Biomarkers of Cartilage and Bone Damage as a Measure of Joint Damage in Haemophilia.

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 1214-1214
Author(s):  
Nathalie W.D. Jansen ◽  
Goris Roosendaal ◽  
Bjorn Lundin ◽  
Lily Heijnen ◽  
Matthias Theobald ◽  
...  
Keyword(s):  
Joint Space Width ◽  
Joint Damage ◽  
Cartilage Degeneration ◽  
Joint Space ◽  
Joint Disease ◽  
Joint Degeneration ◽  
Serum Samples ◽  
Haemophilic Arthropathy ◽  
Bone Changes ◽  
The Individual

Abstract Purpose Biomarkers of bone and cartilage turnover have frequently been evaluated for joint diseases such as rheumatoid arthritis (RA) and osteoarthritis (OA). Results have thus fare not been very conclusive. Some biomarkers such as urinary CTXII and serum COMP appear to correlate with severity of joint degeneration, whereas other are less distinctive. Hemophilic arthropathy (HA) is a very progressive joint degeneration as a result of frequent joint bleeds. From clinical practice it is concluded that the rate of degeneration exceeds that of OA and RA joints. This degeneration has characteristics of both inflammation mediated (as seen in RA) and degenerative (as seen in OA) joint disease. Furthermore, the joint damage is largely restricted to 3 major joints (ankle, knees, and elbows). Therefore, it might be that this rapidly progressive, localized joint degeneration can be used for the evaluation and validation of biomarkers of cartilage and bone turnover. In the present study we therefore investigated whether commercially available biomarkers of cartilage and bone in blood and/or urine are associated with severity of joint damage in patients with haemophilic arthropathy. Methods Blood and urine were collected from 36 patients suffering from haemophilia. Urine samples were assessed for the amount of CTX-I and CTX-II. Serum samples were assessed for the amount of CTX-I, CTX-II, COMP, C1,2C, C2C, and CS846. Radiographs of ankles, knees and elbows were scored according to Pettersson, a radiographic joint score specific for haemophilic arthropathy based on cartilage and bone changes. Results U-CTX-II (R=0.39; p=0.01), C1,2C (R=0.31; p=0.04) and CS846 (R=0.31; p=0.03) showed (marginal) correlations with the Pettersson score. Slightly better correlations were obtained when only narrowing of joint space width (JSW) as one of the items in the Pettersson score was used. The other biomarkers showed no correlation with the Pettersson score. Also the bone biomarkers did not correlate with specific bone changes. Interestingly, combined indexes of different markers, based on linear stepwise regression analysis, increased the correlation significantly up to R=0.65; p≤0.001) for the combination of U-CTX-II, COMP and CS846. Conclusions The present results show that even despite this rapidly progressive degeneration of 6 large joints, from the individual biomarkers determined only U-CTX-II, C1,2C and CS846 show correlation with the severity of arthropathy. Importantly, a relation improved when the markers were related to the process they are supposed to describe (cartilage degeneration markers with JSW narrowing). Most important, combination of markers, significantly improve the relation with the radiographically determined joint degeneration. In general however, it may be concluded that these markers alone seem not of sufficient value for evaluation of joint damage yet.

Musculoskeletal Pathologies in Children with Haemophilia Evaluated using a Standardised Physical Joint Scoring System to Assess Disability

2011 ◽  
Vol 07 (01) ◽  
pp. 76 ◽  
Author(s):  
Sonata Saulyte Trakymiene ◽  
Keyword(s):  
Treatment Efficacy ◽  
Scoring System ◽  
Joint Damage ◽  
Joint Disease ◽  
Severe Haemophilia ◽  
International Consensus ◽  
Health Score ◽  
Haemophilic Arthropathy ◽  
Joint Health ◽  
Joint Assessment

Repeated bleeding into the joints leads to the development of chronic and progressive joint disease in 90% of people with severe haemophilia. Owing to recurrent haemarthroses, musculoskeletal outcome remains an important hallmark of treatment efficacy in haemophilia. Physical joint assessment is commonly used to measure structural and functional joint damage. With the development and introduction of prophylaxis, the most widely used instruments for the assessment of haemophilic arthropathy were found to lack sensitivity to detect the earliest signs of joint disease. To address these inadequacies, a new international consensus tool, the Haemophilia Joint Health Score (HJHS), was developed. The HJHS appears to be a sensitive, reliable and valid tool. However, the HJHS needs further evaluation in various patient populations to assess its applicability and usefulness.

A retrospective study of canine hip dysplasia in 116 military working dogs. Part I: Angle measurements and orthopedic foundation for animals (OFA) grading

1996 ◽  
Vol 32 (5) ◽  
pp. 413-422 ◽  
Author(s):  
CM Banfield ◽  
JE Bartels ◽  
JA Hudson ◽  
JC Wright ◽  
JT Hathcock ◽  
...  
Keyword(s):  
Hip Dysplasia ◽  
Joint Space Width ◽  
Joint Space ◽  
Degenerative Joint Disease ◽  
Joint Disease ◽  
Working Dogs ◽  
Estimated Risk ◽  
Width Measurements ◽  
Military Working Dogs ◽  
Canine Hip Dysplasia

The progression of hip dysplasia was investigated in 116 military working dogs. Serial pelvic radiographs were graded for degree of dysplasia and degenerative joint disease (DJD). Norberg angles, angles of inclination, and joint space widths were measured. There was a significant correlation between the Norberg angle and the degree of dysplasia (p less than 0.0001). Angles of inclination and joint space width measurements did not demonstrate a correlation to canine hip dysplasia. Dysplastic dogs had a significant estimated risk for development of DJD compared to normal dogs (p less than 0.0001; odds ratio of 70.2). Dogs with normal hip conformation at 24 months of age or older did not develop moderate nor severe DJD.

Influence of gender on assessments of disease activity and function in early rheumatoid arthritis in relation to radiographic joint damage

2009 ◽  
Vol 69 (01) ◽  
pp. 230-233 ◽  
Author(s):  
M Ahlmén ◽  
B Svensson ◽  
K Albertsson ◽  
K Forslind ◽  
I Hafström
Keyword(s):  
Disease Activity ◽  
Pain Perception ◽  
Joint Destruction ◽  
Joint Damage ◽  
Area Under The Curve ◽  
Joint Space ◽  
Joint Disease ◽  
Similar Degree ◽  
Sharp Score ◽  
Hands And Feet

Objective:To evaluate gender differences in score on 28-joint Disease Activity Score (DAS28), Health Assessment Questionnaire (HAQ) and Signals Of Functional Impairment (SOFI) and to relate these scores to radiographic joint destruction.Methods:In all, 549 patients with early RA (62% women) from the BARFOT (for “Better Anti-Rheumatic FarmacOTherapy”) study were included. At baseline, 1, 2 and 5 years DAS28, HAQ and SOFI scoring, and radiographs of hands and feet were performed. The radiographs were scored using the van der Heijde–Sharp score.Results:In women the DAS28 was significantly higher than in men due to higher scores for general health and tender joints. Likewise, HAQ and VAS pain were rated significantly higher in women. The SOFI score was worse in men during the first 2 years, depending on higher upper limb scores. Total Sharp score (TotSharp), erosion score and joint space narrowing score did not differ between the sexes at any time point. The DAS28 area under the curve (AUC) correlated significantly with TotSharp at 5 years in both genders (r = 0.316, r = 0.313) mainly owing to swollen joints and erythrocyte sedimentation rate (ESR). The SOFI AUC correlated significantly with TotSharp in women (r = 0.135 to 0.220) but not in men.Conclusions:Despite a similar degree of radiographic joint destruction women had, compared with men, worse scores for DAS28 and HAQ, possibly due to higher pain perception and less muscular strength and perhaps because men overestimate their functional capacity.

Clinical synovitis in a particular joint is associated with progression of erosions and joint space narrowing in that same joint, but not in patients initially treated with infliximab

2010 ◽  
Vol 69 (12) ◽  
pp. 2107-2113 ◽  
Author(s):  
N B Klarenbeek ◽  
M Güler-Yüksel ◽  
D M F M van der Heijde ◽  
H M J Hulsmans ◽  
P J S M Kerstens ◽  
...  
Keyword(s):  
Joint Space Narrowing ◽  
Clinical Signs ◽  
Joint Damage ◽  
Treatment Strategies ◽  
Joint Space ◽  
X Rays ◽  
Joint Level ◽  
Damage Progression ◽  
The Individual ◽  
Hands And Feet

ObjectivesTo assess the relationship between joint tenderness, swelling and joint damage progression in individual joints and to evaluate the influence of treatment on these relationships.MethodsFirst-year data of the Behandel Strategieën (BeSt) study were used, in which patients recently diagnosed as having rheumatoid arthritis (RA) were randomly assigned into four different treatment strategies. Baseline and 1-year x-rays of the hands and feet were assessed using the Sharp–van der Heijde score (SHS). With generalised estimating equations, 3-monthly assessments of tender and swollen joints of year 1 were related to erosion progression, joint space narrowing (JSN) progression and total SHS progression at the individual joint level (definition >0.5 SHS units) in year 1, corrected for potential confounders and within-patient correlation for multiple joints per patient.ResultsDuring year 1, 59% of all 13 959 joints analysed were ever tender and 45% ever swollen, 2.1% showed erosion progression, 1.9% JSN progression and 3.6% SHS progression. Swelling and tenderness were both independently associated with erosion and JSN progression with comparable OR, although with higher OR in the hands than in the feet. Local swelling and tenderness were not associated with local damage progression in patients initially treated with infliximab.ConclusionClinical signs of synovitis are associated with erosion and JSN progression in individual joints after 1 year in RA. A disconnect between synovitis and joint damage progression was observed at joint level in patients who were treated with methotrexate and infliximab as initial treatment, confirming the disconnect between synovitis and the development of joint damage in tumour necrosis factor blockers seen at patient level.

scholarly journals Integrative multiomics analysis of Premolis semirufa caterpillar venom in the search for molecules leading to a joint disease

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Giselle Pidde ◽  
Milton Y. Nishiyama ◽  
Ursula Castro de Oliveira ◽  
Isadora M. Villas-Boas ◽  
Adriana F. Paes-Leme ◽  
...  
Keyword(s):  
Bone Structure ◽  
Meta Analysis ◽  
Joint Stiffness ◽  
Cartilage Degeneration ◽  
Joint Space ◽  
Joint Disease ◽  
Homologous Proteins ◽  
Pharmacological Targets ◽  
Human Proteins ◽  
And Cartilage

AbstractThe joint disease called pararamosis is an occupational disease caused by accidental contact with bristles of the caterpillar Premolis semirufa. The chronic inflammatory process narrows the joint space and causes alterations in bone structure and cartilage degeneration, leading to joint stiffness. Aiming to determine the bristle components that could be responsible for this peculiar envenomation, in this work we have examined the toxin composition of the caterpillar bristles extract and compared it with the differentially expressed genes (DEGs) in synovial biopsies of patients affected with rheumatoid arthritis (RA) and osteoarthritis (OA). Among the proteins identified, 129 presented an average of 63% homology with human proteins and shared important conserved domains. Among the human homologous proteins, we identified seven DEGs upregulated in synovial biopsies from RA or OA patients using meta-analysis. This approach allowed us to suggest possible toxins from the pararama bristles that could be responsible for starting the joint disease observed in pararamosis. Moreover, the study of pararamosis, in turn, may lead to the discovery of specific pharmacological targets related to the early stages of articular diseases.

scholarly journals Validation of joint space narrowing on plain radiographs and its relevance to partial knee arthroplasty

2021 ◽  
Vol 10 (3) ◽  
pp. 173-187
Author(s):  
Farouk Khury ◽  
Michael Fuchs ◽  
Hassan Awan Malik ◽  
Janina Leiprecht ◽  
Heiko Reichel ◽  
...  
Keyword(s):  
Subchondral Bone ◽  
Knee Arthroplasty ◽  
Joint Space Width ◽  
Cartilage Degeneration ◽  
Significant Negative Correlation ◽  
Joint Space ◽  
Cartilage Volume ◽  
Partial Knee Arthroplasty ◽  
Osteoarthritis Initiative ◽  
Kellgren And Lawrence

Aims To explore the clinical relevance of joint space width (JSW) narrowing on standardized-flexion (SF) radiographs in the assessment of cartilage degeneration in specific subregions seen on MRI sequences in knee osteoarthritis (OA) with neutral, valgus, and varus alignments, and potential planning of partial knee arthroplasty. Methods We retrospectively reviewed 639 subjects, aged 45 to 79 years, in the Osteoarthritis Initiative (OAI) study, who had symptomatic knees with Kellgren and Lawrence grade 2 to 4. Knees were categorized as neutral, valgus, and varus knees by measuring hip-knee-angles on hip-knee-ankle radiographs. Femorotibial JSW was measured on posteroanterior SF radiographs using a special software. The femorotibial compartment was divided into 16 subregions, and MR-tomographic measurements of cartilage volume, thickness, and subchondral bone area were documented. Linear regression with adjustment for age, sex, body mass index, and Kellgren and Lawrence grade was used. Results We studied 345 neutral, 87 valgus, and 207 varus knees. Radiological JSW narrowing was significantly (p < 0.01) associated with cartilage volume and thickness in medial femorotibial compartment in neutral ( r = 0.78, odds ratio (OR) 2.33) and varus knees ( r = 0.86, OR 1.92), and in lateral tibial subregions in valgus knees ( r = 0.87, OR 3.71). A significant negative correlation was found between JSW narrowing and area of subchondral bone in external lateral tibial subregion in valgus knees ( r = −0.65, p < 0.01) and in external medial tibial subregion in varus knees ( r = −0.77, p < 0.01). No statistically significant correlation was found in anterior and posterior subregions. Conclusion SF radiographs can be potentially used for initial detection of cartilage degeneration as assessed by MRI in medial and lateral but not in anterior or posterior subregions. Cite this article: Bone Joint Res 2021;10(3):173–187.

scholarly journals DGEMRIC in the Assessment of Pre-Morphological Cartilage Degeneration in Rheumatic Disease: Rheumatoid Arthritis vs. Psoriatic Arthritis

Diagnostics ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 147
Author(s):  
Daniel B. Abrar ◽  
Christoph Schleich ◽  
Miriam Frenken ◽  
Stefan Vordenbäumen ◽  
Jutta Richter ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Magnetic Resonance ◽  
Joint Space Width ◽  
Cartilage Degeneration ◽  
Joint Space ◽  
Cartilage Degradation ◽  
Pip Joint ◽  
Disease Entities ◽  
Space Width ◽  
Potential Use

Background: Even though cartilage loss is a known feature of psoriatic (PsA) and rheumatoid arthritis (RA), research is sparse on its role in the pathogenesis of PsA, its potential use for disease monitoring and for differentiation from RA. We therefore assessed the use of delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC) to evaluate biochemical cartilage changes in metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints in PsA patients and compared these to RA patients. Materials and Methods: A total of 17 patients with active PsA and 20 patients with active RA were evaluated by high-resolution 3 Tesla dGEMRIC using a dedicated 16-channel hand coil. Images were analyzed by two independent raters for dGEMRIC indices and joint space width (JSW) at MCP and PIP joint levels. Results: No significant differences of dGEMRIC values could be found between both study populations (PsA 472.25 ms, RA 461.11 ms; p = 0.763). In all RA and most PsA patients, PIP joints showed significantly lower dGEMRIC indices than MCP joints (RA: D2: p = 0.009, D3: p = 0.008, D4: p = 0.002, D5: p = 0.002; PsA: D3: p = 0.001, D4: p = 0.004). Most joint spaces had similar widths in both disease entities and no significant differences were found. Conclusions: As evaluated by dGEMRIC, the molecular composition of the MCP and PIP joint cartilage of PsA patients is similar to that of RA patients, demonstrating the scientific and clinical feasibility of compositional magnetic resonance (MR) imaging in these disease entities. Patterns and severity of compositional cartilage degradation of the finger joints may therefore be assessed beyond mere morphology in PsA and RA patients.

scholarly journals Relationship between motion, using the GaitSmartTM system, and radiographic knee osteoarthritis: an explorative analysis in the IMI-APPROACH cohort

Rheumatology ◽  
2020 ◽  
Author(s):  
Eefje M van Helvoort ◽  
Diana Hodgins ◽  
Simon C Mastbergen ◽  
Anne Karien Marijnissen ◽  
Hans Guehring ◽  
...  
Keyword(s):  
Characteristic Curve ◽  
Joint Space Width ◽  
Joint Damage ◽  
Principal Component ◽  
Joint Space ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Additional Information ◽  
Radiographic Parameters ◽  
Patient Reported

Abstract Objectives To assess underlying domains measured by GaitSmartTMparameters and whether these are additional to established OA markers including patient reported outcome measures (PROMs) and radiographic parameters, and to evaluate if GaitSmart analysis is related to the presence and severity of radiographic knee OA. Methods GaitSmart analysis was performed during baseline visits of participants of the APPROACH cohort (n = 297). Principal component analyses (PCA) were performed to explore structure in relationships between GaitSmart parameters alone and in addition to radiographic parameters and PROMs. Logistic and linear regression analyses were performed to analyse the relationship of GaitSmart with the presence (Kellgren and Lawrence grade ≥2 in at least one knee) and severity of radiographic OA (ROA). Results Two hundred and eighty-four successful GaitSmart analyses were performed. The PCA identified five underlying GaitSmart domains. Radiographic parameters and PROMs formed additional domains indicating that GaitSmart largely measures separate concepts. Several GaitSmart domains were related to the presence of ROA as well as the severity of joint damage in addition to demographics and PROMs with an area under the receiver operating characteristic curve of 0.724 and explained variances (adjusted R2) of 0.107, 0.132 and 0.147 for minimum joint space width, osteophyte area and mean subchondral bone density, respectively. Conclusions GaitSmart analysis provides additional information over established OA outcomes. GaitSmart parameters are also associated with the presence of ROA and extent of radiographic severity over demographics and PROMS. These results indicate that GaitsmartTM may be an additional outcome measure for the evaluation of OA.

scholarly journals FRI0499 ACROMEGALY ARTROPATHY: IS THERE SOMETHING MORE BEHIND THE PAIN? A CROSS-SECTIONAL STUDY TO EVALUATE RHEUMATIC DISEASE IN GROWTH HORMONE SECRETING TUMOR PATIENTS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 848.1-848
Author(s):  
M. Scarati ◽  
S. Parisi ◽  
N. Prencipe ◽  
M. C. Ditto ◽  
E. Ghigo ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Logistic Regression ◽  
Rheumatic Disease ◽  
Power Doppler ◽  
Connective Tissue Diseases ◽  
Joint Damage ◽  
Joint Space ◽  
Tumor Patients ◽  
Cross Sectional ◽  
Significant Difference

Background:Acromegaly is a rare disease with a remarkable impact on patients, both in terms of life expectancy and quality of life. Osteo-articular complications are one of the most frequently reported bothers. The “acromegaly artropathy” characterizes more than 70% of patients at diagnosis. Artropathy affects both spine and peripheral joints. A recent prospective study documented progression of acromegalic arthropathy identified as a worsening of osteophytes and joint space narrowing in 72–74% of patients despite long-term biochemical control. In addiction the Literature has occasionally reported cases of simultaneous presence of rheumatic diseases (rheumatoid arthritis, polymyalgia rheumatica, undifferentiated connective tissue diseases) and acromegaly and in all these cases the treatment has been delayed, because of wrong symptoms attribution to acromegaly artropathy.Objectives:The primary goal of the study is to better characterize joint pain in acromegaly patients and to evaluate the prevalence of rheumatic disease in growth hormone (GH) secreting pituitary tumor patients.Methods:We enrolled 20 acromegaly subjects (AS) and 20 control subjects (CS). In each subject immunological pattern (rheumatoid factor – RF; antinuclear antibodies - ANA, ENA; anti-citrullinated protein antibodies - ACPA; erythrocyte sedimentation rate – ESR) has been evaluated; they, also, underwent bilateral joint ultrasound of hands and wrists and nail capillaroscopy. The Chi square test and the Fisher’s exact test were used to evaluate the association between binary variables, while the Spearman’s test to evaluate the correlation of continuous ones. A multiple or logistic regression model was calculated in order to define the association between the capillaroscopic alterations and other detected variables.Results:Articular pain emerged as significantly more frequent in AS (p = 0.0269). No statistically significant differences are detected regarding immunological pattern. ANA and ENA screening resulted positive in 10% in AS and in 5% in CS. No IgA ACPA were detected in AS or CS, while IgG ACPA were positive only in one AS subject. No significant differences were detected between IgM and IgG RFin the two groups (AS 5% and CS 0%). Three fold higher IgG FR in AS compared to CS were detected. ESR levels were significantly higher than CS (p = 0.0405), as well as increased power doppler (PWD) articular uptake (AS 30% vs CS 5% p 0.081). The capillaroscopic evaluation showed a significant difference in almost each parameter that has been evaluated (logistic regression: number of enlargement p 0.004, hemorragies p 0.01 and capillaries p 0.001), showing a moderate-severe microangiopathy in AS. Interestingly, analyzing only the acromegaly cohort, we noticed higher GH levels at the enrollment in patients which developed capillary enlargements (GH: 0.95 ng/ml IQ 0,6-1,6) compared to other ones (GH: 0.55 ng/ml IQ 0.4-0.7; p = 0.08) and a significant lower number of hemorrhages (p = 0.02) in patients treated with GH antagonist pegvisomant.Conclusion:Our results demonstrated that joint damage in acromegaly does not seem to have an autoimmune etiology. Therefore, articular damage is mechanical and increased ESR and PWD alterations seems to confirm the presence of an inflammatory component. In addition, acromegaly is characterized by a microvascular pattern of moderate-severe microangiopathy, without correlation to IGF-I, but GH levels. Although requiring further confirmatory studies, our preliminary results seem to indicate how the capillaroscopic examination could be useful to detect earlier microangiopathy and to identify patients with a greater risk of macroangiopathy development..References:[1]Claessen KMJA et al. Bone and joint disorders in acromegaly. Neuroendocrinology. 2016;103(1):86-95.[2]Örük G et al. Is every joint symptom related to acromegaly? Endocrine. 2013 Apr;43(2):404-11.Disclosure of Interests:None declared

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