ◽  
F.W. Roemer ◽  
H. Wong ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Knee Pain ◽  
Subchondral Bone ◽  
Cartilage Loss

scholarly journals Global surgery for paediatric casualties in armed conflict

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Frederike J. C. Haverkamp ◽  
Lisanne van Gennip ◽  
Måns Muhrbeck ◽  
Harald Veen ◽  
Andreas Wladis ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Armed Conflict ◽  
Patient Characteristics ◽  
International Committee ◽  
Armed Conflicts ◽  
Adult Patients ◽  
Injury Patterns ◽  
Treatment Needs ◽  
Conflict Zones ◽  
Body Regions

Abstract Background Understanding injury patterns specific for paediatric casualties of armed conflict is essential to facilitate preparations by organizations that provide medical care in conflict areas. The aim of this retrospective cohort study is to identify injury patterns and treatment requirements that are specific for paediatric patients in conflict zones. Methods Characteristics of children (age < 15 years) treated in medical facilities supported by the International Committee of the Red Cross (ICRC) between 1988 and 2014 in Kabul, Kao-i-Dang, Lokichogio, Kandahar, Peshawar, Quetta and Goma were analysed; patient characteristics were compared between treatment facilities and with those of adult patients (age ≥ 15 years). Results Of the patients listed in the database, 15% (5843/38,088) were aged < 15 years. The median age was 10 years (IQR 6–12); 75% (4406/5843) were male. Eighty-six percent (5012/5,843) of the admitted children underwent surgery, with a median of 2 surgeries per patient (IQR 1–3). When compared with adult patients, children were more frequently seen with fragment injuries, burns and mine injuries; they had injuries to multiple body regions more often and had higher in-hospital mortality rates. Conclusions Children more often sustained injuries to multiple body regions and had higher in-hospital mortality than adults. These findings could have implications for how the ICRC and other organizations prepare personnel and structure logistics to meet the treatment needs of paediatric victims of armed conflicts.

The association between change in bone marrow lesion size and change in tibiofemoral cartilage volume and knee symptoms

Rheumatology ◽  
2020 ◽  
Author(s):  
Guoqi Cai ◽  
Dawn Aitken ◽  
Laura L Laslett ◽  
Catherine Hill ◽  
Anita E Wluka ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Knee Pain ◽  
Lesion Size ◽  
Cartilage Volume ◽  
Cartilage Loss ◽  
Time Intervals ◽  
Knee Oa ◽  
Symptomatic Knee Osteoarthritis ◽  
Symptomatic Knee ◽  
And Function

Abstract Objective To describe the association between change in subchondral bone marrow lesions (BMLs) and change in tibiofemoral cartilage volume and knee symptoms in patients with symptomatic knee OA. Methods In total, 251 participants (mean 61.7 years, 51% female) were included. Tibiofemoral cartilage volume was measured at baseline and 24 months, and BML size at baseline, 6 and 24 months. Knee pain and function scores were evaluated at baseline, 6 and 24 months. Change in total and compartment-specific BML size was categorized according to the Least Significance Criterion. Linear mixed-effects models were used to evaluate the associations of change in BMLs over 6 and 24 months with change in cartilage volume over 24 months and knee symptoms over 6 and 24 months. Results Total BML size enlarged in 26% of participants, regressed in 31% and remained stable in 43% over 24 months. Compared with stable BMLs in the same compartment, enlarging BMLs over 24 months were associated with greater cartilage loss (difference: −53.0mm3, 95% CI: −100.0, −6.0), and regressing BMLs were not significantly associated with reduced cartilage loss (difference: 32.4mm3, 95% CI: −8.6, 73.3) over 24 months. Neither enlargement nor regression of total BML size over 6 and 24 months was associated with change in knee pain and function over the same time intervals. Conclusions In subjects with symptomatic knee osteoarthritis and BMLs, enlarging BMLs may lead to greater cartilage loss but regressing lesions are not associated with reduced cartilage loss while neither is associated with change in knee symptoms.

Age-Related Injuries From Escalators

2021 ◽  
pp. 000313482110508
Author(s):  
Shayne R. Caswell ◽  
Chad Cash ◽  
Andrew Gratton ◽  
James Yon ◽  
Christina Colosimo ◽  
...  
Keyword(s):  
Age Groups ◽  
Emergency Department Visits ◽  
Adult Patients ◽  
Categorical Variables ◽  
White Female ◽  
Facial Trauma ◽  
Injury Patterns ◽  
Injury Surveillance System ◽  
Age Related ◽  
Youth Population

Introduction Escalators and moving stairways are omnipresent in modern life. No study to date has examined nationwide incidence and outcomes associated with injuries directly related to escalator use. The aim of this study was to describe the injury patterns, incidence, and disposition as it pertains to youth compared to adults. Methods Descriptive and comparative analyses were performed using National Electronic Injury Surveillance System data. The frequencies of categorical variables were calculated across the two age groups. Chi-squared test was performed on all categorical variables. Significance was defined as two-tailed P < 0.05. Logistic regression was used on variables that were determined to be significant from the frequency tables, with additional variable selection being used to arrive on a final model for each outcome. Results From 2009 to 2019, there were 810 youth and 3669 adults injured in escalator-associated emergency department visits. Incidence in the youth population decreased over time. Disposition was similar between groups. Injury types were similar among groups. White female adults were more likely to sustain injuries related to escalator use. Adult patients were also significantly more likely to sustain head/neck/facial trauma. Last, adult patients were found to be more likely to suffer a fatal event in comparison to the youth population. Discussion Differences in the injury patterns between youth and adult patients related to the use of escalators illustrate a need for improved injury prevention. Improved education and safety guidelines, particularly in individuals in ages 18 and up, would likely lessen the discrepancies between age groups identified in this study.

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