Morphology

2016 ◽  
Author(s):  
Richard Aspden ◽  
Jenny Gregory
Keyword(s):  
Structural Changes ◽  
Imaging Modality ◽  
Alpha Angle ◽  
Joint Space ◽  
Imaging Biomarkers ◽  
Shape Variation ◽  
Shape Modelling ◽  
Knee Oa ◽  
Joint Morphology ◽  
New Variables

The study of joint morphology can help us to understand the risk factors for osteoarthritis (OA), how it progresses, and aids in developing imaging biomarkers for study of the disease. OA results in gross structural changes in affected joints. Growth of osteophytes, deformation of joint components, and loss of joint space where cartilage has broken down are all characteristics of the disorder. Certain bone shapes as well as malalignment predispose people to future OA, or may be a marker for early OA. Geometrical measures, such as the alpha angle or Wiberg’s CE angle, used to be the primary tool for investigating morphology. In recent years, however, statistical shape modelling (SSM) has become increasingly popular. SSM can be used with any imaging modality and has been successfully applied to a number of musculoskeletal conditions. It uses sets of landmark points denoting the anatomy of one or more bones to generate new variables (modes) that describe and quantify the shape variation in a set of images via principal components analysis. With the aid of automated search algorithms for point placement, the use of SSMs is expanding and provides a valuable and versatile tool for exploration of bone and joint morphometry. Whilst the majority of research has focused on hip and knee OA, this chapter provides an overview of joint morphology through the whole skeleton and how it has helped our ability to understand and quantify the risk and progression of osteoarthritis.

scholarly journals Comparison of Diagnostic Performance of Semi-Quantitative Knee Ultrasound and Knee Radiography with MRI: Oulu Knee Osteoarthritis Study

2016 ◽  
Vol 6 (1) ◽  
Author(s):  
Jana Podlipská ◽  
Ali Guermazi ◽  
Petri Lehenkari ◽  
Jaakko Niinimäki ◽  
Frank W. Roemer ◽  
...  
Keyword(s):  
Articular Cartilage ◽  
Knee Osteoarthritis ◽  
Diagnostic Performance ◽  
Structural Changes ◽  
Morphological Changes ◽  
Cost Effective ◽  
Conventional Radiography ◽  
Joint Space ◽  
Meniscal Extrusion ◽  
Knee Oa

Abstract Osteoarthritis (OA) is a common degenerative musculoskeletal disease highly prevalent in aging societies worldwide. Traditionally, knee OA is diagnosed using conventional radiography. However, structural changes of articular cartilage or menisci cannot be directly evaluated using this method. On the other hand, ultrasound is a promising tool able to provide direct information on soft tissue degeneration. The aim of our study was to systematically determine the site-specific diagnostic performance of semi-quantitative ultrasound grading of knee femoral articular cartilage, osteophytes and meniscal extrusion, and of radiographic assessment of joint space narrowing and osteophytes, using MRI as a reference standard. Eighty asymptomatic and 79 symptomatic subjects with mean age of 57.7 years were included in the study. Ultrasound performed best in the assessment of femoral medial and lateral osteophytes, and medial meniscal extrusion. In comparison to radiography, ultrasound performed better or at least equally well in identification of tibio-femoral osteophytes, medial meniscal extrusion and medial femoral cartilage morphological degeneration. Ultrasound provides relevant additional diagnostic information on tissue-specific morphological changes not depicted by conventional radiography. Consequently, the use of ultrasound as a complementary imaging tool along with radiography may enable more accurate and cost-effective diagnostics of knee osteoarthritis at the primary healthcare level.

scholarly journals Assessment of clinical significance of ultrasonographic detection ofhyperechogenic deposits in hyaline cartilage in patients with knee osteoarthritis

2019 ◽  
Vol 57 (1) ◽  
pp. 33-37
Author(s):  
A. V. Petrov ◽  
N. V. Matveeva ◽  
A. A. Petrov
Keyword(s):  
Structural Changes ◽  
Hyaline Cartilage ◽  
Clinical Manifestations ◽  
Joint Space ◽  
Calcium Pyrophosphate ◽  
Knee Joints ◽  
X Ray ◽  
Knee Oa ◽  
Reactive Protein ◽  
History Of

The aimof the study was to assess the relationship between the detection of hyperechogenic deposits (HD) in the hyaline cartilage of the knee joints (KJ) at ultrasonography in patients with osteoarthritis (OA), clinical manifestations and structural changes according to KJ ultrasonography and radiography.Material and methods.A prospective analysis of clinical, radiological and ultrasonographic data of 114 patients with knee OA was conducted. The patients were divided into two groups: 32 patients with HD detected in at least one of the KJ, and 82 patients without HD; 32 patients of the 1st group and 34 patients of the 2nd group were observed for 2 years. A comparative assessment of initial clinical manifestations (WOMAC index), x-ray data and ultrasonographic parameters of the subchondral bone, hyaline cartilage and the degree of synovial inflammation in the groups of patients at the beginning of the study and after 2 years was carried out. The exclusion criteria were other joint diseases; paroxysmal course of the inflammatory process in KJ; trauma and history of operations on KJ; ESR >20 mm/h, uric acid level >360 μmol/l and C-reactive protein >5 mg/l.Results and discussion.HD in hyaline cartilage was found in 28.1% of patients with knee OA. After 2 years HD remained in all patients having them at inclusion, and in 5.6% of the patients they were found for the first time. In 13 patients with HD in hyaline cartilage, synovial fluid was studied and in all cases calcium pyrophosphate crystals were identified by phase-contrast microscopy. The presence of HD in the hyaline cartilage of patients with knee OA was accompanied by more pronounced ultrasonographic signs of synovitis and was associated with a higher rate of osteophytes growth in the absence of the changes of the hyaline cartilage thickness according to the ultrasonography and the width of the joint space according to x-ray.Conclusion.The presence of HD in the hyaline cartilage of patients with knee OA according to ultrasound examination may be associated with the deposition of calcium pyrophosphate crystals and is associated with persistent synovitis and accelerated growth of osteophytes.

scholarly journals OP0303 CORTICOSTEROID INJECTION IN KNEE OSTEOARTHRITIS IS ASSOCIATED WITH REDUCTION IN MENISCAL THICKNESS AND JOINT SPACE WIDTH WITH NO EFFECT ON CARTILAGE THICKNESS: A CASE CONTROL STUDY

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 188.1-188
Author(s):  
J. P. Pelletier ◽  
J. P. Raynauld ◽  
F. Abram ◽  
M. Dorais ◽  
P. Paiement ◽  
...  
Keyword(s):  
Treatment Period ◽  
Structural Changes ◽  
Joint Space Width ◽  
Lateral Compartment ◽  
Joint Space ◽  
Cartilage Volume ◽  
Post Treatment ◽  
Womac Pain ◽  
Knee Oa ◽  
Pre Treatment

Background:Intra-articular corticosteroid injections (IACI) are commonly used for the treatment of symptomatic knee osteoarthritis (OA) and therapeutic guidelines have recommended their use. However, their safety regarding the evolution of structural changes remains unknown.Objectives:This study explored the effects of IACI on the evolution of knee OA structural changes assessed by magnetic resonance imaging (MRI).Methods:Participants were selected from the Osteoarthritis Initiative database. In this nested case-control design study, participants who received one treatment with IACI and had MRI exams available at the yearly follow-up visits before (pre-treatment), during (treatment), and after (post-treatment) were defined as “cases”. Each case was matched with one control for age, gender, body mass index (BMI), height, joint space width (JSW), cartilage volume, bone marrow lesion (BML), meniscal extrusion, and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain at baseline. Ninety-three (93) participants fulfilling the inclusion criteria were selected and matched to controls (n=93). The study structural variables were MRI (cartilage volume, meniscal thickness, bone marrow lesion (BML), bone curvature), X-rays (JSW), and symptoms (WOMAC pain), assessed at the yearly consecutive visits and changes measured within the follow-up periods.Results:At baseline, the control and treatment groups were balanced. In the pre-treatment period, the cartilage volume loss in the medial compartment was significantly greater in the IACI (p=0.006) compared to the control group, with a numerical trend (p=0.071) in the lateral compartment. In the treatment period, the cartilage loss was not different between groups, with the exception of a significantly greater loss in the lateral compartment in the IACI group (p=0.041). In the post-treatment period there was no difference in the cartilage loss between the groups in both compartments. For the meniscal thickness loss in the pre-treatment period, no difference was found between groups; however, there was a significantly greater loss (p=0.007) during the treatment period in the IACI. In the post-treatment period, the loss of the medial meniscus was similar in both groups. For the lateral meniscus, there was no significant difference at any time between the two groups. The loss in JSW in the pre- and post-treatment periods was not different between groups, but was significantly greater (p=0.011) in the IACI group in the treatment period. The changes in the BML sizes over time were small and similar between groups. For the bone curvature, IACI group showed a smaller change compared to the control (p=0.037) at the treatment period. The WOMAC pain changes in both groups were small and unlikely to be clinically relevant.Conclusion:This study provides evidence that in knee OA, IACI were not associated with the occurrence of any deleterious effect on knee structures post-treatment, including cartilage volume and loss. The increase in the rate loss of medial meniscal thickness, which was associated with a loss of JSW, was a transient phenomenon and its clinical relevance unknown at that time.Acknowledgments:This initiative was funded by a grant from La Chaire en arthrose de l’Université de Montréal, and by ArthroLab Inc. (both in Montreal, Quebec, Canada).Disclosure of Interests:Jean-Pierre Pelletier Shareholder of: ArthroLab Inc., Grant/research support from: TRB Chemedica, Speakers bureau: TRB Chemedica and Mylan, Jean-Pierre Raynauld Consultant of: ArthroLab Inc., François Abram Employee of: ArthroLab Inc., Marc Dorais Consultant of: ArthroLab Inc., Patrice Paiement Employee of: ArthroLab Inc., Johanne Martel-Pelletier Shareholder of: ArthroLab Inc., Grant/research support from: TRB Chemedica

scholarly journals Phospholipase A2 inhibitor–loaded micellar nanoparticles attenuate inflammation and mitigate osteoarthritis progression

2021 ◽  
Vol 7 (15) ◽  
pp. eabe6374
Author(s):  
Yulong Wei ◽  
Lesan Yan ◽  
Lijun Luo ◽  
Tao Gui ◽  
Biang Jang ◽  
...  
Keyword(s):  
Clinical Success ◽  
Joint Space ◽  
Therapeutic Agents ◽  
Knee Joints ◽  
Phospholipid Membrane ◽  
Drug Discovery And Development ◽  
Knee Oa ◽  
Clinical Challenge ◽  
Osteoarthritis Progression ◽  
Human And Mouse

Treating osteoarthritis (OA) remains a major clinical challenge. Despite recent advances in drug discovery and development, no disease-modifying drug for knee OA has emerged with any notable clinical success, in part, due to the lack of valid and responsive therapeutic targets and poor drug delivery within knee joints. In this work, we show that the amount of secretory phospholipase A2 (sPLA2) enzyme increases in the articular cartilage in human and mouse OA cartilage tissues. We hypothesize that the inhibition of sPLA2 activity may be an effective treatment strategy for OA. To develop an sPLA2-responsive and nanoparticle (NP)–based interventional platform for OA management, we incorporated an sPLA2 inhibitor (sPLA2i) into the phospholipid membrane of micelles. The engineered sPLA2i-loaded micellar NPs (sPLA2i-NPs) were able to penetrate deep into the cartilage matrix, prolong retention in the joint space, and mitigate OA progression. These findings suggest that sPLA2i-NPs can be promising therapeutic agents for OA treatment.

The Prevalence of Radiographic Findings of Structural Hip Deformities for Femoroacetabular Impingement in Patients With Hip Pain

2020 ◽  
Vol 48 (3) ◽  
pp. 647-653 ◽  
Author(s):  
Jun Zhou ◽  
Heath P. Melugin ◽  
Rena F. Hale ◽  
Devin P. Leland ◽  
Christopher D. Bernard ◽  
...  
Keyword(s):  
Femoroacetabular Impingement ◽  
Mixed Type ◽  
Imaging Modality ◽  
Alpha Angle ◽  
Young Patients ◽  
Radiographic Finding ◽  
Hip Pain ◽  
Radiographic Findings ◽  
Protrusio Acetabuli ◽  
Center Edge

Background: Radiography is the initial imaging modality used to evaluate femoroacetabular impingement (FAI), and diagnostic radiographic findings are well-established. However, the prevalence of these radiographic findings in patients with hip pain is unknown. Purpose: The purpose was 3-fold: (1) to determine the overall prevalence of radiographic FAI deformities in young patients presenting with hip pain, (2) to identify the most common radiographic findings in patients with cam-type FAI, and (3) to identify the most common radiographic findings in patients with pincer-type FAI. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A geographic database was used to identify patients aged 14 to 50 years with hip pain between the years 2000 to 2016. The following were evaluated on radiographs: cam type: typical pistol grip deformity, alpha angle >55°; pincer type: crossover sign (COS), coxa profunda or protrusio acetabuli, lateral center edge angle (LCEA) ≥40°, Tönnis angle <0°; and mixed type: both cam- and pincer-type features. Posterior wall sign (PWS) and ischial spine sign (ISS) were also evaluated. The prevalence of each was determined. Descriptive statistics were performed on all radiographic variables. Results: There were 1893 patients evaluated, and 1145 patients (60.5%; 1371 hips; 374 male and 771 female; mean age, 28.8 ± 8.4 years) had radiographic findings consistent with FAI. Of these hips, 139 (10.1%) had cam type, 245 (17.9%) had pincer type, and 987 (72.0%) had mixed type. The prevalence of a pistol grip deformity and an alpha angle >55° was 577 (42.1%) and 1069 (78.0%), respectively. The mean alpha angle was 66.9°± 10.5°. The prevalence of pincer-type radiographic findings was the following: COS, 1062 (77.5%); coxa profunda, 844 (61.6%); ISS, 765 (55.8%); PWS, 764 (55.7%); Tönnis angle <0°, 312 (22.8%); LCEA ≥40°, 170 (12.4%); and protrusio acetabuli, 7 (0.5%). Conclusion: The overall prevalence of radiographic findings consistent with FAI in young patients with hip pain was 60.5%. Radiographic findings for mixed-type FAI were the most prevalent. The most common radiographic finding for cam-type FAI was an alpha angle >55°. The most common radiographic finding for pincer-type FAI was the COS.

scholarly journals High systemic bone mineral density increases the risk of incident knee OA and joint space narrowing, but not radiographic progression of existing knee OA: the MOST study

2009 ◽  
Vol 69 (01) ◽  
pp. 163-168 ◽  
Author(s):  
M C Nevitt ◽  
Y Zhang ◽  
M K Javaid ◽  
T Neogi ◽  
J R Curtis ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Bone Mineral ◽  
Joint Space Narrowing ◽  
Weight Bearing ◽  
Joint Space ◽  
Whole Body ◽  
Mineral Density ◽  
Knee Oa ◽  
Increased Risk

Objectives:Previous studies suggest that high systemic bone mineral density (BMD) is associated with incident knee osteoarthritis (OA) defined by osteophytes but not with joint space narrowing (JSN), and are inconsistent regarding BMD and progression of existing OA. The association of BMD with incident and progressive tibiofemoral OA was tested in a large prospective study of men and women aged 50–79 years with or at risk for knee OA.Methods:Baseline and 30-month weight-bearing posteroanterior and lateral knee radiographs were scored for Kellgren-Lawrence (K-L) grade, JSN and osteophytes. Incident OA was defined as the development of K-L grade ⩾2 at follow-up. All knees were classified for increases in grade of JSN and osteophytes from baseline. The association of gender-specific quartiles of baseline BMD with risk of incident and progressive OA was analysed using logistic regression, adjusting for covariates.Results:The mean (SD) age of 1754 subjects was 63.2 (7.8) years and body mass index was 29.9 (5.4) kg/m2. In knees without baseline OA, higher femoral neck and whole body BMD were associated with an increased risk of incident OA and increases in grade of JSN and osteophytes (p<0.01 for trends); adjusted odds were 2.3–2.9-fold greater in the highest compared with the lowest BMD quartiles. In knees with existing OA, progression was not significantly related to BMD.Conclusions:In knees without OA, higher systemic BMD was associated with a greater risk of the onset of JSN and K-L grade ⩾2. The role of systemic BMD in early knee OA pathogenesis warrants further investigation.

scholarly journals Artrose i Norge

2009 ◽  
Vol 18 (1) ◽  
Author(s):  
Barbara Slatkowsky-Christensen ◽  
Margreth Grotle
Keyword(s):  
Risk Factors ◽  
Subchondral Bone ◽  
Joint Space ◽  
Epidemiological Studies ◽  
Quadriceps Strength ◽  
Point Of View ◽  
The Body ◽  
Knee Oa ◽  
Geographical Variations ◽  
The Individual

Osteoarthritis (OA) is a complex process affecting many different joint areas in the body. The joints most commonly affected are the knees, hips, and hands. From a patho-physiological point of view, some features are crucial for the diagnosis, such as cartilage fibrillation and thinning, subchondral sclerosis and the presence of osteophytes. The currently most widely used definitions of OA include pathogenetic features (mechanical and biological events), morphologic features (changes in articular cartilage and subchondral bone) as well as clinical features (joint pain, stiffness, tenderness, limitation of movement, crepitus and occasionally inflammation/effusion).<br />The features that until now have been used for diagnosis and classification are based on radiographic and/or clinical descriptions. From a clinical perspective, OA is the most prevalent rheumatic joint disorder, causing pain and stiffness of the joints and for the individual impaired function and health status. For epidemiological descriptions of prevalence and incidence of OA, radiographic criteria are the most reliable and commonly used. Definitions of radiographic OA include descriptions of cartilage thinning (such as joint space narrowing), subchondral bone involvement (sclerosis) and/or the presence and grading of osteophytes. Although there are geographical variations in the occurrence of OA of different joint areas, OA is seen in all populations studied. The prevalence and incidence estimates show a vide variation, however. Still the epidemiological studies of OA are hampered by a number of factors including different definitions of the disorder, different subsets of disease, and low degree of correlation between different definitions (radiographic vs clinical). Several highly suggested risk factors have been identified for knee OA. Several of these may be important targets for intervention or prevention, such as physical activity, body mass index, nutritional constituents and quadriceps strength. There is a need for prospective studies evaluating risk factors in hip and hand OA. Although there are problems in studying OA epidemiologically, the available data have shown that OA is an extremely common and disabling disorder. Through a further development of both epidemiological and other methods of OA research, this area can continue to be exciting and rapidly developing.

Hand Joint Space Narrowing and Osteophytes Are Associated with Magnetic Resonance Imaging-defined Knee Cartilage Thickness and Radiographic Knee Osteoarthritis: Data from the Osteoarthritis Initiative

2011 ◽  
Vol 39 (1) ◽  
pp. 161-166 ◽  
Author(s):  
IDA K. HAUGEN ◽  
SEBASTIAN COTOFANA ◽  
MARTIN ENGLUND ◽  
TORE K. KVIEN ◽  
DONATUS DREHER ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Joint Space Narrowing ◽  
Joint Space ◽  
Cartilage Thickness ◽  
Resonance Imaging ◽  
Knee Cartilage ◽  
Knee Oa ◽  
Osteoarthritis Initiative ◽  
Hand Radiographs

Objective.To evaluate whether features of radiographic hand osteoarthritis (OA) are associated with quantitative magnetic resonance imaging (MRI)-defined knee cartilage thickness, radiographic knee OA, and 1-year structural progression.Methods.A total of 765 participants in Osteoarthritis Initiative (OAI; 455 women, mean age 62.5 yrs, SD 9.4) obtained hand radiographs (at baseline), knee radiographs (baseline and Year 1), and knee MRI (baseline and Year 1). Hand radiographs were scored for presence of osteophytes and joint space narrowing (JSN). Knee radiographs were scored according to the Kellgren-Lawrence (KL) scale. Cartilage thickness in the medial and lateral femorotibial compartments was measured quantitatively from coronal FLASHwe images. We examined the cross-sectional and longitudinal associations between features of hand OA (total osteophyte and JSN scores) and knee cartilage thickness, 1-year knee cartilage thinning (above smallest detectable change), presence of knee OA (KL grade ≥ 3), and progression of knee OA (KL change ≥ 1) by linear and logistic regression. Both hand OA features were included in a multivariate model (if p ≤ 0.25) adjusted for age, sex, and body mass index (BMI).Results.Hand JSN was associated with reduced knee cartilage thickness (ß = −0.02, 95% CI −0.03, −0.01) in the medial femorotibial compartment, while hand osteophytes were associated with the presence of radiographic knee OA (OR 1.10, 95% CI 1.03–1.18; multivariate models) with both hand OA features as independent variables adjusted for age, sex, and BMI). Radiographic features of hand OA were not associated with 1-year cartilage thinning or radiographic knee OA progression.Conclusion.Our results support a systemic OA susceptibility and possibly different mechanisms for osteophyte formation and cartilage thinning.

scholarly journals Association between disease progression and depression onset in persons with radiographic knee osteoarthritis

Rheumatology ◽  
2020 ◽  
Vol 59 (11) ◽  
pp. 3390-3399
Author(s):  
Alan M Rathbun ◽  
Michelle D Shardell ◽  
Alice S Ryan ◽  
Michelle S Yau ◽  
Joseph J Gallo ◽  
...  
Keyword(s):  
Disease Progression ◽  
Disease Severity ◽  
Gait Speed ◽  
Joint Space Width ◽  
Joint Space ◽  
Knee Oa ◽  
Increased Risk ◽  
Pain Subscale ◽  
Space Width

Abstract Objectives Osteoarthritis (OA) disease progression may lead to deteriorating psychosocial function, but it is unclear what aspects of disease severity are related to the onset of depression. This study assessed which components of OA disease progression cumulatively contribute to depression onset in persons with radiographic knee OA. Methods Osteoarthritis Initiative participants (n = 1651) with radiographic disease (Kellgren-Lawrence grade ≥2) in one or both knees and below the screening threshold for probable depression [Center for Epidemiological Studies Depression (CES-D) scale &lt;16] at baseline were included. Disease severity was measured from baseline to the third annual follow-up visit using joint space width, 20-meter gait speed, and the Western Ontario and McMaster Universities Osteoarthritis Index pain subscale, each categorized into quintiles. Depression onset (CES-D ≥ 16) was assessed annually at four follow-up visits. Marginal structural models that account for time-dependent confounding and attrition evaluated the association between each time-varying disease severity measure and depression onset. Results Each disease severity measure exhibited a non-linear relationship concerning the probability of depression onset, with the higher quintiles generally being associated with a larger risk. The highest quintile (relative to the lowest) of joint space width and gait speed were both significantly associated with depression onset. By contrast, none of the higher pain quintiles compared with the lowest were significantly associated with the onset of depression. Conclusion Faster disease progression as measured by either worsening structural severity or decreasing physical performance corresponds to an increased risk of depression among individuals with radiographic knee OA.

Analysis of spatial osteochondral heterogeneity in advanced knee osteoarthritis exposes influence of joint alignment

2020 ◽  
Vol 12 (562) ◽  
pp. eaba9481 ◽  
Author(s):  
Sophie Haberkamp ◽  
Tamás Oláh ◽  
Patrick Orth ◽  
Magali Cucchiarini ◽  
Henning Madry
Keyword(s):  
Weight Loss ◽  
Structural Changes ◽  
Scientific Basis ◽  
Strong Correlations ◽  
Varus Knee ◽  
Varus Malalignment ◽  
Compensatory Mechanisms ◽  
Site Specific ◽  
Knee Oa ◽  
Specific Effects

Osteoarthritis (OA) is considerably affected by joint alignment. Here, we investigate the patterns of spatial osteochondral heterogeneity in patients with advanced varus knee OA together with clinical data. We report strong correlations of osteochondral parameters within individual topographical patterns, highlighting their fundamental and location-dependent interactions in OA. We further identify site-specific effects of varus malalignment on the lesser loaded compartment and, conversely, an unresponsive overloaded compartment. Last, we trace compensatory mechanisms to the overloaded subarticular spongiosa in patients with additional high body weight. We therefore propose to consider and to determine axial alignment in clinical trials when selecting the location to assess structural changes in OA. Together, these findings broaden the scientific basis of therapeutic load redistribution and weight loss in varus knee OA.

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