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Moradi K, Kwee RM, Mohajer B, Guermazi A, Roemer FW, Ibad HA, Haugen IK, Berenbaum F, Demehri S. Erosive hand osteoarthritis and sarcopenia: data from Osteoarthritis Initiative cohort. Ann Rheum Dis 2024; 83:799-806. [PMID: 38242637 DOI: 10.1136/ard-2023-224997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 01/04/2024] [Indexed: 01/21/2024]
Abstract
OBJECTIVES There is no evidence linking specific osteoarthritis (OA) types, such as erosive hand OA (EHOA), with distant generalised changes in muscle composition (sarcopenia), which can potentially be modified. This study pioneers the exploration of the association between EHOA and sarcopenia, both of which are predominantly observed in the older adults. METHODS Using the Osteoarthritis Initiative cohort, we selected hand OA (modified Kellgren and Lawrence (grade ≥2 in ≥1 hand joint) participants with radiographic central erosions in ≥1 joints (EHOA group) and propensity score-matched hand OA participants with no erosion (non-EHOA group). MRI biomarkers of thigh muscles were measured at baseline, year 2 and year 4 using a validated deep-learning algorithm. To adjust for 'local' effects of coexisting knee OA (KOA), participants were further stratified according to presence of radiographic KOA. The outcomes were the differences between EHOA and non-EHOA groups in the 4-year rate of change for both intramuscular adipose tissue (intra-MAT) deposition and contractile (non-fat) area of thigh muscles. RESULTS After adjusting for potential confounders, 844 thighs were included (211 EHOA:633 non-EHOA; 67.1±7.5 years, female/male:2.9). Multilevel mixed-effect regression models showed that EHOA is associated a different 4-year rate of change in intra-MAT deposition (estimate, 95% CI: 71.5 mm2/4 years, 27.9 to 115.1) and contractile area (estimate, 95% CI: -1.8%/4 years, -2.6 to -1.0) of the Quadriceps. Stratified analyses showed that EHOA presence is associated with adverse changes in thigh muscle quality only in participants without KOA. CONCLUSIONS EHOA is associated with longitudinal worsening of thigh muscle composition only in participants without concomitant KOA. Further research is needed to understand the systemic factors linking EHOA and sarcopenia, which unlike EHOA is modifiable through specific interventions.
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Affiliation(s)
- Kamyar Moradi
- Russell H. Morgan Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Robert M Kwee
- Russell H. Morgan Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Department of Radiology, Zuyderland Medical Center, Heerlen/Sittard/Geleen, The Netherlands
| | - Bahram Mohajer
- Russell H. Morgan Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Ali Guermazi
- Department of Radiology, Chobanian & Avedisian Boston University School of Medicine, Boston, Massachusetts, USA
| | - Frank W Roemer
- Department of Radiology, Chobanian & Avedisian Boston University School of Medicine, Boston, Massachusetts, USA
- Department of Radiology, Universitätsklinikum Erlangen & Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Hamza Ahmed Ibad
- Russell H. Morgan Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Ida K Haugen
- Center for Treatment of Rheumatic and Musculoskeletal Diseases, Diakonhjemmet Hospital, Oslo, Norway
| | - Francis Berenbaum
- Department of Rheumatology, Sorbonne University, INSERM CRSA, Saint-Antoine Hospital APHP, Paris, France
| | - Shadpour Demehri
- Russell H. Morgan Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Mohajer B, Moradi K, Guermazi A, Dolatshahi M, Roemer FW, Ibad HA, Parastooei G, Conaghan PG, Zikria BA, Wan M, Cao X, Lima JAC, Demehri S. Statin use and longitudinal changes in quantitative MRI-based biomarkers of thigh muscle quality: data from Osteoarthritis Initiative. Skeletal Radiol 2024; 53:683-695. [PMID: 37840051 DOI: 10.1007/s00256-023-04473-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 09/26/2023] [Accepted: 09/26/2023] [Indexed: 10/17/2023]
Abstract
OBJECTIVE To assess whether changes in MRI-based measures of thigh muscle quality associated with statin use in participants with and without/at-risk of knee osteoarthritis. METHODS This retrospective cohort study used data from the Osteoarthritis Initiative study. Statin users and non-users were matched for relevant covariates using 1:1 propensity-score matching. Participants were further stratified according to baseline radiographic knee osteoarthritis status. We used a validated deep-learning method for thigh muscle MRI segmentation and calculation of muscle quality biomarkers at baseline, 2nd, and 4th visits. Mean difference and 95% confidence intervals (CI) in longitudinal 4-year measurements of muscle quality biomarkers, including cross-sectional area, intramuscular adipose tissue, contractile percent, and knee extensors and flexors maximum and specific contractile force (force/muscle area) were the outcomes of interest. RESULTS After matching, 3772 thighs of 1910 participants were included (1886 thighs of statin-users: 1886 of non-users; age: 62 ± 9 years (average ± standard deviation), range: 45-79; female/male: 1). During 4 years, statin use was associated with a slight decrease in muscle quality, indicated by decreased knee extension maximum (mean-difference, 95% CI: - 1.85 N/year, - 3.23 to - 0.47) and specific contractile force (- 0.04 N/cm2/year, - 0.07 to - 0.01), decreased thigh muscle contractile percent (- 0.03%/year, - 0.06 to - 0.01), and increased thigh intramuscular adipose tissue (3.06 mm2/year, 0.53 to 5.59). Stratified analyses showed decreased muscle quality only in participants without/at-risk of knee osteoarthritis but not those with established knee osteoarthritis. CONCLUSIONS Statin use is associated with a slight decrease in MRI-based measures of thigh muscle quality over 4 years. However, considering statins' substantial cardiovascular benefits, these slight muscle changes may be relatively less important in overall patient care.
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Affiliation(s)
- Bahram Mohajer
- Russell H. Morgan Department of Radiology and Radiological Science, Musculoskeletal Radiology, Johns Hopkins University School of Medicine, 601 N Caroline St, JHOC 3142, Baltimore, MD, 21287, USA.
| | - Kamyar Moradi
- Russell H. Morgan Department of Radiology and Radiological Science, Musculoskeletal Radiology, Johns Hopkins University School of Medicine, USA, Baltimore
| | - Ali Guermazi
- Department of Radiology, Chobanian & Avedisian Boston University School of Medicine, Boston, MA, USA
| | - Mahsa Dolatshahi
- Russell H. Morgan Department of Radiology and Radiological Science, Musculoskeletal Radiology, Johns Hopkins University School of Medicine, USA, Baltimore
| | - Frank W Roemer
- Department of Radiology, Chobanian & Avedisian Boston University School of Medicine, Boston, MA, USA
- Department of Radiology, Universitätsklinikum Erlangen & Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Hamza A Ibad
- Russell H. Morgan Department of Radiology and Radiological Science, Musculoskeletal Radiology, Johns Hopkins University School of Medicine, 601 N Caroline St, JHOC 3142, Baltimore, MD, 21287, USA
| | | | - Philip G Conaghan
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds, UK
| | - Bashir A Zikria
- Department of Orthopedic Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Mei Wan
- Department of Orthopedic Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Xu Cao
- Department of Orthopedic Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Joao A C Lima
- Division of Cardiology, Department of Medicine, Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Shadpour Demehri
- Russell H. Morgan Department of Radiology and Radiological Science, Musculoskeletal Radiology, Johns Hopkins University School of Medicine, 601 N Caroline St, JHOC 3142, Baltimore, MD, 21287, USA
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Martel-Pelletier J, Paiement P, Pelletier JP. Magnetic resonance imaging assessments for knee segmentation and their use in combination with machine/deep learning as predictors of early osteoarthritis diagnosis and prognosis. Ther Adv Musculoskelet Dis 2023; 15:1759720X231165560. [PMID: 37151912 PMCID: PMC10155034 DOI: 10.1177/1759720x231165560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 03/23/2023] [Indexed: 05/09/2023] Open
Abstract
Knee osteoarthritis (OA) is a prevalent and disabling disease that can develop over decades. This disease is heterogeneous and involves structural changes in the whole joint, encompassing multiple tissue types. Detecting OA before the onset of irreversible changes is crucial for early management, and this could be achieved by allowing knee tissue visualization and quantifying their changes over time. Although some imaging modalities are available for knee structure assessment, magnetic resonance imaging (MRI) is preferred. This narrative review looks at existing literature, first on MRI-developed approaches for evaluating knee articular tissues, and second on prediction using machine/deep-learning-based methodologies and MRI as input or outcome for early OA diagnosis and prognosis. A substantial number of MRI methodologies have been developed to assess several knee tissues in a semi-quantitative and quantitative fashion using manual, semi-automated and fully automated systems. This dynamic field has grown substantially since the advent of machine/deep learning. Another active area is predictive modelling using machine/deep-learning methodologies enabling robust early OA diagnosis/prognosis. Moreover, incorporating MRI markers as input/outcome in such predictive models is important for a more accurate OA structural diagnosis/prognosis. The main limitation of their usage is the ability to move them in rheumatology practice. In conclusion, MRI knee tissue determination and quantification provide early indicators for individuals at high risk of developing this disease or for patient prognosis. Such assessment of knee tissues, combined with the development of models/tools from machine/deep learning using, in addition to other parameters, MRI markers for early diagnosis/prognosis, will maximize opportunities for individualized risk assessment for use in clinical practice permitting precision medicine. Future efforts should be made to integrate such prediction models into open access, allowing early disease management to prevent or delay the OA outcome.
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Affiliation(s)
- Johanne Martel-Pelletier
- Osteoarthritis Research Unit, University of
Montreal Hospital Research Centre (CRCHUM), 900 Saint-Denis, R11.412B,
Montreal, QC H2X 0A9, Canada
| | - Patrice Paiement
- Osteoarthritis Research Unit, University of
Montreal Hospital Research Centre (CRCHUM), Montreal, QC, Canada
| | - Jean-Pierre Pelletier
- Osteoarthritis Research Unit, University of
Montreal Hospital Research Centre (CRCHUM), Montreal, QC, Canada
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Taniguchi M, Fukumoto Y, Yagi M, Hirono T, Yamagata M, Asayama A, Okada S, Nakai R, Kobayashi M, Ichihashi N. A higher intramuscular fat in vastus medialis is associated with functional disabilities and symptoms in early stage of knee osteoarthritis: a case-control study. Arthritis Res Ther 2023; 25:61. [PMID: 37060080 PMCID: PMC10103393 DOI: 10.1186/s13075-023-03048-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 04/07/2023] [Indexed: 04/16/2023] Open
Abstract
BACKGROUND The characteristics of muscle degeneration in individual quadriceps in early knee osteoarthritis (OA) and the association of muscle quantity and quality on knee dysfunction remain unclear. This study aimed to clarify the characteristics of muscle degeneration in individual quadriceps muscles in early knee OA and elucidate the association of muscle volume and intramuscular adipose tissue (intraMAT) with knee dysfunction, including functional disabilities, symptoms, and joint morphology. METHODS Fifty participants were categorized into early knee OA and healthy control groups. 3.0 T magnetic resonance imaging (MRI) using T1-weighted and Dixon methods and 3D SPACE in the thigh muscle and knee joint regions was performed. Quadriceps muscle volume, intraMAT, and whole-organ MRI score (WORMS) were assessed. The Knee Society Score (KSS) was used to evaluate functional disabilities and knee symptoms. Univariate analysis of variance was conducted with covariates to clarify the differences in muscle volume and intraMAT between the two groups. Multiple linear regression analyses were performed using the KSS function and symptom subcategories and WORMS as dependent variables and muscle volume, intraMAT, and the presence of early knee OA as independent variables, such as potential confounders. RESULTS The quadriceps intraMAT, especially in the vastus medialis (VM), was significantly higher in patients with early knee OA than in healthy controls. The VM intraMAT, not muscle volume, was significantly associated with KSS function [B = - 3.47; 95% confidence interval [CI], - 5.24 to - 1.71; p < 0.001] and symptom scores [B = - 0.63; 95% CI, - 1.09 to - 0.17; p = 0.008], but not with WORMS. CONCLUSION These findings suggest that higher VM intraMAT is characteristic of quadriceps muscle degeneration in early knee OA and its increase is associated with functional disabilities and symptoms.
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Affiliation(s)
- Masashi Taniguchi
- Human Health Sciences, Graduate School of Medicine, Kyoto University, 53-Kawahara-Cho, Shogoin, Sakyo-Ku, Kyoto, 606-8507, Japan.
| | - Yoshihiro Fukumoto
- Human Health Sciences, Graduate School of Medicine, Kyoto University, 53-Kawahara-Cho, Shogoin, Sakyo-Ku, Kyoto, 606-8507, Japan
- Faculty of Rehabilitation, Kansai Medical University, Hirakata, Japan
| | - Masahide Yagi
- Human Health Sciences, Graduate School of Medicine, Kyoto University, 53-Kawahara-Cho, Shogoin, Sakyo-Ku, Kyoto, 606-8507, Japan
| | - Tetsuya Hirono
- Human Health Sciences, Graduate School of Medicine, Kyoto University, 53-Kawahara-Cho, Shogoin, Sakyo-Ku, Kyoto, 606-8507, Japan
- School of Health and Sport Science, Chukyo University, Aichi, Japan
- Research Fellow of Japan Society for the Promotion of Science, Tokyo, Japan
| | - Momoko Yamagata
- Human Health Sciences, Graduate School of Medicine, Kyoto University, 53-Kawahara-Cho, Shogoin, Sakyo-Ku, Kyoto, 606-8507, Japan
- Faculty of Rehabilitation, Kansai Medical University, Hirakata, Japan
| | - Akihiro Asayama
- Human Health Sciences, Graduate School of Medicine, Kyoto University, 53-Kawahara-Cho, Shogoin, Sakyo-Ku, Kyoto, 606-8507, Japan
- Department of Rehabilitation, Japanese Red Cross Nagahama Hospital, Shiga, Japan
| | - Shogo Okada
- Human Health Sciences, Graduate School of Medicine, Kyoto University, 53-Kawahara-Cho, Shogoin, Sakyo-Ku, Kyoto, 606-8507, Japan
| | - Ryusuke Nakai
- Kyoto University Institute for the Future of Human Society, Kyoto, Japan
| | | | - Noriaki Ichihashi
- Human Health Sciences, Graduate School of Medicine, Kyoto University, 53-Kawahara-Cho, Shogoin, Sakyo-Ku, Kyoto, 606-8507, Japan
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Mohajer B, Moradi K, Guermazi A, Mammen JSR, Hunter DJ, Roemer FW, Demehri S. Levothyroxine use and longitudinal changes in thigh muscles in at-risk participants for knee osteoarthritis: preliminary analysis from Osteoarthritis Initiative cohort. Arthritis Res Ther 2023; 25:58. [PMID: 37041609 PMCID: PMC10088133 DOI: 10.1186/s13075-023-03012-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 02/14/2023] [Indexed: 04/13/2023] Open
Abstract
BACKGROUND We examined the association between levothyroxine use and longitudinal MRI biomarkers for thigh muscle mass and composition in at-risk participants for knee osteoarthritis (KOA) and their mediatory role in subsequent KOA incidence. METHODS Using the Osteoarthritis Initiative (OAI) data, we included the thighs and corresponding knees of participants at risk but without established radiographic KOA (baseline Kellgren-Lawrence grade (KL) < 2). Levothyroxine users were defined as self-reported use at all annual follow-up visits until the 4th year and were matched with levothyroxine non-users for potential confounders (KOA risk factors, comorbidities, and relevant medications covariates) using 1:2/3 propensity score (PS) matching. Using a previously developed and validated deep learning method for thigh segmentation, we assessed the association between levothyroxine use and 4-year longitudinal changes in muscle mass, including cross-sectional area (CSA) and muscle composition biomarkers including intra-MAT (within-muscle fat), contractile percentage (non-fat muscle CSA/total muscle CSA), and specific force (force per CSA). We further assessed whether levothyroxine use is associated with an 8-year risk of standard KOA radiographic (KL ≥ 2) and symptomatic incidence (incidence of radiographic KOA and pain on most of the days in the past 12 months). Finally, using a mediation analysis, we assessed whether the association between levothyroxine use and KOA incidence is mediated via muscle changes. RESULTS We included 1043 matched thighs/knees (266:777 levothyroxine users:non-users; average ± SD age: 61 ± 9 years, female/male: 4). Levothyroxine use was associated with decreased quadriceps CSAs (mean difference, 95%CI: - 16.06 mm2/year, - 26.70 to - 5.41) but not thigh muscles' composition (e.g., intra-MAT). Levothyroxine use was also associated with an increased 8-year risk of radiographic (hazard ratio (HR), 95%CI: 1.78, 1.15-2.75) and symptomatic KOA incidence (HR, 95%CI: 1.93, 1.19-3.13). Mediation analysis showed that a decrease in quadriceps mass (i.e., CSA) partially mediated the increased risk of KOA incidence associated with levothyroxine use. CONCLUSIONS Our exploratory analyses suggest that levothyroxine use may be associated with loss of quadriceps muscle mass, which may also partially mediate the increased risk of subsequent KOA incidence. Study interpretation should consider underlying thyroid function as a potential confounder or effect modifier. Therefore, future studies are warranted to investigate the underlying thyroid function biomarkers for longitudinal changes in the thigh muscles.
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Affiliation(s)
- Bahram Mohajer
- Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 601 N Caroline St., JHOC 5165, Baltimore, MD 21287 USA
| | - Kamyar Moradi
- Tehran University of Medical Sciences, School of Medicine, Tehran, Iran
| | - Ali Guermazi
- Department of Radiology, Chobanian & Avedisian Boston University School of Medicine, Boston, MA USA
| | - Jennifer S. R. Mammen
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD USA
| | - David J. Hunter
- Rheumatology Department, Royal North Shore Hospital, St Leonards, 2065 NSW Australia
- Sydney Musculoskeletal Health, Arabanoo Precinct, Kolling Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, 2065 NSW Australia
| | - Frank W. Roemer
- Department of Radiology, Chobanian & Avedisian Boston University School of Medicine, Boston, MA USA
- Department of Radiology, Universitätsklinikum Erlangen & Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Shadpour Demehri
- Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 601 N Caroline St., JHOC 5165, Baltimore, MD 21287 USA
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Mohajer B, Moradi K, Guermazi A, Dolatshahi M, Zikria B, Najafzadeh N, Kalyani RR, Roemer FW, Berenbaum F, Demehri S. Diabetes-associated thigh muscle degeneration mediates knee osteoarthritis-related outcomes: results from a longitudinal cohort study. Eur Radiol 2023; 33:595-605. [PMID: 35951046 PMCID: PMC10448875 DOI: 10.1007/s00330-022-09035-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 07/01/2022] [Accepted: 07/24/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We examined the association between diabetes mellitus (DM) and longitudinal MRI biomarkers for thigh muscle degeneration in patients with knee osteoarthritis (KOA) and their mediatory role in worsening KOA-related symptoms. METHODS The Osteoarthritis Initiative (OAI) participants with radiographic KOA (Kellgren-Lawrence grade ≥ 2) were included. Thighs and corresponding knees of KOA patients with versus without self-reported DM were matched for potential confounders using propensity score (PS) matching. We developed and used a validated deep learning method for longitudinal thigh segmentation. We assessed the association of DM with 4-year longitudinal muscle degeneration in biomarkers of muscle cross-sectional area (CSA) and contractile percentage (non-fat CSA/total CSA). We further investigated whether DM is associated with 9-year risk of KOA radiographic progression, knee replacement (KR), and symptoms worsening. Finally, we evaluated whether the DM-KOA worsening association is mediated through preceding muscle degeneration. RESULTS After PS matching, 698 thighs/knees were included (185:513 with:without DM; average ± SD age:64 ± 8-years; female/male:1.4). Baseline DM was associated with a decreased contractile percent of total thigh muscles and quadriceps (mean difference, 95%CI -0.16%/year, -0.25 to -0.07, and -0.21%/year, -0.33 to -0.08). DM was also associated with an increased risk of worsening KOA-related symptoms (hazard ratio, 95%CI 1.70, 1.18-2.46) but not radiographic progression or KR. The decrease in quadriceps contractile percent partially mediated the increased risk of symptoms worsening in patients with DM. CONCLUSIONS Baseline DM is associated with thigh muscle degeneration and KOA-related symptoms worsening. As a potentially modifiable risk factor, DM-associated longitudinal thigh muscle degeneration may partially mediate the symptoms worsening in patients with DM and coexisting KOA. KEY POINTS • Diabetes mellitus (DM) is associated with worsening knee osteoarthritis (KOA)-related symptoms. • As a potentially modifiable factor, DM-associated thigh muscle (quadriceps) degeneration partially mediates the worsening of KOA-related symptoms.
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Affiliation(s)
- Bahram Mohajer
- Musculoskeletal Radiology, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 601 N Caroline St, JHOC 5165, Baltimore, MD, 21287, USA
| | - Kamyar Moradi
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Guermazi
- Department of Radiology, Boston University School of Medicine, Boston, MA, USA
| | - Mahsa Dolatshahi
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Bashir Zikria
- Department of Orthopedic Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | - Rita R Kalyani
- Division of Endocrinology, Diabetes, and Metabolism, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Frank W Roemer
- Department of Radiology, Boston University School of Medicine, Boston, MA, USA
- Department of Radiology, Universitätsklinikum Erlangen & Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Francis Berenbaum
- Department of Rheumatology, Sorbonne University, INSERM CRSA, AP-HP Hospital Saint Antoine, Paris, France
| | - Shadpour Demehri
- Musculoskeletal Radiology, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 601 N Caroline St, JHOC 5165, Baltimore, MD, 21287, USA.
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Taniguchi M, Fukumoto Y, Yagi M, Motomura Y, Okada S, Okada S, Kobayashi M, Ichihashi N. Enhanced echo intensity in vastus medialis is associated with worsening of functional disabilities and symptoms in patients with knee osteoarthritis: a 3 years longitudinal study. Rheumatol Int 2022; 43:953-960. [PMID: 36394599 PMCID: PMC9672570 DOI: 10.1007/s00296-022-05246-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 11/09/2022] [Indexed: 11/18/2022]
Abstract
Patients with knee osteoarthritis (OA) experience muscle quality loss, and is characterized by the enhanced echo intensity (EI) of the vastus medialis (VM) muscles and a high extracellular water-to-intracellular water (ECW/ICW) ratio of the thigh. This study aimed to elucidate the association between muscle degeneration and the worsening of functional disabilities and symptoms in patients with KOA over 3 years duration. Thirty-three patients with KOA who completed follow-up over 3 years were included in the analysis. The knee scoring system (KSS) was used to evaluate the functional abilities and symptoms. Based on the 3 years change in KSS scores, patients were classified into progressive or non-progressive groups. Muscle thickness (MT) and EI of the VM were determined using ultrasonography. The ECW/ICW ratio was measured using segmental-bioelectrical impedance spectroscopy. Multivariable logistic regression analyses were conducted with the groups as the dependent variables and VM-MT, VM-EI, and ECW/ICW ratio at baseline as independent variables, including potential confounders. Thirteen (39.4%) patients showed progressive features. VM-EI at baseline was significantly associated with the progression of functional disabilities (adjusted odds ratio [OR] 1.24; 95% confidence interval [CI] 1.03 − 1.50) and symptoms (adjusted OR 1.13; 95% CI 1.01 − 1.25). Enhanced VM-EI was associated with the worsening of functional disabilities and symptoms in patients with KOA over a period of 3 years. Therefore, the assessment of VM-EI using ultrasonography is a useful indicator for predicting the future worsening of KOA.
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Affiliation(s)
- Masashi Taniguchi
- Graduate School of Medicine, Human Health Sciences, Kyoto University, 53-Kawahara-Cho, Shogoin, Sakyo-Ku, Kyoto, 606-8507 Japan
| | - Yoshihiro Fukumoto
- Graduate School of Medicine, Human Health Sciences, Kyoto University, 53-Kawahara-Cho, Shogoin, Sakyo-Ku, Kyoto, 606-8507 Japan
- Faculty of Rehabilitation, Kansai Medical University, Hirakata, Japan
| | - Masahide Yagi
- Graduate School of Medicine, Human Health Sciences, Kyoto University, 53-Kawahara-Cho, Shogoin, Sakyo-Ku, Kyoto, 606-8507 Japan
| | - Yoshiki Motomura
- Graduate School of Medicine, Human Health Sciences, Kyoto University, 53-Kawahara-Cho, Shogoin, Sakyo-Ku, Kyoto, 606-8507 Japan
- Department of Orthopaedic Surgery, Kobayashi Hospital, Kyoto, Japan
| | - Sayaka Okada
- Graduate School of Medicine, Human Health Sciences, Kyoto University, 53-Kawahara-Cho, Shogoin, Sakyo-Ku, Kyoto, 606-8507 Japan
| | - Shogo Okada
- Graduate School of Medicine, Human Health Sciences, Kyoto University, 53-Kawahara-Cho, Shogoin, Sakyo-Ku, Kyoto, 606-8507 Japan
| | | | - Noriaki Ichihashi
- Graduate School of Medicine, Human Health Sciences, Kyoto University, 53-Kawahara-Cho, Shogoin, Sakyo-Ku, Kyoto, 606-8507 Japan
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Mohajer B, Dolatshahi M, Moradi K, Najafzadeh N, Eng J, Zikria B, Wan M, Cao X, Roemer FW, Guermazi A, Demehri S. Role of Thigh Muscle Changes in Knee Osteoarthritis Outcomes: Osteoarthritis Initiative Data. Radiology 2022; 305:169-178. [PMID: 35727152 PMCID: PMC9524577 DOI: 10.1148/radiol.212771] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 04/12/2022] [Accepted: 05/06/2022] [Indexed: 11/11/2022]
Abstract
Background Longitudinal data on the association of quantitative thigh muscle MRI markers with knee osteoarthritis (KOA) outcomes are scarce. These associations are of clinical importance, with potential use for thigh muscle-directed disease-modifying interventions. Purpose To measure KOA-associated longitudinal changes in MRI-derived muscle cross-sectional area (CSA) and adipose tissue and their association with downstream symptom worsening and knee replacement (KR). Materials and Methods In a secondary analysis of the Osteoarthritis Initiative multicenter prospective cohort (February 2004 through October 2015), knees of participants with available good-quality thigh MRI scans at baseline and at least one follow-up visit were included and classified as with and without KOA according to baseline radiographic Kellgren-Lawrence grade of 2 or higher and matched for confounders with use of propensity score matching. An automated deep learning model for thigh MRI two-dimensional segmentation was developed and tested. Markers of muscle CSA and intramuscular adipose tissue (intra-MAT) were measured at baseline and 2nd- and 4th-year follow-up (period 1) and compared between knees with and without KOA by using linear mixed-effect regression models. Furthermore, in knees with KOA, the association of period 1 changes in muscle markers with risk of KR (Cox proportional hazards) and symptom worsening (mixed-effect models) during the 4th to 9th year (period 2) was evaluated. Results This study included 4634 matched thighs (2317 with and 2317 without KOA) of 2344 participants (mean age, 62 years ± 9 [SD]; 1292 women). Compared with those without, knees with KOA had a decrease in quadriceps CSA (mean difference, -8.21 mm2/year; P = .004) and an increase in quadriceps intra-MAT (1.98 mm2/year; P = .007). Decreased CSA and increased intra-MAT of quadriceps during period 1 was predictive of downstream (period 2) KOA symptom worsening (Western Ontario and McMaster Universities Osteoarthritis Index total score: odds ratio, 0.24 [negative association] [P < .001] and 1.38 [P = .012], respectively). Quadriceps CSA changes were negatively associated with higher future KR risk (hazard ratio, 0.70; P < .001). Conclusion Knee osteoarthritis was associated with longitudinal MRI-derived decreased quadriceps cross-sectional area and increased intramuscular adipose tissue. These potentially modifiable risk factors were predictive of downstream symptom worsening and knee replacement. Clinical trial registration no. NCT00080171 © RSNA, 2022 Online supplemental material is available for this article.
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Affiliation(s)
- Bahram Mohajer
- From the Division of Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science (B.M., S.D.), Russell H. Morgan Department of Radiology and Radiological Science (J.E.), and Department of Orthopedic Surgery (B.Z., M.W., X.C.), Johns Hopkins University School of Medicine, 601 N Caroline St, JHOC 3142, Baltimore, MD 21287; Tehran University of Medical Sciences, School of Medicine, Tehran, Iran (M.D., K.M.); Sharif University of Technology, Tehran, Iran (N.N.); Department of Radiology, Boston University School of Medicine, Boston, Mass (F.W.R., A.G.); and Department of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany (F.W.R.)
| | - Mahsa Dolatshahi
- From the Division of Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science (B.M., S.D.), Russell H. Morgan Department of Radiology and Radiological Science (J.E.), and Department of Orthopedic Surgery (B.Z., M.W., X.C.), Johns Hopkins University School of Medicine, 601 N Caroline St, JHOC 3142, Baltimore, MD 21287; Tehran University of Medical Sciences, School of Medicine, Tehran, Iran (M.D., K.M.); Sharif University of Technology, Tehran, Iran (N.N.); Department of Radiology, Boston University School of Medicine, Boston, Mass (F.W.R., A.G.); and Department of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany (F.W.R.)
| | - Kamyar Moradi
- From the Division of Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science (B.M., S.D.), Russell H. Morgan Department of Radiology and Radiological Science (J.E.), and Department of Orthopedic Surgery (B.Z., M.W., X.C.), Johns Hopkins University School of Medicine, 601 N Caroline St, JHOC 3142, Baltimore, MD 21287; Tehran University of Medical Sciences, School of Medicine, Tehran, Iran (M.D., K.M.); Sharif University of Technology, Tehran, Iran (N.N.); Department of Radiology, Boston University School of Medicine, Boston, Mass (F.W.R., A.G.); and Department of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany (F.W.R.)
| | - Nima Najafzadeh
- From the Division of Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science (B.M., S.D.), Russell H. Morgan Department of Radiology and Radiological Science (J.E.), and Department of Orthopedic Surgery (B.Z., M.W., X.C.), Johns Hopkins University School of Medicine, 601 N Caroline St, JHOC 3142, Baltimore, MD 21287; Tehran University of Medical Sciences, School of Medicine, Tehran, Iran (M.D., K.M.); Sharif University of Technology, Tehran, Iran (N.N.); Department of Radiology, Boston University School of Medicine, Boston, Mass (F.W.R., A.G.); and Department of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany (F.W.R.)
| | - John Eng
- From the Division of Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science (B.M., S.D.), Russell H. Morgan Department of Radiology and Radiological Science (J.E.), and Department of Orthopedic Surgery (B.Z., M.W., X.C.), Johns Hopkins University School of Medicine, 601 N Caroline St, JHOC 3142, Baltimore, MD 21287; Tehran University of Medical Sciences, School of Medicine, Tehran, Iran (M.D., K.M.); Sharif University of Technology, Tehran, Iran (N.N.); Department of Radiology, Boston University School of Medicine, Boston, Mass (F.W.R., A.G.); and Department of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany (F.W.R.)
| | - Bashir Zikria
- From the Division of Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science (B.M., S.D.), Russell H. Morgan Department of Radiology and Radiological Science (J.E.), and Department of Orthopedic Surgery (B.Z., M.W., X.C.), Johns Hopkins University School of Medicine, 601 N Caroline St, JHOC 3142, Baltimore, MD 21287; Tehran University of Medical Sciences, School of Medicine, Tehran, Iran (M.D., K.M.); Sharif University of Technology, Tehran, Iran (N.N.); Department of Radiology, Boston University School of Medicine, Boston, Mass (F.W.R., A.G.); and Department of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany (F.W.R.)
| | - Mei Wan
- From the Division of Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science (B.M., S.D.), Russell H. Morgan Department of Radiology and Radiological Science (J.E.), and Department of Orthopedic Surgery (B.Z., M.W., X.C.), Johns Hopkins University School of Medicine, 601 N Caroline St, JHOC 3142, Baltimore, MD 21287; Tehran University of Medical Sciences, School of Medicine, Tehran, Iran (M.D., K.M.); Sharif University of Technology, Tehran, Iran (N.N.); Department of Radiology, Boston University School of Medicine, Boston, Mass (F.W.R., A.G.); and Department of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany (F.W.R.)
| | - Xu Cao
- From the Division of Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science (B.M., S.D.), Russell H. Morgan Department of Radiology and Radiological Science (J.E.), and Department of Orthopedic Surgery (B.Z., M.W., X.C.), Johns Hopkins University School of Medicine, 601 N Caroline St, JHOC 3142, Baltimore, MD 21287; Tehran University of Medical Sciences, School of Medicine, Tehran, Iran (M.D., K.M.); Sharif University of Technology, Tehran, Iran (N.N.); Department of Radiology, Boston University School of Medicine, Boston, Mass (F.W.R., A.G.); and Department of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany (F.W.R.)
| | - Frank W. Roemer
- From the Division of Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science (B.M., S.D.), Russell H. Morgan Department of Radiology and Radiological Science (J.E.), and Department of Orthopedic Surgery (B.Z., M.W., X.C.), Johns Hopkins University School of Medicine, 601 N Caroline St, JHOC 3142, Baltimore, MD 21287; Tehran University of Medical Sciences, School of Medicine, Tehran, Iran (M.D., K.M.); Sharif University of Technology, Tehran, Iran (N.N.); Department of Radiology, Boston University School of Medicine, Boston, Mass (F.W.R., A.G.); and Department of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany (F.W.R.)
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9
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Teoli A, Martel-Pelletier J, Abram F, Pelletier JP, Robbins SM. Vastus medialis intramuscular fat is associated with reduced quadriceps strength, but not knee osteoarthritis severity. Clin Biomech (Bristol, Avon) 2022; 96:105669. [PMID: 35636307 DOI: 10.1016/j.clinbiomech.2022.105669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 05/04/2022] [Accepted: 05/11/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND Vastus medialis intramuscular fat has been proposed to be a modifiable determinant of knee cartilage loss in patients with knee osteoarthritis. The objective was to determine whether vastus medialis intramuscular fat relates to osteoarthritis severity and quadriceps muscle strength in patients with non-traumatic and post-traumatic knee osteoarthritis. METHODS For this cross-sectional study, participants with knee osteoarthritis were classified into two groups: non-traumatic (n = 22; mean age = 60 years) and post-traumatic (n = 19; mean age = 56 years). Healthy adults were included (n = 22; mean age = 59 years). A 3-Tesla magnetic resonance imaging was used to measure vastus medialis cross-sectional area and intramuscular fat. Isometric knee extensor muscle torque was assessed using an isokinetic dynamometer and normalized to body mass (Nm/kg). Knee osteoarthritis severity was assessed using standing antero-posterior radiographs (Kellgren-Lawrence scores). Regression analyses examined relationships between 1) vastus medialis intramuscular fat with knee osteoarthritis severity and osteoarthritis group, after accounting for sex and body mass index, and 2) knee extensor muscle torque with vastus medialis intramuscular fat, after accounting for sex and vastus medialis cross-sectional area. FINDINGS Vastus medialis intramuscular fat was positively associated with body mass index (B = 0.321, P < 0.001), but not with osteoarthritis severity or group (P > 0.05). Higher vastus medialis intramuscular fat was associated with reduced knee extensor muscle torque (B = -0.040, P = 0.018). INTERPRETATION Greater vastus medialis intramuscular fat was associated with lower quadriceps muscle strength in patients with knee OA. It is unclear whether this is due to the accumulation of vastus medialis intramuscular fat or other potential factors, such as diet and physical inactivity.
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Affiliation(s)
- Anthony Teoli
- Centre for Interdisciplinary Research in Rehabilitation, Lethbridge-Layton-Mackay Rehabilitation Centre, and School of Physical and Occupational Therapy, McGill University, Montreal, Canada.
| | - Johanne Martel-Pelletier
- Osteoarthritis Research Unit, University of Montreal Hospital Research Centre (CRCHUM), Montreal, Canada.
| | | | - Jean-Pierre Pelletier
- Osteoarthritis Research Unit, University of Montreal Hospital Research Centre (CRCHUM), Montreal, Canada.
| | - Shawn M Robbins
- Centre for Interdisciplinary Research in Rehabilitation, Lethbridge-Layton-Mackay Rehabilitation Centre, and School of Physical and Occupational Therapy, McGill University, Montreal, Canada.
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10
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van den Noort JC, van der Leeden M, Stapper G, Wirth W, Maas M, Roorda LD, Lems WF, Dekker J, van der Esch M. Muscle weakness is associated with non-contractile muscle tissue of the vastus medialis muscle in knee osteoarthritis. BMC Musculoskelet Disord 2022; 23:91. [PMID: 35086518 PMCID: PMC8796405 DOI: 10.1186/s12891-022-05025-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 01/10/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Quadriceps weakness is assumed to be associated with compositional properties of the vastus medialis muscle in patients with knee osteoarthritis (OA). METHODS The aim was to determine the association of non-contractile muscle tissue in the vastus medialis muscle, measured with routine MRI, with muscle extensor strength in patients with knee OA. Sagittal T1-weighted 3T MRI of 94 patients with knee OA, routinely acquired in clinical practice were used for analysis. Using the MRI's, the amount of non-contractile muscle tissue in the vastus medialis muscle was measured, expressed as a percentage of (non)-contractile tissue, dichotomized into a low and a high non-contractile percentage group. Muscle strength was assessed by isokinetic measurement of knee extensors and by conduction of the Get-Up and Go (GUG) test. In regression analyses, associations of percentage of non-contractile muscle tissue with muscle strength and GUG time were determined and controlled for sex, age, BMI and radiographic severity. RESULTS A high percentage of non-contractile muscle tissue (> 11.2%) was associated with lower muscle strength (B = -0.25, P = 0.006) and with longer GUG time (B = 1.09, P = 0.021). These associations were specifically confounded by sex and BMI, because these two variables decreased the regression coefficient (B) with > 10%. CONCLUSIONS A high percentage of non-contractile muscle tissue in the vastus medialis muscle measured by clinical T1-weighted 3T MRI is associated with muscle weakness. The association is confounded by sex and BMI. Non-contractile muscle tissue seems to be an important compositional property of the vastus medialis muscle underlying quadriceps weakness.
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Affiliation(s)
- Josien C van den Noort
- Department of Radiology and Nuclear Medicine, Amsterdam Movement Sciences, Medical Imaging Quantification Center (MIQC), Amsterdam UMC, Univ of Amsterdam, Meibergdreef 9, Amsterdam, Netherlands. .,Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, Netherlands.
| | - Marike van der Leeden
- Amsterdam Rehabilitation Research Center Reade, Amsterdam, Netherlands.,Department of Rehabilitation Medicine, EMGO Institute for Health and Care Research, Amsterdam UMC, Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, Netherlands
| | - Gerard Stapper
- Amsterdam Rehabilitation Research Center Reade, Amsterdam, Netherlands
| | - Wolfgang Wirth
- Institute of Anatomy, PMU, Salzburg, Austria.,Chondrometrics GmbH, Ainring, Germany
| | - Mario Maas
- Department of Radiology and Nuclear Medicine, Amsterdam Movement Sciences, Medical Imaging Quantification Center (MIQC), Amsterdam UMC, Univ of Amsterdam, Meibergdreef 9, Amsterdam, Netherlands
| | - Leo D Roorda
- Amsterdam Rehabilitation Research Center Reade, Amsterdam, Netherlands
| | - Willem F Lems
- Department of Rheumatology, Amsterdam UMC, Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, Netherlands.,Department of Rheumatology, Amsterdam Rehabilitation Center Reade, Amsterdam, Netherlands
| | - Joost Dekker
- Department of Rehabilitation Medicine, EMGO Institute for Health and Care Research, Amsterdam UMC, Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, Netherlands.,Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, Netherlands
| | - Martin van der Esch
- Amsterdam Rehabilitation Research Center Reade, Amsterdam, Netherlands.,Amsterdam University of Applied Sciences, Faculty of Health, Amsterdam, Netherlands
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11
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Suzuki K, Hasebe Y, Yamamoto M, Saita K, Ogihara S. Risk Factor Analysis for Fat Infiltration in the Lumbar Paraspinal Muscles in Patients With Lumbar Degenerative Diseases. Geriatr Orthop Surg Rehabil 2022; 13:21514593211070688. [PMID: 35070477 PMCID: PMC8772358 DOI: 10.1177/21514593211070688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 12/10/2021] [Accepted: 12/14/2021] [Indexed: 12/03/2022] Open
Abstract
Introduction This study aimed to investigate factors related to fat infiltration in patients with lumbar degenerative diseases (lumbar disc herniation and/or spinal stenosis), examining a wide range of potential risk variables. Materials and methods We studied consecutive adult patients who underwent posterior lumbar spinal surgery for degenerative diseases at our hospital between July 2013 and June 2017. Preoperative magnetic resonance imaging was used to evaluate the presence or absence of fat infiltration at the level of the L4-5 lumbar paraspinal muscles using Kjaer’s evaluation method. Patients without fat infiltration (0%–10%) were rated as grade 0, grade 1 for moderate fat infiltration (10%–50%), and grade 2 for severe fat infiltration (>50%). Patients were then divided into two groups: Group A (without fat infiltration, grade 0) and Group B (with fat infiltration, grade 1 or 2). Detailed patient clinical data were collected and analyzed. Results A total of 205 consecutive patients were enrolled; 54 (26.3%) patients were assigned to Group A and 151 (73.7%) to Group B. Logistic regression analysis revealed two independent risk factors for fat infiltration of the lumbar paraspinal muscles: female sex and older age (P < .001). Discussion Fat infiltration of the lumbar paraspinal muscles is reported to be associated with the development of pain and dysfunction of the lumbar region and postoperative complications of spinal instrumented fusion surgery. To the best of our knowledge, no previous studies have identified female sex and older age as independent risk factors for fat infiltration in the lumbar paraspinal muscles using multivariate analysis. Conclusions Female sex and older age were independent risk factors for fat infiltration in the lumbar paraspinal muscles. The results of the current study may provide useful information for the study of preventive measures for fat infiltration.
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Affiliation(s)
- Kenta Suzuki
- Department of Rehabilitation, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan
| | - Yuki Hasebe
- Department of Rehabilitation, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan
| | - Mitsuru Yamamoto
- Department of Rehabilitation, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan
| | - Kazuo Saita
- Department of Orthopaedic Surgery, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan
| | - Satoshi Ogihara
- Department of Orthopaedic Surgery, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan
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12
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Common Biochemical and Magnetic Resonance Imaging Biomarkers of Early Knee Osteoarthritis and of Exercise/Training in Athletes: A Narrative Review. Diagnostics (Basel) 2021; 11:diagnostics11081488. [PMID: 34441422 PMCID: PMC8391340 DOI: 10.3390/diagnostics11081488] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 07/29/2021] [Accepted: 08/09/2021] [Indexed: 12/24/2022] Open
Abstract
Knee osteoarthritis (OA) is the most common joint disease of the world population. Although considered a disease of old age, OA also affects young individuals and, more specifically among them, those practicing knee-joint-loading sports. Predicting OA at an early stage is crucial but remains a challenge. Biomarkers that can predict early OA development will help in the design of specific therapeutic strategies for individuals and, for athletes, to avoid adverse outcomes due to exercising/training regimens. This review summarizes and compares the current knowledge of fluid and magnetic resonance imaging (MRI) biomarkers common to early knee OA and exercise/training in athletes. A variety of fluid biochemical markers have been proposed to detect knee OA at an early stage; however, few have shown similar behavior between the two studied groups. Moreover, in endurance athletes, they are often contingent on the sport involved. MRI has also demonstrated its ability for early detection of joint structural alterations in both groups. It is currently suggested that for optimal forecasting of early knee structural alterations, both fluid and MRI biomarkers should be analyzed as a panel and/or combined, rather than individually.
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13
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Kumar D, Link TM, Jafarzadeh SR, LaValley MP, Majumdar S, Souza RB. Association of Quadriceps Adiposity With an Increase in Knee Cartilage, Meniscus, or Bone Marrow Lesions Over Three Years. Arthritis Care Res (Hoboken) 2021; 73:1134-1139. [PMID: 32339414 PMCID: PMC7606313 DOI: 10.1002/acr.24232] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 04/21/2020] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To evaluate the association of fatty infiltration of the quadriceps and vastus medialis (VM) with an increase in knee cartilage, meniscus, or bone marrow lesions, using magnetic resonance imaging (MRI) in knee osteoarthritis (OA) over 3 years. METHODS Participants (n = 69) with and without radiographic knee OA underwent MRI at baseline and 3 years later. Chemical shift-based water/fat MRI was used to quantify the intramuscular fat fraction and the lean anatomical cross-sectional area (ACSA) for the VM and entire quadriceps muscles. MRI images of the knee were analyzed using the semiquantitative modified whole-organ MRI score (mWORMS) grading to assess change in lesions in the articular cartilage, meniscus, and bone marrow. Logistic regression was used to assess whether baseline quadriceps and VM fat fraction and lean ACSA were associated with an increase in mWORMS scores. Odds ratios (ORs) were adjusted for age, sex, and body mass index. RESULTS Overall, of the 69 subjects, 43 (62%) had an increase in cartilage lesions (26 of 43), meniscus lesions (19 of 43), or bone marrow lesions (22 of 43) scores. The quadriceps (OR 2.13 [95% confidence interval (95% CI) 1.09-4.15]) and VM (OR 2.05 [95% CI 1.25-3.36]) fat fraction were both associated with an increase in cartilage, meniscus, or bone marrow lesion scores over 3 years. The association of quadriceps or VM lean ACSA with the outcomes was not significant. CONCLUSION These longitudinal findings using quantitative MRI methods for assessment of muscle adiposity highlight the role of quadriceps adiposity, specifically in the VM, in knee OA progression. However, studies in larger cohorts are needed to confirm these findings.
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Affiliation(s)
- Deepak Kumar
- Department of Physical Therapy & Athletic Training, College of Health and Rehabilitation Sciences: Sargent College, Boston University, Boston, MA, USA,Section of Rheumatology, Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Thomas M. Link
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
| | - S. Reza Jafarzadeh
- Section of Rheumatology, Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Michael P. LaValley
- Section of Rheumatology, Department of Medicine, Boston University School of Medicine, Boston, MA, USA,Department of Biostatistics, School of Public Health, Boston University
| | - Sharmila Majumdar
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
| | - Richard B. Souza
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA,Department of Physical Therapy and Rehabilitation Science, University of California, San Francisco, CA, USA
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14
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Enhanced echo intensity and a higher extracellular water-to-intracellular water ratio are helpful clinical signs for detecting muscle degeneration in patients with knee osteoarthritis. Clin Rheumatol 2021; 40:4207-4215. [PMID: 33999290 DOI: 10.1007/s10067-021-05763-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 04/30/2021] [Accepted: 05/03/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVES Enhanced muscle echo intensity (EI) with ultrasound imaging and a higher extracellular water-to-intracellular water (ECW/ICW) ratio with segmental-bioelectrical impedance spectroscopy (S-BIS) represent muscle quality loss. This study aimed to clarify quadriceps muscle degeneration characteristics, focusing on muscle quality changes in patients with knee osteoarthritis (OA). METHOD Forty-one women with knee OA (mean age, 71.4±6.0 years) and 27 healthy women (mean age, 75.6±4.9 years) participated. Ultrasonography was used to evaluate the muscle thickness (MT) and the EI of each quadriceps compartment. The ECW/ICW ratio was obtained by S-BIS. MT, EI, and ECW/ICW ratio differences between the two groups were tested using univariate analysis of variance, adjusting for age and body mass index. Logistic regression analyses were performed with the group as the dependent variable, and the MT and EI of the vastus medialis (VM) and the ECW/ICW ratio as independent variables. RESULTS Patients with knee OA had a significant decrease in VM MT, enhanced VM, and vastus intermedius EIs and a higher ECW/ICW ratio compared with healthy participants. Logistic regression analysis showed that the VM EI (odds ratio [OR], 1.19; 95% confidence interval [CI], 1.06-1.35) and the ECW/ICW ratio were independently associated with knee OA (OR, 1.19; 95% CI, 1.00-1.42). CONCLUSIONS VM EI and the ECW/ICW ratio, rather than VM MT, characterised quadriceps muscle degeneration in patients with knee OA. Therefore, enhanced EI and a higher ECW/ICW ratio are helpful clinical signs for detecting muscle degeneration in patients with knee OA. Key Points •Echo intensity (EI) of the vastus medialis and the extracellular-to-intracellular water (ECW/ICW) ratio significantly increased in patients with knee osteoarthritis OA). •Enhanced EI and a higher ECW/ICW ratio are useful clinical signs for detecting muscle degeneration in patients with knee OA.
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15
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Taniguchi M, Ikezoe T, Kamitani T, Tsuboyama T, Ito H, Matsuda S, Tabara Y, Matsuda F, Ichihashi N. Extracellular-to-intracellular water ratios are associated with functional disability levels in patients with knee osteoarthritis: results from the Nagahama Study. Clin Rheumatol 2021; 40:2889-2896. [PMID: 33486595 DOI: 10.1007/s10067-021-05591-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 01/09/2021] [Accepted: 01/12/2021] [Indexed: 12/23/2022]
Abstract
INTRODUCTION/OBJECTIVES To test the hypothesis that greater extracellular-to-intracellular water (ECW/ICW) ratios in lower-limb muscles are associated with worsened functional abilities in patients with knee osteoarthritis (OA). METHODS We analyzed data from 787 participants (82.2% female; mean age, 69.6 ± 5.3 years) from the Nagahama Prospective Cohort who were ≥60 years old and had radiographically confirmed bilateral knee OA. The Knee Scoring System (KSS) was used to assess functional abilities. Lower-limb ECW/ICW ratios and skeletal mass index values were determined with multi-frequency bioelectrical impedance analysis (BIA). Multiple linear regression analysis was used to test for associations between ECW/ICW ratios and functional abilities. Subgroup analyses based on OA severities and symptomaticity were also conducted. RESULTS Increased ECW/ICW ratios were associated with a 4.38-point decrease in the KSS function scores (95% confidence interval [CI], 3.15-5.62 points) after adjusting for covariates. This association varied according to the degree of knee symptoms, especially in individuals with radiologically mild OA. ECW/ICW ratios in individuals with asymptomatic mild OA were associated with a 2.14-point decrease in the KSS function score (95% CI, 0.32-3.96 points), whereas those in individuals with severe symptomatic mild OA were associated with a 6.16-point decrease (95% CI, 2.13-10.19 points). CONCLUSIONS Our findings indicate that higher ECW/ICW ratios are associated with greater functional disability in patients with knee OA. Therefore, ECW/ICW ratio measurements with multi-frequency BIA can serve as valuable indicators for functional disability in patients with knee OA. Key Points • Higher extracellular-to-intracellular water (ECW/ICW) ratios are associated with greater functional disability levels in patients with knee osteoarthritis (OA). • ECW/ICW ratios are useful clinical signs as a biomarker for poor functional abilities in patients with knee OA.
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Affiliation(s)
- Masashi Taniguchi
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, 53-Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan.
| | - Tome Ikezoe
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, 53-Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Tsukasa Kamitani
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Tadao Tsuboyama
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, 53-Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan.,Department of Physical Therapy, School of Health Sciences, Bukkyo University, Kyoto, Japan
| | - Hiromu Ito
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Shuichi Matsuda
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yasuharu Tabara
- Center for Genomic Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Fumihiko Matsuda
- Center for Genomic Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Noriaki Ichihashi
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, 53-Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
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Primorac D, Molnar V, Rod E, Jeleč Ž, Čukelj F, Matišić V, Vrdoljak T, Hudetz D, Hajsok H, Borić I. Knee Osteoarthritis: A Review of Pathogenesis and State-Of-The-Art Non-Operative Therapeutic Considerations. Genes (Basel) 2020; 11:E854. [PMID: 32722615 PMCID: PMC7464436 DOI: 10.3390/genes11080854] [Citation(s) in RCA: 170] [Impact Index Per Article: 42.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 07/11/2020] [Accepted: 07/23/2020] [Indexed: 02/07/2023] Open
Abstract
Being the most common musculoskeletal progressive condition, osteoarthritis is an interesting target for research. It is estimated that the prevalence of knee osteoarthritis (OA) among adults 60 years of age or older is approximately 10% in men and 13% in women, making knee OA one of the leading causes of disability in elderly population. Today, we know that osteoarthritis is not a disease characterized by loss of cartilage due to mechanical loading only, but a condition that affects all of the tissues in the joint, causing detectable changes in tissue architecture, its metabolism and function. All of these changes are mediated by a complex and not yet fully researched interplay of proinflammatory and anti-inflammatory cytokines, chemokines, growth factors and adipokines, all of which can be measured in the serum, synovium and histological samples, potentially serving as biomarkers of disease stage and progression. Another key aspect of disease progression is the epigenome that regulates all the genetic expression through DNA methylation, histone modifications, and mRNA interference. A lot of work has been put into developing non-surgical treatment options to slow down the natural course of osteoarthritis to postpone, or maybe even replace extensive surgeries such as total knee arthroplasty. At the moment, biological treatments such as platelet-rich plasma, bone marrow mesenchymal stem cells and autologous microfragmented adipose tissue containing stromal vascular fraction are ordinarily used. Furthermore, the latter two mentioned cell-based treatment options seem to be the only methods so far that increase the quality of cartilage in osteoarthritis patients. Yet, in the future, gene therapy could potentially become an option for orthopedic patients. In the following review, we summarized all of the latest and most important research in basic sciences, pathogenesis, and non-operative treatment.
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Affiliation(s)
- Dragan Primorac
- St. Catherine Specialty Hospital, 49210 Zabok/10000 Zagreb, Croatia; (V.M.); (E.R.); (Ž.J.); (F.Č.); (V.M.); (T.V.); (D.H.); (H.H.); (I.B.)
- Eberly College of Science, The Pennsylvania State University, University Park, State College, PA 16802, USA
- The Henry C. Lee College of Criminal Justice and Forensic Sciences, University of New Haven, West Haven, CT 06516, USA
- Medical School, University of Split, 21000 Split, Croatia
- School of Medicine, Faculty of Dental Medicine and Health, University “Josip Juraj Strossmayer”, 31000 Osijek, Croatia
- School of Medicine, JJ Strossmayer University of Osijek, 31000 Osijek, Croatia
- Medical School, University of Rijeka, 51000 Rijeka, Croatia
- Medical School REGIOMED, 96 450 Coburg, Germany
- Medical School, University of Mostar, 88000 Mostar, Bosnia and Herzegovina
| | - Vilim Molnar
- St. Catherine Specialty Hospital, 49210 Zabok/10000 Zagreb, Croatia; (V.M.); (E.R.); (Ž.J.); (F.Č.); (V.M.); (T.V.); (D.H.); (H.H.); (I.B.)
- School of Medicine, JJ Strossmayer University of Osijek, 31000 Osijek, Croatia
| | - Eduard Rod
- St. Catherine Specialty Hospital, 49210 Zabok/10000 Zagreb, Croatia; (V.M.); (E.R.); (Ž.J.); (F.Č.); (V.M.); (T.V.); (D.H.); (H.H.); (I.B.)
- School of Medicine, JJ Strossmayer University of Osijek, 31000 Osijek, Croatia
| | - Željko Jeleč
- St. Catherine Specialty Hospital, 49210 Zabok/10000 Zagreb, Croatia; (V.M.); (E.R.); (Ž.J.); (F.Č.); (V.M.); (T.V.); (D.H.); (H.H.); (I.B.)
- School of Medicine, JJ Strossmayer University of Osijek, 31000 Osijek, Croatia
- Department of Nursing, University North, 48 000 Varaždin, Croatia
| | - Fabijan Čukelj
- St. Catherine Specialty Hospital, 49210 Zabok/10000 Zagreb, Croatia; (V.M.); (E.R.); (Ž.J.); (F.Č.); (V.M.); (T.V.); (D.H.); (H.H.); (I.B.)
- Medical School, University of Split, 21000 Split, Croatia
| | - Vid Matišić
- St. Catherine Specialty Hospital, 49210 Zabok/10000 Zagreb, Croatia; (V.M.); (E.R.); (Ž.J.); (F.Č.); (V.M.); (T.V.); (D.H.); (H.H.); (I.B.)
| | - Trpimir Vrdoljak
- St. Catherine Specialty Hospital, 49210 Zabok/10000 Zagreb, Croatia; (V.M.); (E.R.); (Ž.J.); (F.Č.); (V.M.); (T.V.); (D.H.); (H.H.); (I.B.)
- Department of Orthopedics, Clinical Hospital “Sveti Duh”, 10000 Zagreb, Croatia
| | - Damir Hudetz
- St. Catherine Specialty Hospital, 49210 Zabok/10000 Zagreb, Croatia; (V.M.); (E.R.); (Ž.J.); (F.Č.); (V.M.); (T.V.); (D.H.); (H.H.); (I.B.)
- School of Medicine, JJ Strossmayer University of Osijek, 31000 Osijek, Croatia
- Department of Orthopedics, Clinical Hospital “Sveti Duh”, 10000 Zagreb, Croatia
| | - Hana Hajsok
- St. Catherine Specialty Hospital, 49210 Zabok/10000 Zagreb, Croatia; (V.M.); (E.R.); (Ž.J.); (F.Č.); (V.M.); (T.V.); (D.H.); (H.H.); (I.B.)
- Medical School, University of Zagreb, 10000 Zagreb, Croatia
| | - Igor Borić
- St. Catherine Specialty Hospital, 49210 Zabok/10000 Zagreb, Croatia; (V.M.); (E.R.); (Ž.J.); (F.Č.); (V.M.); (T.V.); (D.H.); (H.H.); (I.B.)
- Medical School, University of Split, 21000 Split, Croatia
- Medical School, University of Rijeka, 51000 Rijeka, Croatia
- Medical School, University of Mostar, 88000 Mostar, Bosnia and Herzegovina
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Abstract
Being the most common musculoskeletal progressive condition, osteoarthritis is an interesting target for research. It is estimated that the prevalence of knee osteoarthritis (OA) among adults 60 years of age or older is approximately 10% in men and 13% in women, making knee OA one of the leading causes of disability in elderly population. Today, we know that osteoarthritis is not a disease characterized by loss of cartilage due to mechanical loading only, but a condition that affects all of the tissues in the joint, causing detectable changes in tissue architecture, its metabolism and function. All of these changes are mediated by a complex and not yet fully researched interplay of proinflammatory and anti-inflammatory cytokines, chemokines, growth factors and adipokines, all of which can be measured in the serum, synovium and histological samples, potentially serving as biomarkers of disease stage and progression. Another key aspect of disease progression is the epigenome that regulates all the genetic expression through DNA methylation, histone modifications, and mRNA interference. A lot of work has been put into developing non-surgical treatment options to slow down the natural course of osteoarthritis to postpone, or maybe even replace extensive surgeries such as total knee arthroplasty. At the moment, biological treatments such as platelet-rich plasma, bone marrow mesenchymal stem cells and autologous microfragmented adipose tissue containing stromal vascular fraction are ordinarily used. Furthermore, the latter two mentioned cell-based treatment options seem to be the only methods so far that increase the quality of cartilage in osteoarthritis patients. Yet, in the future, gene therapy could potentially become an option for orthopedic patients. In the following review, we summarized all of the latest and most important research in basic sciences, pathogenesis, and non-operative treatment.
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Characteristics of individual thigh muscles including cross-sectional area and adipose tissue content measured by magnetic resonance imaging in knee osteoarthritis: a cross-sectional study. Rheumatol Int 2019; 39:679-687. [PMID: 30689015 DOI: 10.1007/s00296-019-04247-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Accepted: 01/22/2019] [Indexed: 12/15/2022]
Abstract
This study aimed to identify the parameters related to the area and adipose tissue content of thigh muscles that are associated with radiographic knee osteoarthritis grade. Fifty patients (mean age ± standard deviation, 73.0 ± 4.5 years) were divided into early osteoarthritis (n = 23) and established osteoarthritis (n = 27) groups based on Kellgren-Lawrence classification. The femorotibial angle was measured from anteroposterior radiographs of the lower limbs. Individual thigh muscle and adipose tissue areas were analyzed using axial T1-weighted magnetic resonance imaging. After intergroup comparison, logistic regression analysis was performed to determine independent parameters associated with established osteoarthritis. Moreover, correlation coefficients were assessed between the left-right differences of osteoarthritis grade and parameters. Established osteoarthritis exhibited a significantly greater femorotibial angle and increased adipose tissue content in the subcutaneous, intermuscle, and intramuscle of the adductor, vastus lateralis, vastus intermedius, as well as a lower vastus medialis area, in comparison to early osteoarthritis. A greater femorotibial angle, increased intermuscular adipose tissue, and a lower vastus medialis area to knee extensor ratio were significantly independently associated with established osteoarthritis (odds ratio 3.2, 1.8, and 2.0, respectively). The left-right differences of femorotibial angle and vastus medialis area were significantly correlated with osteoarthritis grade, whereas adipose tissue content had no significant correlations with osteoarthritis grade. Greater femorotibial angle and lower vastus medialis area were related with higher osteoarthritis grade. Greater intermuscular adipose tissue content was associated with established osteoarthritis; however, in the left-right differences, adipose tissue content was not related with osteoarthritis grade.
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Wang Y, Teichtahl AJ, Abram F, Hussain SM, Pelletier JP, Cicuttini FM, Martel-Pelletier J. Knee pain as a predictor of structural progression over 4 years: data from the Osteoarthritis Initiative, a prospective cohort study. Arthritis Res Ther 2018; 20:250. [PMID: 30400973 PMCID: PMC6235215 DOI: 10.1186/s13075-018-1751-4] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 10/22/2018] [Indexed: 12/25/2022] Open
Abstract
Background There is evidence that knee pain not only is a consequence of structural deterioration in osteoarthritis (OA) but also contributes to structural progression. Clarifying this is important because targeting the factors related to knee pain may offer a clinical approach for slowing the progression of knee OA. The aim of this study was to examine whether knee pain over 1 year predicted cartilage volume loss, incidence and progression of radiographic osteoarthritis (ROA) over 4 years. Methods Osteoarthritis Initiative participants with no ROA (Kellgren-Lawrence grade ≤ 1) (n = 2120) and with ROA (Kellgren-Lawrence grade > 2) (n = 2249) were examined. Knee pain was assessed at baseline and 1 year using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Knee pain patterns were categorised as no pain (WOMAC pain < 5 at baseline and 1 year), fluctuating pain (WOMAC pain > 5 at either time point) and persistent pain (WOMAC pain > 5 at both time points). Cartilage volume, incidence and progression of ROA were assessed using magnetic resonance imaging and x-rays at baseline and 4-years. Results In both non-ROA and ROA, greater baseline WOMAC knee pain score was associated with increased medial and lateral cartilage volume loss (p ≤ 0.001), incidence (OR 1.07, 95% CI 1.01–1.13) and progression (OR 1.07, 95% CI 1.03–1.10) of ROA. Non-ROA and ROA participants with fluctuating and persistent knee pain had increased cartilage volume loss compared with those with no pain (p for trend ≤ 0.01). Non-ROA participants with fluctuating knee pain had increased risk of incident ROA (OR 1.62, 95% CI 1.04–2.54), corresponding to a number needed to harm of 19.5. In ROA the risk of progressive ROA increased in participants with persistent knee pain (OR 1.82, 95% CI 1.28–2.60), corresponding to a number needed to harm of 9.6. Conclusions Knee pain over 1 year predicted accelerated cartilage volume loss and increased risk of incident and progressive ROA. Early management of knee pain and controlling knee pain over time by targeting the underlying mechanisms may be important for preserving knee structure and reducing the burden of knee OA. Electronic supplementary material The online version of this article (10.1186/s13075-018-1751-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yuanyuan Wang
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia.
| | - Andrew J Teichtahl
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - François Abram
- Medical Imaging Research & Development, ArthroLab Inc., Montreal, QC, Canada
| | - Sultana Monira Hussain
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Jean-Pierre Pelletier
- Osteoarthritis Research Unit, University of Montreal Hospital Research Centre (CRCHUM), Montreal, QC, Canada
| | - Flavia M Cicuttini
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Johanne Martel-Pelletier
- Osteoarthritis Research Unit, University of Montreal Hospital Research Centre (CRCHUM), Montreal, QC, Canada
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Culvenor AG, Felson DT, Wirth W, Dannhauer T, Eckstein F. Is local or central adiposity more strongly associated with incident knee osteoarthritis than the body mass index in men or women? Osteoarthritis Cartilage 2018; 26:1033-1037. [PMID: 29772342 PMCID: PMC6050106 DOI: 10.1016/j.joca.2018.05.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 04/19/2018] [Accepted: 05/01/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To determine whether central (abdominal) or peripheral (thigh) adiposity measures are associated with incident radiographic knee osteoarthritis (RKOA) independent of body mass index (BMI) and whether their relation to RKOA was stronger than that of BMI. DESIGN 161 Osteoarthritis Initiative (OAI) participants (62% female) with incident RKOA (Kellgren/Lawrence grade 0/1 at baseline, developing an osteophyte and joint space narrowing (JSN) grade ≥1 by year-4) were matched to 186 controls (58% female) without incident RKOA. Baseline waist-height-ratio (WHtR), and anatomical cross-sectional areas of thigh subcutaneous (SCF) and intermuscular fat (IMF) were measured, the latter using axial magnetic resonance images. Logistic regression assessed the relationship between each adiposity measure and incident RKOA before and after adjustment for BMI, and area under receiver operating characteristic curves (AUC) for each adiposity measure was compared to that of BMI using chi-squared tests. RESULTS BMI, WHtR, subcutaneous fat (SCF) and IMF were all significantly associated with incident RKOA when analysed separately, with similar effect sizes (odds ratio range 1.30-1.53). After adjusting for BMI, odds ratios (ORs) for WHtR, SCF and IMF were attenuated and no longer statistically significant. No measure of central or peripheral adiposity was significantly more strongly associated with incident RKOA than BMI. Results were similar for men and women. CONCLUSIONS Although both central (WHtR) and peripheral (SCF and IMF) adiposity were significantly associated with incident RKOA, neither was more strongly associated with incident RKOA than BMI. The simple measure of BMI appears sufficient to capture the elevated risk of RKOA associated with greater amounts of localised adiposity.
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Affiliation(s)
- A G Culvenor
- Institute of Anatomy, Paracelsus Medical University Salzburg & Nuremberg, Salzburg, Austria; La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Bundoora, Australia.
| | - D T Felson
- Clinical Epidemiology Research & Training Unit, Boston University School of Medicine, Boston, MA, USA; The University of Manchester and Central Manchester NHS Foundation Trust, Manchester, UK.
| | - W Wirth
- Institute of Anatomy, Paracelsus Medical University Salzburg & Nuremberg, Salzburg, Austria.
| | - T Dannhauer
- Institute of Anatomy, Paracelsus Medical University Salzburg & Nuremberg, Salzburg, Austria.
| | - F Eckstein
- Institute of Anatomy, Paracelsus Medical University Salzburg & Nuremberg, Salzburg, Austria.
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Osteoarthritis year in review 2016: imaging. Osteoarthritis Cartilage 2017; 25:216-226. [PMID: 27965137 DOI: 10.1016/j.joca.2016.12.009] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 11/21/2016] [Accepted: 12/05/2016] [Indexed: 02/02/2023]
Abstract
PURPOSE The current narrative review covers original research related to imaging in osteoarthritis (OA) in humans published in English between April 1st 2015 and March 31st 2016, in peer reviewed journals available in Medline via PubMed (http://www.ncbi.nlm.nih.gov/pubmed/). METHODS Relevant studies in humans, subjectively decided by the authors, contributing significantly to the OA imaging field, were selected from an extensive Medline search using the terms "Osteoarthritis" in combination with "MRI", "Imaging", "Radiography", "X-rays", "Ultrasound", "Computed tomography", "Nuclear medicine", "PET-CT", "PET-MRI", "Scintigraphy", "SPECT". Publications were sorted according to relevance for the OA imaging research community with an emphasis on high impact special interest journals using the software for systematic reviews www.covidence.org. RESULTS An overview of newly published studies compared to studies reported previous years is presented, followed by a review of selected imaging studies of primarily knee, hip and hand OA focussing on (1) results for detection of OA and OA-related pathology (2) studies dealing with treatments and (3) studies focussing on prognosis of disease progression or joint replacement. A record high number of 1420 articles were published, among others, of new technologies and tools for improved morphological and pathophysiological understanding of OA-related changes in joints. Also, imaging data were presented of monitoring treatment effect and prognosis of OA progression, primarily using established radiographic, magnetic resonance imaging (MRI), and ultrasound (US) methods. CONCLUSION Imaging continues to play an important role in OA research, where several exciting new technologies and computer aided analysis methods are emerging to complement the conventional imaging approaches.
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Abstract
Osteoarthritis (OA) is the most common joint disorder, is associated with an increasing socioeconomic impact owing to the ageing population and mainly affects the diarthrodial joints. Primary OA results from a combination of risk factors, with increasing age and obesity being the most prominent. The concept of the pathophysiology is still evolving, from being viewed as cartilage-limited to a multifactorial disease that affects the whole joint. An intricate relationship between local and systemic factors modulates its clinical and structural presentations, leading to a common final pathway of joint destruction. Pharmacological treatments are mostly related to relief of symptoms and there is no disease-modifying OA drug (that is, treatment that will reduce symptoms in addition to slowing or stopping the disease progression) yet approved by the regulatory agencies. Identifying phenotypes of patients will enable the detection of the disease in its early stages as well as distinguish individuals who are at higher risk of progression, which in turn could be used to guide clinical decision making and allow more effective and specific therapeutic interventions to be designed. This Primer is an update on the progress made in the field of OA epidemiology, quality of life, pathophysiological mechanisms, diagnosis, screening, prevention and disease management.
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Imaging of osteoarthritis (OA): What is new? Best Pract Res Clin Rheumatol 2016; 30:653-669. [PMID: 27931960 DOI: 10.1016/j.berh.2016.09.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Revised: 09/04/2016] [Accepted: 09/06/2016] [Indexed: 12/17/2022]
Abstract
In daily clinical practice, conventional radiography is still the most applied imaging technique to supplement clinical examination of patients with suspected osteoarthritis (OA); it may not always be needed for diagnosis. Modern imaging modalities can visualize multiple aspects of the joint, and depending on the diagnostic need, radiography may no longer be the modality of choice. Magnetic resonance imaging (MRI) provides a complete assessment of the joint and has a pivotal role in OA research. Computed tomography (CT) and nuclear medicine offer alternatives in research scenarios, while ultrasound can visualize bony and soft-tissue pathologies and is highly feasible in the clinic. In this chapter, we overview the recent literature on established and newer imaging modalities, summarizing their ability to detect and quantify the range of OA pathologies and determining how they may contribute to early OA diagnosis. This accurate imaging-based detection of pathologies will underpin true understanding of much needed structure-modifying therapies.
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