scholarly journals Automatic Grading of Individual Knee Osteoarthritis Features in Plain Radiographs Using Deep Convolutional Neural Networks

Diagnostics ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. 932
Author(s):  
Aleksei Tiulpin ◽  
Simo Saarakkala
Keyword(s):  
Knee Osteoarthritis ◽  
Joint Space Narrowing ◽  
Joint Space ◽  
Research Society ◽  
Fine Tuning ◽  
Deep Convolutional Neural Networks ◽  
Fine Grained ◽  
Knee Oa ◽  
Osteoarthritis Initiative ◽  
Osteoarthritis Research Society

Knee osteoarthritis (OA) is the most common musculoskeletal disease in the world. In primary healthcare, knee OA is diagnosed using clinical examination and radiographic assessment. Osteoarthritis Research Society International (OARSI) atlas of OA radiographic features allows performing independent assessment of knee osteophytes, joint space narrowing and other knee features. This provides a fine-grained OA severity assessment of the knee, compared to the gold standard and most commonly used Kellgren–Lawrence (KL) composite score. In this study, we developed an automatic method to predict KL and OARSI grades from knee radiographs. Our method is based on Deep Learning and leverages an ensemble of residual networks with 50 layers. We used transfer learning from ImageNet with a fine-tuning on the Osteoarthritis Initiative (OAI) dataset. An independent testing of our model was performed on the Multicenter Osteoarthritis Study (MOST) dataset. Our method yielded Cohen’s kappa coefficients of 0.82 for KL-grade and 0.79, 0.84, 0.94, 0.83, 0.84 and 0.90 for femoral osteophytes, tibial osteophytes and joint space narrowing for lateral and medial compartments, respectively. Furthermore, our method yielded area under the ROC curve of 0.98 and average precision of 0.98 for detecting the presence of radiographic OA, which is better than the current state-of-the-art.

Experimental Observation of the Sequence of Tibial Plateau Chondrocyte and Matrix Degeneration in Spontaneous Osteoarthritis in Guinea Pigs

2020 ◽  
Author(s):  
XIAOJIAN WANG ◽  
XIAOJIAN Wang ◽  
Lei Wei ◽  
Yan Xue ◽  
Rong-shan Li
Keyword(s):  
Knee Osteoarthritis ◽  
Guinea Pigs ◽  
Tibial Plateau ◽  
Caspase 3 ◽  
Physiological State ◽  
Research Society ◽  
Cartilage Tissue ◽  
Knee Oa ◽  
The Matrix ◽  
Osteoarthritis Research Society

Abstract Background To observe the sequence of chondrocyte degeneration and matrix degradation in the superficial surface cartilage of the tibial plateau in guinea pigs with spontaneous knee osteoarthritis (OA).Methods Forty guinea pigs were euthanized at the ages of 10 months (n=20) and 12 months (n=20). The degree of degeneration of the tibial plateau cartilage was evaluated by Osteoarthritis Research Society International (OARSI) score.The levels of MMP-13 and Caspase-3 in the chondrocytes were detected by immunohistochemistry (IHC). The serum concentration of CTX-II was measured and compared.Western blot analysis was used to detect the levels of MMP-13 and Caspase-3 in the cartilage tissue.Results The OARSI score in the 10-month-old group(6.4±1.7) was lower than that in the 12-month-old group(12.7±3.2)(P＜0.05). Immunohistochemical staining confirmed the levels of MMP-13(10-month-old,6.1±2.0;12-month-old,5.8±1.6) and Caspase-3(10-month-old,2.6±0.6;12-month-old,2.8±0.9) in two groups appeared to be nonsignificant (all P＜0.05).The serum CTX-II in the 10-month-old group(8.6±1.2) was lower than that in the 12-month-old group(13.7±2.3) (P＜0.05). The western blot results confirmed the levels of MMP-13(10-month-old,0.82±0.21;12-month-old,0.86±0.27) and Caspase-3(10-month-old,0.22±0.07;12-month-old,0.20±0.08) in two groups appeared to be nonsignificant (all P＜0.05).Conclusion The superficial chondrocytes of the tibial plateau first appeared to be hypertrophic and then apoptotic, and the matrix was further degraded when spontaneous knee osteoarthritis occurred in guinea pigs.Changes in the physiological state of chondrocytes are the initiating factors in the pathogenesis of knee OA.

scholarly journals Automated Knee Osteoarthritis Assessment Increases Physicians’ Agreement Rate and Accuracy: Data from the Osteoarthritis Initiative

Cartilage ◽  
2019 ◽  
pp. 194760351988879 ◽  
Author(s):  
Stefan Nehrer ◽  
Richard Ljuhar ◽  
Peter Steindl ◽  
Rene Simon ◽  
Dietmar Maurer ◽  
...  
Keyword(s):  
Joint Space Narrowing ◽  
Detection System ◽  
Intraclass Correlation ◽  
Plain Radiograph ◽  
Joint Space ◽  
Research Society ◽  
Computer Assisted ◽  
Agreement Rate ◽  
Osteoarthritis Initiative ◽  
The Impact

Objective. To assess the impact of a computerized system on physicians’ accuracy and agreement rate, as compared with unaided diagnosis. Methods. A set of 124 unilateral knee radiographs from the Osteoarthritis Initiative (OAI) study were analyzed by a computerized method with regard to Kellgren-Lawrence (KL) grade, as well as joint space narrowing, osteophytes, and sclerosis Osteoarthritis Research Society International (OARSI) grades. Physicians scored all images, with regard to osteophytes, sclerosis, joint space narrowing OARSI grades and KL grade, in 2 modalities: through a plain radiograph ( unaided) and a radiograph presented together with the report from the computer assisted detection system ( aided). Intraclass correlation between the physicians was calculated for both modalities. Furthermore, physicians’ performance was compared with the grading of the OAI study, and accuracy, sensitivity, and specificity were calculated in both modalities for each of the scored features. Results. Agreement rates for KL grade, sclerosis, and osteophyte OARSI grades, were statistically increased in the aided versus the unaided modality. Readings for joint space narrowing OARSI grade did not show a statistically difference between the 2 modalities. Readers’ accuracy and specificity for KL grade >0, KL >1, sclerosis OARSI grade >0, and osteophyte OARSI grade >0 was significantly increased in the aided modality. Reader sensitivity was high in both modalities. Conclusions. These results show that the use of an automated knee OA software increases consistency between physicians when grading radiographic features of OA. The use of the software also increased accuracy measures as compared with the OAI study, mostly through increases in specificity.

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 meniscal volume and development of knee osteoarthritis

Rheumatology ◽  
2020 ◽  
Author(s):  
Dawei Xu ◽  
Jan van der Voet ◽  
Nils M Hansson ◽  
Stefan Klein ◽  
Edwin H G Oei ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Primary Outcome ◽  
Joint Space Narrowing ◽  
Joint Space ◽  
Primary Outcome Measure ◽  
Obese Women ◽  
Knee Oa ◽  
Kellgren And Lawrence ◽  
Over Time

Abstract Objective To assess the association between meniscal volume, its change over time and the development of knee OA after 30 months in overweight/obese women. Methods Data from the PRevention of knee Osteoarthritis in Overweight Females study were used. This cohort included 407 women with a BMI ≥ 27 kg/m2, free of OA-related symptoms. The primary outcome measure was incident OA after 30 months, defined by one out of the following criteria: medial or lateral joint space narrowing (JSN)  ≥ 1.0 mm, incident radiographic OA [Kellgren and Lawrence (K&L)  ≥ 2], or incident clinical OA. The secondary outcomes were either of these items separately. Menisci at both baseline and follow-up were automatically segmented to obtain meniscal volume and delta-volumes. Generalized estimating equations were used to evaluate associations between the volume measures and the outcomes. Results Medial and lateral baseline and delta-volumes were not significantly associated to the primary outcome. Lateral meniscal baseline volume was significantly associated to lateral JSN [odds ratio (OR) = 0.87; 95% CI: 0.75, 0.99], while other measures were not. Medial and lateral baseline volume were positively associated to K&L incidence (OR = 1.32 and 1.22; 95% CI: 1.15, 1.50 and 1.03, 1.45, respectively), while medial and lateral delta-volume were negatively associated to K&L incidence (OR = 0.998 and 0.997; 95% CI: 0.997, 1.000 and 0.996, 0.999, respectively). None of the meniscal measures were significantly associated to incident clinical OA. Conclusion Larger baseline meniscal volume and the decrease of meniscal volume over time were associated to the development of structural OA after 30 months in overweight and obese women.

scholarly journals The Inverse OARSI-OMERACT Criteria Is a Valid Indicator of the Clinical Worsening of Knee Osteoarthritis: Data from the Osteoarthritis Initiative

2020 ◽  
pp. jrheum.200145
Author(s):  
Jeffrey B. Driban ◽  
Matthew S. Harkey ◽  
Lori Lyn Price ◽  
Grace H. Lo ◽  
Timothy E. McAlindon
Keyword(s):  
Knee Osteoarthritis ◽  
Knee Pain ◽  
Knee Replacement ◽  
Walking Speed ◽  
Cox Model ◽  
Research Society ◽  
Osteoarthritis Initiative ◽  
Osteoarthritis Research Society ◽  
And Function ◽  
Relationship Of

Objective We assessed if the inverse Osteoarthritis Research Society International (OARSI) and Outcome Measures in Rheumatology (OMERACT) criteria relate to concurrent radiographic knee osteoarthritis (KOA) progression and decline in walking speed, as well as future knee replacement. Methods We conducted knee-based analyses of data from the Osteoarthritis Initiative. All knees had symptomatic OA: at least doubtful radiographic KOA (Kellgren-Lawrence grade ≥ 1) and knee pain ≥ 10/100 (Western Ontario and McMaster Universities Osteoarthritis Index pain) at the 12-month visit. The inverse of the OARSI-OMERACT responder criteria depended on knee pain and function, and global assessment of knee impact. We used generalized linear mixed models to assess the relationship of the inverse OARSI‑OMERACT criteria over 2 years (i.e., 12-month and 36-month visits) with worsening radiographic severity (any increase in Kellgren-Lawrence grade from 12 months to 36 months) and decline in self-selected 20-m walking speed of ≥ 0.1m/s (from 12 months to 36 months). We used a Cox model to assess time to knee replacement during the 6 years after the 36-month visit as an outcome. Results Among the 1746 analyzed, 19% met the inverse OARSI-OMERACT criteria. Meeting the inverse OARSI-OMERACT criteria was associated with almost double the odds of experiencing concurrent worsening in radiographic KOA severity (OR 1.89, 95% CI 1.32–2.70) or decline in walking speed (OR 1.82, 95% CI 1.37–2.40). A knee meeting the inverse OARSI-OMERACT criteria was more likely to receive a knee replacement after the 36-month visit (23%) compared with a nonresponder (10%; HR 2.54, 95% CI 1.89–3.41). Conclusion The inverse OARSI-OMERACT criteria for worsening among people with KOA had good construct validity in relation to clinically relevant outcomes.

scholarly journals Future Directions in Painful Knee Osteoarthritis: Harnessing Complexity in a Heterogeneous Population

2014 ◽  
Vol 94 (3) ◽  
pp. 422-432 ◽  
Author(s):  
Andrew J. Kittelson ◽  
Steven Z. George ◽  
Katrina S. Maluf ◽  
Jennifer E. Stevens-Lapsley
Keyword(s):  
Knee Osteoarthritis ◽  
Disease Process ◽  
Research Society ◽  
Future Directions ◽  
Pain Experience ◽  
Knee Oa ◽  
Research Priority ◽  
Osteoarthritis Research Society ◽  
Knee Pathology

This perspective article proposes a conceptual model for the pain experience for individuals diagnosed with knee osteoarthritis (OA). Pain in knee OA is likely a heterogeneous, multifactorial phenomenon that involves not only the OA disease process but also elements specific to patient psychology and pain neurophysiology. The relevant contributions to the pain experience for any individual patient remain difficult, if not impossible, to definitively determine, and the rationale for many clinical treatment decisions arises primarily from a mechanistic understanding of OA pathophysiology. The Osteoarthritis Research Society International (OARSI) recently identified “phenotyping” of OA pain as a research priority to “better target pain therapies to individual patients.” This perspective article proposes that contributions from 3 domains—knee pathology, psychological distress, and pain neurophysiology—should be considered equally important in future efforts to understand pain phenotypes in knee OA. Ultimately, characterization of pain phenotypes may aid in the understanding of the pain experience and the development of interventions specific to pain for individual patients.

scholarly journals Uptake of the OMERACT-OARSI Hip and Knee Osteoarthritis Core Outcome Set: Review of Randomized Controlled Trials from 1997 to 2017

2019 ◽  
Vol 46 (8) ◽  
pp. 976-980 ◽  
Author(s):  
Toby O. Smith ◽  
Michael Mansfield ◽  
Gillian A. Hawker ◽  
David J. Hunter ◽  
Lyn M. March ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Global Assessment ◽  
Core Outcome Set ◽  
Research Society ◽  
Controlled Trials ◽  
Core Outcome ◽  
Knee Oa ◽  
Randomized Controlled ◽  
Outcome Set ◽  
Osteoarthritis Research Society

Objective.To assess the uptake of the OMERACT-OARSI (Outcome Measures in Rheumatology- Osteoarthritis Research Society International) core outcome set (COS) domains in hip and/or knee osteoarthritis (OA) trials.Methods.There were 382 trials of hip and/or knee OA identified from the ClinicalTrial.gov registry from 1997 to 2017. Frequency of COS adoption was assessed by year and per 5-yearly phases.Results.COS adoption decreased from 61% between 1997 and 2001 to 38% between 2012 and 2016. Pain (95%) and physical function (86%) were most consistently adopted. Patient’s global assessment (48%) was the principal missing domain.Conclusion.Limited adoption of the COS domains indicates that further consideration to improve uptake is required.

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.

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