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Peng X, Xie AM, Fan HG, Zhu HL, Yang D, Wan DE, He F, Luo C, Li H, Shuang F. The clinical application value of 3.0T magnetic resonance T2 mapping imaging in evaluating the degree of acetabular cartilage degeneration in joint replacement surgery running title: MRI and acetabular cartilage degeneration. J Orthop Surg Res 2024; 19:414. [PMID: 39030606 PMCID: PMC11264721 DOI: 10.1186/s13018-024-04898-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2024] [Accepted: 07/03/2024] [Indexed: 07/21/2024] Open
Abstract
BACKGROUND To explore and compare the values of 3.0T magnetic resonance imaging (MRI) T2 mapping in evaluating the degree of acetabular cartilage degeneration in hip replacement surgery. METHODS A total of 26 elderly patients with femoral neck fractures who were scanned in 3.0T MRI T2 mapping quantification technique were included. Basing on MRI images, the degree of acetabular cartilage degeneration was classified into Grade 0, 1, 2, 3 and 4, according to the International Cartilage Repair Society (ICRS) scores. In addition, 8 healthy volunteers were included for control group. RESULTS By comparison with health population, T2 relaxation values in the anterior, superior, and posterior regions of acetabular cartilage in patients with femoral neck fracture were obviously increased (P < 0.001). Among the patients with femoral neck fractures, there were 16 hip joint with Grade 1-2 (mild degeneration subgroup) and 10 hip joints with Grade 3-4 (severe degeneration subgroup), accounting for 61.54% and 38.46%, respectively. Additionally, T2 relaxation values in the anterior and superior bands of articular cartilage were positively related to the MRI-based grading (P < 0.05); while there was no significant difference of T2 relaxation values in the posterior areas of articular cartilage between severe degeneration subgroup and mild degeneration subgroup (P > 0.05). Importantly, acetabular cartilage degeneration can be detected through signal changes of T2 mapping pseudo-color images. CONCLUSION 3.0T MRI T2 mapping technology can be used to determine the degree of acetabular cartilage degeneration, which can effectively monitor the disease course.
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Affiliation(s)
- Xiang Peng
- Department of Orthopedics, The 908th Hospital of Chinese People's Liberation Army Joint Logistics Support Force, No.1028 Jinggangshan Street, Qingyunpu District, Nanchang, 330002, Jiangxi Province, China
| | - An-Min Xie
- Department of Diagnostic Radiology, The 908th Hospital of Chinese People's Liberation Army Joint Logistics Support Force, Nanchang, 330002, Jiangxi Province, China
| | - Hua-Gang Fan
- Department of Diagnostic Radiology, The 908th Hospital of Chinese People's Liberation Army Joint Logistics Support Force, Nanchang, 330002, Jiangxi Province, China
| | - Hong-Liang Zhu
- Department of Orthopedics, The 908th Hospital of Chinese People's Liberation Army Joint Logistics Support Force, No.1028 Jinggangshan Street, Qingyunpu District, Nanchang, 330002, Jiangxi Province, China
| | - Di Yang
- Department of Orthopedics, The 908th Hospital of Chinese People's Liberation Army Joint Logistics Support Force, No.1028 Jinggangshan Street, Qingyunpu District, Nanchang, 330002, Jiangxi Province, China
| | - De-En Wan
- Department of Orthopedics, The 908th Hospital of Chinese People's Liberation Army Joint Logistics Support Force, No.1028 Jinggangshan Street, Qingyunpu District, Nanchang, 330002, Jiangxi Province, China
| | - Fei He
- Department of Quality Management, The 908th Hospital of Chinese People's Liberation Army Joint Logistics Support Force, Nanchang, 330002, Jiangxi Province, China
| | - Chong Luo
- Department of Orthopedics, The 908th Hospital of Chinese People's Liberation Army Joint Logistics Support Force, No.1028 Jinggangshan Street, Qingyunpu District, Nanchang, 330002, Jiangxi Province, China
| | - Hao Li
- Department of Orthopedics, The 908th Hospital of Chinese People's Liberation Army Joint Logistics Support Force, No.1028 Jinggangshan Street, Qingyunpu District, Nanchang, 330002, Jiangxi Province, China.
| | - Feng Shuang
- Department of Orthopedics, The 908th Hospital of Chinese People's Liberation Army Joint Logistics Support Force, No.1028 Jinggangshan Street, Qingyunpu District, Nanchang, 330002, Jiangxi Province, China.
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González-de-la-Flor Á. A New Clinical Examination Algorithm to Prescribe Conservative Treatment in People with Hip-Related Pain. Pain Ther 2024; 13:457-479. [PMID: 38698256 PMCID: PMC11111658 DOI: 10.1007/s40122-024-00604-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 04/04/2024] [Indexed: 05/05/2024] Open
Abstract
Hip-related pain is a common issue in active adults affecting their quality of life, mobility, and overall function, and it can lead to persistent disability. However, diagnosing hip-related pain is challenging due to the many potential sources and causes, including intra-articular and extra-articular pathology, and referred pain from other areas (lumbar or groin related pain). To address this, there is a need for a clinical algorithm based on the best available evidence and expert consensus. This algorithm could guide healthcare professionals in assessing and managing patients with hip-related pain, during the diagnosis, test selection, intervention, monitoring, and promoting collaboration among various healthcare providers. This clinical algorithm for hip-related pain is a comprehensive, flexible, adaptable to different settings, and regularly updated to incorporate new research findings. This literature review aims to establish a clinical algorithm specifically for prescribing exercise treatment to patients with hip-related pain, addressing their individual needs and enhancing their overall care.
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Affiliation(s)
- Ángel González-de-la-Flor
- Faculty of Sport Sciences, Universidad Europea de Madrid, Calle Tajo s/n, 28670, Villaviciosa de Odón, Madrid, Spain.
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3
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Mourad C, Vande Berg B. Osteoarthritis of the hip: is radiography still needed? Skeletal Radiol 2023; 52:2259-2270. [PMID: 36538067 PMCID: PMC10509135 DOI: 10.1007/s00256-022-04270-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Revised: 11/12/2022] [Accepted: 11/18/2022] [Indexed: 12/24/2022]
Abstract
Diagnosis of hip osteoarthritis (OA) is based on clinical arguments, and medical imaging is obtained to confirm the diagnosis and rule out other possible sources of pain. Conventional radiographs are recommended as the first line imaging modality to investigate chronic hip pain. They should be obtained in a rigorous technique that includes an antero-posterior (AP) radiograph of the pelvis. The choice of the appropriate lateral view depends on the clinical indication, Lequesne's false profile being valuable in the assessment of OA. Magnetic resonance imaging (MRI) is more sensitive to detect joint effusion/synovitis, cartilage, labral, and bone marrow lesions. However, structural joint changes are frequent in asymptomatic population and neither radiographs nor MRI have shown a good correlation with pain and functional impairment. MRI seems to be more suitable than radiographs as a biomarker for clinical trials addressing early OA. The absence of a validated MR biomarker of early OA, together with issues related to machine availability and MRI protocol repeatability, prevent the widespread use of MRI in clinical trials.
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Affiliation(s)
- Charbel Mourad
- Department of Diagnostic and Interventional Radiology, Hôpital Libanais Geitaoui CHU, Beyrouth, 1100, Achrafieh, Lebanon.
| | - Bruno Vande Berg
- Department of Radiology, Cliniques CHC Montlégia, Boulevard Patience Et Beaujonc 2, 4000, Liège, Belgium
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4
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Ponsiglione A, Campo I, Sachs C, Sofia C, Álvarez-Hornia Pérez E, Ciabattoni R, Sharaf DE, Causa-Andrieu P, Stanzione A, Cuocolo R, Zawaideh J, Brembilla G. Extraprostatic incidental findings on prostate mpMRI: A pictorial review from the ESUR junior network. Eur J Radiol 2023; 166:110984. [PMID: 37480649 DOI: 10.1016/j.ejrad.2023.110984] [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: 05/29/2023] [Revised: 07/10/2023] [Accepted: 07/16/2023] [Indexed: 07/24/2023]
Abstract
The role of multiparametric MRI (mpMRI) in prostate cancer setting is increasingly consolidated and, as a result, its usage in clinical practice is in exponential growth. However, beyond the prostate gland, several key structures are included in the field of view of mpMRI scans. Consequently, various extra-prostatic incidental findings (IFs) belonging to different anatomical systems can be accidentally recognized. Therefore, it is mandatory for a radiologist to be familiar with the wide range of pathologies potentially encountered, to guide management and avoid patient anxiety and costs due to additional work-up prompted by clinically insignificant extra-prostatic findings. With this pictorial review, we aim to illustrate a wide range of IFs that can be detected when performing mpMRI of the prostate, focusing on their imaging characteristics, differential diagnosis, and clinical relevance. Additionally, we propose the CheckDEEP, the Checklist for DEtection of ExtraProstatic findings, to be used for a thorough evaluation of target areas within each anatomical system.
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Affiliation(s)
- Andrea Ponsiglione
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy.
| | - Irene Campo
- Radiology Unit, Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Camilla Sachs
- Department of Radiology, Ospedale Ca' Foncello, 31100, Treviso, Italy
| | - Carmelo Sofia
- Department of Biomedical Sciences and Morphologic and Functional Imaging, Policlinico Universitario G. Martino, University of Messina, Messina, Italy
| | | | - Riccardo Ciabattoni
- Department of Radiology, Ospedale San Salvatore di Pesaro, Azienda Sanitaria Territoriale Pesaro Urbino, Pesaro, Italy
| | - Doaa E Sharaf
- Department of Radiology, Urology & Nephrology Center, Mansoura University, Mansoura, Egypt
| | | | - Arnaldo Stanzione
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Renato Cuocolo
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, Italy
| | - Jeries Zawaideh
- Department of Radiology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Giorgio Brembilla
- Department of Radiology, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
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5
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van der Have A, Van Rossom S, Jonkers I. Musculoskeletal-Modeling-Based, Full-Body Load-Assessment Tool for Ergonomists (MATE): Method Development and Proof of Concept Case Studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1507. [PMID: 36674262 PMCID: PMC9859546 DOI: 10.3390/ijerph20021507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 01/06/2023] [Accepted: 01/12/2023] [Indexed: 06/17/2023]
Abstract
A new ergonomic-risk-assessment tool was developed that combines musculoskeletal-model-based loading estimates with insights from fatigue failure theory to evaluate full-body musculoskeletal loading during dynamic tasks. Musculoskeletal-modeling output parameters, i.e., joint contact forces and muscle forces, were combined with tissue-specific injury thresholds that account for loading frequency to determine the injury risk for muscles, lower back, and hip cartilage. The potential of this new risk-assessment tool is demonstrated for defining ergonomic interventions in terms of lifting characteristics, back and shoulder exoskeleton assistance, box transferring, stoop lifting, and an overhead wiring task, respectively. The MATE identifies the risk of WMSDs in different anatomical regions during occupational tasks and allows for the evaluation of the impact of interventions that modify specific lifting characteristics, i.e., load weight versus task repetition. Furthermore, and in clear contrast to currently available ergonomic assessment scores, the effects of the exoskeleton assistance level on the risk of WMSDs of full-body musculoskeletal loading (in particular, the muscles, lower back, and hips) can be evaluated and shows small reductions in musculoskeletal loading but not in injury risk. Therefore, the MATE is a risk-assessment tool based on a full-body, musculoskeletal-modeling approach combined with insights from the fatigue failure theory that shows the proof of concept of a shoulder and back exoskeleton. Furthermore, it accounts for subject-specific characteristics (age and BMI), further enhancing individualized ergonomic-risk assessment.
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Affiliation(s)
- Arthur van der Have
- Human Movement Biomechanics Research Group, Department of Movement Sciences, Katholieke Universiteit Leuven, 3001 Heverlee, Belgium
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6
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Trivanovic D, Harder J, Leucht M, Kreuzahler T, Schlierf B, Holzapfel BM, Rudert M, Jakob F, Herrmann M. Immune and stem cell compartments of acetabular and femoral bone marrow in hip osteoarthritis patients. Osteoarthritis Cartilage 2022; 30:1116-1129. [PMID: 35569800 DOI: 10.1016/j.joca.2022.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 03/22/2022] [Accepted: 05/02/2022] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Hip osteoarthritis (OA) affects all components of the osteochondral unit, leading to bone marrow (BM) lesions, and unknown consequences on BM cell functionality. We analyzed the cellular composition in OA-affected acetabula compared to proximal femur shafts obtained of hip OA patients to reveal yet not explored immune and stem cell compartments. DESIGN Combining flow cytometry, cellular assays and transcription analyses, we performed extensive ex vivo phenotyping of acetabular BM cells from 18 hip OA patients, comparing them with their counterparts from patient-matched femoral shaft BM samples. Findings were related to differences in skeletal sites and age. RESULTS Acetabular BM had a greater frequency of T-lymphocytes, non-hematopoietic cells and colony-forming units fibroblastic potential than femoral BM. The incidence of acetabular CD45+CD3+ T-lymphocytes increased (95% CI: 0.1770 to 0.0.8416), while clonogenic hematopoietic progenitors declined (95% CI: -0.9023 to -0.2399) with age of patients. On the other side, in femoral BM, we observed higher B-lymphocyte, myeloid and erythroid cell frequencies. Acetabular mesenchymal stromal cells (MSCs) showed a senescent profile associated with the expression of survival and inflammation-related genes. Efficient osteogenic and chondrogenic differentiation was detected in acetabular MSCs, while adipogenesis was more pronounced in their femoral counterparts. CONCLUSION Our results suggest that distinctions in BM cellular compartments and MSCs may be due to the influence of the OA-stressed microenvironment, but also acetabular vs femoral shaft-specific peculiarities cannot be excluded. These results bring new knowledge on acetabular BM cell populations and may be addressed as novel pathogenic mechanisms and therapeutic targets in OA.
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Affiliation(s)
- D Trivanovic
- IZKF Group Tissue Regeneration in Musculoskeletal Diseases, University Hospital Wuerzburg, Wuerzburg, Bavaria, 97070, Germany; Bernhard-Heine-Center for Locomotion Research, University Wuerzburg, Wuerzburg, Bavaria, 97070, Germany
| | - J Harder
- Bernhard-Heine-Center for Locomotion Research, University Wuerzburg, Wuerzburg, Bavaria, 97070, Germany
| | - M Leucht
- Bernhard-Heine-Center for Locomotion Research, University Wuerzburg, Wuerzburg, Bavaria, 97070, Germany
| | - T Kreuzahler
- IZKF Group Tissue Regeneration in Musculoskeletal Diseases, University Hospital Wuerzburg, Wuerzburg, Bavaria, 97070, Germany; Bernhard-Heine-Center for Locomotion Research, University Wuerzburg, Wuerzburg, Bavaria, 97070, Germany
| | - B Schlierf
- IZKF Group Tissue Regeneration in Musculoskeletal Diseases, University Hospital Wuerzburg, Wuerzburg, Bavaria, 97070, Germany; Bernhard-Heine-Center for Locomotion Research, University Wuerzburg, Wuerzburg, Bavaria, 97070, Germany
| | - B M Holzapfel
- Bernhard-Heine-Center for Locomotion Research, University Wuerzburg, Wuerzburg, Bavaria, 97070, Germany; Department of Orthopaedic Surgery, König-Ludwig-Haus, University of Wuerzburg, Wuerzburg, Bavaria, 97070, Germany; Department of Orthopaedic Surgery, University Clinics, Ludwig-Maximilians University Munich, Munich, 81377, Germany
| | - M Rudert
- Bernhard-Heine-Center for Locomotion Research, University Wuerzburg, Wuerzburg, Bavaria, 97070, Germany; Department of Orthopaedic Surgery, König-Ludwig-Haus, University of Wuerzburg, Wuerzburg, Bavaria, 97070, Germany
| | - F Jakob
- Bernhard-Heine-Center for Locomotion Research, University Wuerzburg, Wuerzburg, Bavaria, 97070, Germany
| | - M Herrmann
- IZKF Group Tissue Regeneration in Musculoskeletal Diseases, University Hospital Wuerzburg, Wuerzburg, Bavaria, 97070, Germany; Bernhard-Heine-Center for Locomotion Research, University Wuerzburg, Wuerzburg, Bavaria, 97070, Germany.
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7
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de Castro JC, Henares-Esguerra EL, Olivia S Tamayo-Shih MB, Wang D, Chang Chien GC. Photoactivated leucocyte-rich platelet-rich plasma treatment in reduction of bone marrow edema in hip osteoarthritis. Regen Med 2022; 17:521-531. [PMID: 35638400 DOI: 10.2217/rme-2021-0165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: To describe the successful treatment of bone marrow edema in the setting of hip osteoarthritis using ultrasound-guided injection of photoactivated leukocyte-rich platelet-rich plasma (LR-PRP). Setting: Outpatient clinic. Patient: 65-year old female with antalgic and listing gait. Case description: The patient presented with a 2-week history of left hip pain. Exam revealed restriction and pain at end range of motion. Imaging showed extensive bone marrow edema and hip effusion. The patient underwent four weekly photoactivated LR-PRP treatments. Results: The patient reported a significant reduction in pain with MRI showing an extensive resolution of bone marrow edema and complete pain relief at 2 and 6 months post-treatment, respectively. Conclusion: Photoactivated LR-PRP may be considered as a treatment option for patients with marrow edema in the setting of hip osteoarthritis.
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Affiliation(s)
- Jeimylo C de Castro
- Department of Physical Medicine & Rehabilitation, The Medical City South Luzon, Santa Rosa, Laguna, 4026, Philippines.,SMARTMD Center for Non-Surgical Pain Interventions, Makati, 1224, Philippines
| | | | | | - Daniel Wang
- Kansas City University, Kansas City, MO 64106, USA
| | - George C Chang Chien
- Pain Management, Ventura County Medical Center, Ventura, CA 93003, USA.,GCC Institute for Regenerative Medicine, Irvine, CA 92606, USA
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Predictors of total hip replacement in community based older adults: a cohort study. Osteoarthritis Cartilage 2021; 29:1130-1137. [PMID: 33965528 DOI: 10.1016/j.joca.2021.04.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 04/22/2021] [Accepted: 04/26/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The purpose of this study is to describe predictors of total hip replacement (THR) in community dwelling older adults. A better understanding of predictors of THR can aid in triaging patients and researching preventative strategies. DESIGN At baseline, participants had assessment of radiographic OA and cam morphology (from pelvic radiographs), shape mode scores and hip bone mineral density (BMD; from dual energy X-ray absorptiometry (DXA)). After 2.6 and 5 years, participants reported hip pain using WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index), and had hip structural changes assessed using magnetic resonance imaging (MRI). Risk of THR was analysed using mixed-effect Poisson regression. RESULTS Incidence of THR for OA over 14 years was 4.6% (37/801). As expected, WOMAC hip pain and hip radiographic OA both predicted risk of THR. Additionally, shape mode 2 score (decreasing acetabular coverage) (RR 1.83/SD; 95% CI 1.1-3.04), shape mode 4 score (non-spherical femoral head) (RR 0.59/SD; 95% CI 0.36-0.96), cam morphology (α > 60°) (RR 2.2/SD; 95% CI 1.33-3.36), neck of femur BMD (RR 2.09/SD, 95% CI 1.48-2.94) and bone marrow lesions (BMLs) increased risk of THR (RR 7.10/unit; 95% CI 1.09-46.29). CONCLUSION In addition to hip pain and radiographic hip OA, measures of hip shape, cam morphology, BMD and BMLs independently predict risk of THR. This supports the role of hip bone geometry and structure in the pathogenesis of end stage hip OA and has identified factors that can be used to improve prediction models for THR.
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[Differential diagnoses of inflammatory hip joint]. Radiologe 2021; 61:395-404. [PMID: 33765171 PMCID: PMC8012330 DOI: 10.1007/s00117-021-00835-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/19/2021] [Indexed: 11/12/2022]
Abstract
Die Differenzialdiagnosen der entzündlichen Hüfterkrankung spielen für die Diagnose des Hüftschmerzes eine bedeutende Rolle. Die rheumatologischen/entzündlichen Veränderungen des Hüftschmerzes mit dem entsprechenden Einsatz der Bildgebung wurden in Teil 1 des CME-Artikels abgehandelt. In diesem zweiten Teil wird ein systematischer Zugang erläutert, um die zahlreichen rheumatologischen Erkrankungen von Degenerationen, synovialen Tumoren und Infektionen zu unterscheiden. Die Interpretation der Pathologien in der Bildgebung im Zusammenhang mit dem klinischen Erscheinungsbild wird für die einzelnen Differenzialdiagnosen genauer erläutert. Das zeitgleiche Auftreten von unterschiedlichen Erkrankungen, zum Teil als sekundäre Komplikation, hat einen erheblichen Einfluss auf die Therapieplanung und sollte vom Radiologen erkannt werden.
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10
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Munsch MA, Safran MR, Mai MC, Vasileff WK. Bone marrow lesions: etiology and pathogenesis at the hip. J Hip Preserv Surg 2020; 7:401-409. [PMID: 33948196 PMCID: PMC8081407 DOI: 10.1093/jhps/hnaa056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 09/30/2020] [Accepted: 11/01/2020] [Indexed: 12/19/2022] Open
Abstract
Bone marrow lesions (BML) are painful changes in subchondral bone which can be reliably identified on magnetic resonance imaging and have been identified in patients suffering from hip osteoarthritis (OA) and related conditions. Created via repetitive microdamage at the articular surface and dysregulated subchondral healing, BML have been linked to traumatic, inflammatory, degenerative, metabolic and neoplastic processes. While BML are known to be a common pathology throughout the body, BML at the hip have not been extensively studied in comparison to those at the knee. Due to the hip’s unique biomechanical architecture, function and loading, and independent risk factors leading to hip OA, hip BMLs must be independently understood. The identification of BML in the setting of a pre-osteoarthritic condition may provide a target for treatment and prevention of joint degeneration. By continuing to define and refine the relationships between BML, subchondral bone cysts and OA, prevention, diagnosis and treatment of OA could shift, leading to an improved quality of life and increased longevity of individuals’ native hips.
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Affiliation(s)
- Maria A Munsch
- Department of Orthopaedics, The Ohio State University, Jameson Crane Sports Medicine Research Institute, Columbus, OH, USA
| | - Marc R Safran
- Department of Orthopaedic Surgery, Stanford University, Redwood City, CA, USA
| | - Matthew C Mai
- Florida Bone & Joint Specialists, Gulf Breeze, FL, USA
| | - W Kelton Vasileff
- Department of Orthopaedics, The Ohio State University, Jameson Crane Sports Medicine Research Institute, Columbus, OH, USA
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11
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Zhang Z. Editorial for “Computer‐Aided Detection
AI
Reduces
Interreader
Variability in Grading Hip Abnormalities With
MRI
”. J Magn Reson Imaging 2020; 52:1173-1174. [DOI: 10.1002/jmri.27170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 04/02/2020] [Indexed: 11/05/2022] Open
Affiliation(s)
- Zhongwei Zhang
- Mallinckrodt Institute of Radiology Washington University School of Medicine St. Louis MO USA
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12
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Ilas DC, Churchman SM, Baboolal T, Giannoudis PV, Aderinto J, McGonagle D, Jones E. The simultaneous analysis of mesenchymal stem cells and early osteocytes accumulation in osteoarthritic femoral head sclerotic bone. Rheumatology (Oxford) 2020; 58:1777-1783. [PMID: 31165896 PMCID: PMC6758575 DOI: 10.1093/rheumatology/kez130] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Accepted: 03/13/2019] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE OA subchondral bone is a key target for therapy development. Osteocytes, the most abundant bone cell, critically regulate bone formation and resorption. Their progenitors, mesenchymal stem cells (MSCs), display altered behaviour in osteoarthritic subchondral bone. This study investigated the relationships between native osteocytes and native MSCs in osteoarthritic femoral heads. METHODS To avoid culture manipulations, a bone treatment procedure was developed to simultaneously obtain pure osteocyte-enriched fragments and matched native CD45-CD271+ MSCs. Gene expression in osteocytes and MSCs was compared between healthy and OA bone and selected molecules were examined by immunohistochemistry in relation to OA tissue pathology. Cell sorting and standard trilineage differentiation assays were employed to test OA MSC functionality. RESULTS Native osteocyte enrichment was confirmed histologically and by higher-level osteocyte maturation transcripts expression, compared with purified MSCs. Compared with healthy bone, native OA osteocytes expressed 9- and 4-fold more early/embedding osteocyte molecules E11 and MMP14, and 6-fold more osteoprotegerin (P<0.01). CD271+ MSCs accumulated in the regions of bone sclerosis (9-fold, P<0.0001) in close juxtaposition to trabeculae densely populated with morphologically immature E11-positive osteocytes (medians of 76% vs 15% in non-sclerotic areas, P<0.0001), and osteoblasts. Gene expression of OA MSCs indicated their bone formation bias, with retained multipotentiality following culture-expansion. CONCLUSIONS In human late-stage OA, osteogenically-committed MSCs and adjacent immature osteocytes exhibit a marked accumulation in sclerotic areas. This hitherto unappreciated MSC-early osteocyte axis could be key to understanding bone abnormalities in OA and represents a potential target for novel therapy development in early disease.
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Affiliation(s)
- Dragos C Ilas
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, The University of Leeds
| | - Sarah M Churchman
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, The University of Leeds
| | - Thomas Baboolal
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, The University of Leeds
| | - Peter V Giannoudis
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, The University of Leeds
| | - Joseph Aderinto
- Department of Orthopaedics, Chapel Allerton, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Dennis McGonagle
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, The University of Leeds
| | - Elena Jones
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, The University of Leeds
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Wörner T, Nilsson J, Thorborg K, Granlund V, Stålman A, Eek F. Hip Function 6 to 10 Months After Arthroscopic Surgery: A Cross-sectional Comparison of Subjective and Objective Hip Function, Including Performance-Based Measures, in Patients Versus Controls. Orthop J Sports Med 2019; 7:2325967119844821. [PMID: 31218235 PMCID: PMC6563410 DOI: 10.1177/2325967119844821] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Background: Little is known about hip-related function, mobility, and performance in patients after hip arthroscopic surgery (HA) during the time that return to sports can be expected. Purpose: To evaluate measures of subjective and objective hip function 6 to 10 months after HA in patients compared with healthy controls and to compare objective function in the HA group between the operated and nonoperated hips. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 33 patients who had undergone HA (mean, 8.1 ± 2.6 months postoperatively) and 33 healthy participants matched on sex, age, and activity level were compared regarding subjective hip function (Copenhagen Hip and Groin Outcome Score [HAGOS]) and objective function including hip range of motion (ROM; flexion, internal rotation, and external rotation), isometric hip muscle strength (adduction, abduction, flexion, internal rotation, and external rotation), and performance-based measures: the Y Balance Test (YBT), medial and lateral triple-hop test, and Illinois agility test. Group differences were analyzed using independent-samples t tests. Paired-samples t tests were used for a comparison of the operated and nonoperated hips. Standard effect sizes (Cohen d) were provided for all outcomes. Results: The HA group reported worse subjective hip function than the control group (HAGOS subscores: d = –0.7 to –2.1; P ≤ .004). Objective measures of hip ROM (d = –0.5 to –1.1; P ≤ .048), hip flexion strength (d = –0.5; P = .043), and posteromedial reach of the YBT (d = –0.5; P = .043) were also reduced in the HA group, although there were no significant differences between groups regarding the remaining objective measures (d = –0.1 to –0.4; P ≥ .102 to .534). The only significant difference between the operated and nonoperated hips in the HA group was reduced passive hip flexion (d = –0.4; P = .045). Conclusion: Patients who had undergone HA demonstrated reduced subjective hip function compared with controls 6 to 10 months after surgery, when return to sports can be expected. While most objective strength and performance test results were comparable between the HA and control groups at 6 to 10 months after surgery, the HA group presented with impairments related to hip mobility and hip flexion strength. No consistent pattern of impairments was found in operated hips compared with nonoperated hips.
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Affiliation(s)
- Tobias Wörner
- Department of Health Sciences, Lund University, Lund, Sweden.,Capio Artro Clinic, Stockholm, Sweden
| | | | - Kristian Thorborg
- Sports Orthopaedic Research Center-Copenhagen (SORC-C), Department of Orthopaedic Surgery, Copenhagen University Hospital, Amager-Hvidovre, Denmark
| | | | - Anders Stålman
- Capio Artro Clinic, Stockholm, Sweden.,Department of Molecular Medicine and Surgery, Stockholm Sports Trauma Research Center, Karolinska Institutet, Stockholm, Sweden
| | - Frida Eek
- Department of Health Sciences, Lund University, Lund, Sweden
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14
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What is the Prevalence of Hip Intra-Articular Pathologies and Osteoarthritis in Active Athletes with Hip and Groin Pain Compared with Those Without? A Systematic Review and Meta-Analysis. Sports Med 2019; 49:951-972. [DOI: 10.1007/s40279-019-01092-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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15
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Mehranfar S, Abdi Rad I, Mostafavi E, Akbarzadeh A. The use of stromal vascular fraction (SVF), platelet-rich plasma (PRP) and stem cells in the treatment of osteoarthritis: an overview of clinical trials. ARTIFICIAL CELLS NANOMEDICINE AND BIOTECHNOLOGY 2019; 47:882-890. [DOI: 10.1080/21691401.2019.1576710] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Sahar Mehranfar
- Department of Genetics and Immunology, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran
- Cellular and Molecular Research Center, Urmia University of Medical Sciences, Urmia, Iran
| | - Isa Abdi Rad
- Department of Genetics and Immunology, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran
- Cellular and Molecular Research Center, Urmia University of Medical Sciences, Urmia, Iran
| | - Ebrahim Mostafavi
- Department of Chemical Engineering, Northeastern University, Boston, MA, USA
| | - Abolfazl Akbarzadeh
- Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Medical Nanotechnology, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
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16
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Heerey JJ, Kemp JL, Mosler AB, Jones DM, Pizzari T, Souza RB, Crossley KM. What is the prevalence of imaging-defined intra-articular hip pathologies in people with and without pain? A systematic review and meta-analysis. Br J Sports Med 2018. [PMID: 29540366 DOI: 10.1136/bjsports-2017-098264] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Intra-articular hip pathologies are thought to be associated with the development of hip and groin pain. A better understanding of the relationship between symptoms and imaging findings may improve the management of individuals with intra-articular hip pathologies. OBJECTIVE To undertake a systematic review and meta-analysis to determine the prevalence of intra-articular hip pathologies in individuals with and without pain. METHODS Seven electronic databases were searched in February 2017 for studies investigating the prevalence of intra-articular hip pathologies using MRI, MRA or CT. Two independent reviewers conducted the search, study selection, quality appraisal and data extraction. Meta-analysis was performed when studies were deemed homogenous, with a strength of evidence assigned to pooled results. RESULTS In general, studies were moderate to high risk of bias, with only five studies adjudged to be low risk of bias. The 29 studies reporting on the prevalence of intra-articular hip pathologies identified limited evidence of a labral tear prevalence of 62% (95% CI 47% to 75%) in symptomatic individuals, with moderate evidence identifying a labral tear prevalence of 54% (95% CI 41% to 66%) in asymptomatic individuals. Limited evidence demonstrated a cartilage defect prevalence of 64% (95% CI 25% to 91%) in symptomatic individuals, compared with moderate evidence of a cartilage defect prevalence of 12% (95% CI 7% to 21%) in asymptomatic individuals. CONCLUSION The prevalence of intra-articular hip pathologies is highly variable in both symptomatic and asymptomatic populations. The prevalence of intra-articular hip pathologies appears to be higher in symptomatic individuals. However, imaging-defined intra-articular hip pathologies are also frequently seen in asymptomatic individuals, highlighting a potential discordant relationship between imaging pathology and pain. PROSPERO REGISTRATION NUMBER CRD42016035444.
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Affiliation(s)
- Joshua J Heerey
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, College of Science, Health and Engineering, La Trobe University, Melbourne, Victoria, Australia
| | - Joanne L Kemp
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, College of Science, Health and Engineering, La Trobe University, Melbourne, Victoria, Australia
| | - Andrea B Mosler
- Rehabilitation Department, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Denise M Jones
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, College of Science, Health and Engineering, La Trobe University, Melbourne, Victoria, Australia
| | - Tania Pizzari
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, College of Science, Health and Engineering, La Trobe University, Melbourne, Victoria, Australia
| | - Richard B Souza
- Department of Physical Therapy and Rehabilitation Science, University of California, San Francisco, California, USA
| | - Kay M Crossley
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, College of Science, Health and Engineering, La Trobe University, Melbourne, Victoria, Australia
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17
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Ahedi HG, Aspden RM, Blizzard LC, Saunders FR, Cicuttini FM, Aitken DA, Jones G, Gregory JS. Hip Shape as a Predictor of Osteoarthritis Progression in a Prospective Population Cohort. Arthritis Care Res (Hoboken) 2017; 69:1566-1573. [DOI: 10.1002/acr.23166] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Revised: 11/18/2016] [Accepted: 12/06/2016] [Indexed: 01/28/2023]
Affiliation(s)
- Harbeer G. Ahedi
- Menzies Institute for Medical Research, University of Tasmania; Hobart Tasmania Australia
| | - Richard M. Aspden
- Aberdeen Centre for Arthritis and Musculoskeletal Health, Institute of Medical Sciences, University of Aberdeen; Aberdeen UK
| | - Leigh C. Blizzard
- Menzies Institute for Medical Research, University of Tasmania; Hobart Tasmania Australia
| | - Fiona R. Saunders
- Aberdeen Centre for Arthritis and Musculoskeletal Health, Institute of Medical Sciences, University of Aberdeen; Aberdeen UK
| | | | - Dawn A. Aitken
- Menzies Institute for Medical Research, University of Tasmania; Hobart Tasmania Australia
| | - Graeme Jones
- Menzies Institute for Medical Research, University of Tasmania; Hobart Tasmania Australia
| | - Jennifer S. Gregory
- Aberdeen Centre for Arthritis and Musculoskeletal Health, Institute of Medical Sciences, University of Aberdeen; Aberdeen UK
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18
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Deseyne N, Conrozier T, Lellouche H, Maillet B, Weber U, Jaremko JL, Paschke J, Epstein J, Maksymowych WP, Loeuille D. Hip Inflammation MRI Scoring System (HIMRISS) to predict response to hyaluronic acid injection in hip osteoarthritis. Joint Bone Spine 2017; 85:475-480. [PMID: 28893678 DOI: 10.1016/j.jbspin.2017.08.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Accepted: 08/31/2017] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To assess predictors of response, according to hip MRI inflammatory scoring system (HIMRISS), in a sample of patients with hip osteoarthritis (OA) treated by hyaluronic acid (HA) injection. METHOD Sixty patients with hip OA were included. Clinical outcomes were assessed at baseline and three months after HA injection by WOMAC. On hip MRI performed before HA injection, bone marrow lesion (BML) and synovitis were assessed by HIMRISS by four readers. The inter-reader reliability of HIMRISS was for HIMRISS total, acetabular BML, femoral BML and synovitis-effusion respectively 0.86, 0.64, 0.83 and 0.78. Associations between MRI features and clinical data were assessed. Logistic regression (univariate and multivariate) was used to explore associations between MRI features and response to HA injection, according to WOMAC50 response at three months. RESULTS In total, 45.5% of patients met WOMAC50 response. Five adverse events were reported. At baseline, WOMAC function correlated significantly to HIMRISS synovitis-effusion (r=0.27, P=0.03). In univariate analysis, BML femoral according to binary assessment (P=0.025), HIMRISS BML femoral (P=0.0038), HIMRISS BML acetabular (P=0.042), HIMRISS total (P=0.0092) were associated negatively with WOMAC50 response. In multivariate analysis, adjusted for age and BMI, HIMRISS femoral BML (P=0.02) and HIMRISS total (P=0.016) were negatively associated with response. At a HIMRISS threshold of<15, 82% of patients were responders, with specificity SP=0.97, sensitivity SN=0.39, and positive and negative predictive values of 0.91 and 0.64, respectively. CONCLUSION HIMRISS is reliable for total scores and sub-domains. It permits identification of responders to HA injection in hip OA patients.
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Affiliation(s)
- Nicolas Deseyne
- Department of Rheumatology, CHRU de Nancy, 5, rue du Morvan, 54500 Vandœuvre-lès-Nancy, France.
| | - Thierry Conrozier
- Department of Rheumatology, North Hospital Franche-Comté, 25200 Montbéliard, France
| | - Henri Lellouche
- Department of Rheumatology, Lariboisière Hospital, 75475 Paris cedex 10, France
| | - Bernard Maillet
- Department of Rheumatology, Clinique Saint-Odilon, 03000 Moulins, France
| | - Ulrich Weber
- King Christian 10th Hospital for Rheumatic Diseases, Gråsten, Denmark; Institute of Regional Health Research, University of Southern Denmark, 5000 Odense, Denmark
| | - Jacob L Jaremko
- Department of Radiology and Diagnostic Imaging, University of Alberta, Alberta AB T6G 2R3, Edmonton, Canada
| | - Joel Paschke
- CaRE Arthritis, Alberta T6W 2Z8, Edmonton, Canada
| | - Jonathan Epstein
- CEC-Inserm CIE6, epidemiology and clinical evaluations department, CHRU de Nancy, 54500 Vandœuvre-lès-Nancy, France
| | - Walter P Maksymowych
- Department of Medicine, University of Alberta, Alberta AB T6G 2R3, Edmonton, Canada
| | - Damien Loeuille
- Department of Rheumatology, CHRU de Nancy, 5, rue du Morvan, 54500 Vandœuvre-lès-Nancy, France
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19
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Abstract
The Orthopaedic Section of the American Physical Therapy Association (APTA) has an ongoing effort to create evidence-based practice guidelines for orthopaedic physical therapy management of patients with musculoskeletal impairments described in the World Health Organization's International Classification of Functioning, Disability, and Health (ICF). The purpose of these revised clinical practice guidelines is to review recent peer-reviewed literature and make recommendations related to hip pain and mobility deficits. J Orthop Sports Phys Ther. 2017;47(6):A1-A37. doi:10.2519/jospt.2017.0301.
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20
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Aguilar HN, Battié MC, Jaremko JL. MRI-based hip cartilage measures in osteoarthritic and non-osteoarthritic individuals: a systematic review. RMD Open 2017; 3:e000358. [PMID: 28405471 PMCID: PMC5372025 DOI: 10.1136/rmdopen-2016-000358] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2016] [Revised: 02/27/2017] [Accepted: 03/01/2017] [Indexed: 11/05/2022] Open
Abstract
Osteoarthritis is a common hip joint disease, involving loss of articular cartilage. The prevalence and prognosis of hip osteoarthritis have been difficult to determine, with various clinical and radiological methods used to derive epidemiological estimates exhibiting significant heterogeneity. MRI-based methods directly visualise hip joint cartilage, and offer potential to more reliably define presence and severity of osteoarthritis, but have been underused. We performed a systematic review of MRI-based estimates of hip articular cartilage in the general population and in patients with established osteoarthritis, using MEDLINE, EMBASE and SCOPUS current to June 2016, with search terms such as ‘hip’, ‘femoral head’, ‘cartilage’, ‘volume’, ‘thickness’, ‘MRI’, etc. Ultimately, 11 studies were found appropriate for inclusion, but they were heterogeneous in osteoarthritis assessment methodology and composition. Overall, the studies consistently demonstrate the reliability and potential clinical utility of MRI-based estimates. However, no longitudinal data or reference values for hip cartilage thickness or volume have been published, limiting the ability of MRI to define or risk-stratify hip osteoarthritis. MRI-based techniques are available to quantify articular cartilage signal, volume, thickness and defects, which could establish the sequence and rate of articular cartilage changes at the hip that yield symptomatic osteoarthritis. However, prevalence and rates of progression of hip osteoarthritis have not been established in any MRI studies in the general population. Future investigations could fill this important knowledge gap using robust MRI methods in population-based cross-sectional and longitudinal studies.
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Affiliation(s)
- Hector N Aguilar
- Faculty of Medicine and Dentistry, Department of Radiology and Diagnostic Imaging , University of Alberta , Edmonton, Alberta , Canada
| | - Michele C Battié
- Faculty of Rehabilitation Medicine, Department of Physical Therapy , University of Alberta , Edmonton, Alberta , Canada
| | - Jacob L Jaremko
- Faculty of Medicine and Dentistry, Department of Radiology and Diagnostic Imaging , University of Alberta , Edmonton, Alberta , Canada
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21
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A narrative overview of the current status of MRI of the hip and its relevance for osteoarthritis research - what we know, what has changed and where are we going? Osteoarthritis Cartilage 2017; 25:1-13. [PMID: 27621214 DOI: 10.1016/j.joca.2016.08.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2016] [Revised: 08/24/2016] [Accepted: 08/28/2016] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To review and discuss the role of magnetic resonance imaging (MRI) in the context of hip osteoarthritis (OA) research. DESIGN The content of this narrative review, based on an extensive PubMed database research including English literature only, describes the advances in MRI of the hip joint and its potential usefulness in hip OA research, reviews the relevance of different MRI features in regard to symptomatic and structural progression in hip OA, and gives an outlook regarding future use of MRI in hip OA research endeavors. RESULTS Recent technical advances have helped to overcome many of the past difficulties related to MRI assessment of hip OA. MRI-based morphologic scoring systems allow for detailed assessment of several hip joint tissues and, in combination with the recent advances in MRI, may increase reproducibility and sensitivity to change. Compositional MRI techniques may add to our understanding of disease onset and progression. Knowledge about imaging pitfalls and anatomical variants is crucial to avoid misinterpretation. In comparison to research on knee OA, the associations between MRI features and the incidence and progression of disease as well as with clinical symptoms have been little explored. Anatomic alterations of the hip joint as seen in femoro-acetabular impingement (FAI) seem to play a role in the onset and progression of structural damage. CONCLUSIONS With the technical advances occurring in recent years, MRI may play a major role in investigating the natural history of hip OA and provide an improved method for assessment of the efficacy of new therapeutic approaches.
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22
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Pedoia V, Gallo MC, Souza RB, Majumdar S. Longitudinal study using voxel-based relaxometry: Association between cartilage T 1ρ and T 2 and patient reported outcome changes in hip osteoarthritis. J Magn Reson Imaging 2016; 45:1523-1533. [PMID: 27626787 DOI: 10.1002/jmri.25458] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Accepted: 08/18/2016] [Indexed: 11/07/2022] Open
Abstract
PURPOSE To study the local distribution of hip cartilage T1ρ and T2 relaxation times and their association with changes in patient reported outcome measures (PROMs) using a fully automatic, local, and unbiased method in subjects with and without hip osteoarthritis (OA). MATERIALS AND METHODS The 3 Tesla MRI studies of the hip were obtained for 37 healthy controls and 16 subjects with radiographic hip OA. The imaging protocol included a three-dimensional (3D) SPGR sequence and a combined 3D T1ρ and T2 sequence. Quantitative cartilage analysis was compared between a traditional region of interest (ROI)-based method and a fully automatic voxel-based relaxometry (VBR) method. Additionally, VBR was used to assess local T1ρ and T2 differences between subjects with and without OA, and to evaluate the association between T1ρ and T2 and 18-month changes PROMs. RESULTS Results for the two methods were consistent in the acetabular (R = 0.79; coefficients of variation [CV] = 2.9%) and femoral cartilage (R = 0.90; CV = 2.6%). VBR revealed local patterns of T1ρ and T2 elevation in OA subjects, particularly in the posterosuperior acetabular cartilage (T1ρ : P = 0.02; T2 : P = 0.038). Overall, higher T1ρ and T2 values at baseline, particularly in the anterosuperior acetabular cartilage (T1ρ : Rho = -0.42; P = 0.002; T2 : Rho = -0.44; P = 0.002), were associated with worsening PROMS at 18-month follow-up. CONCLUSION VBR is an accurate and robust method for quantitative MRI analysis in hip cartilage. VBR showed the capability to detect local variations in T1ρ and T2 values in subjects with and without osteoarthritis, and voxel based correlations demonstrated a regional dependence between baseline T1ρ and T2 values and changes in PROMs. LEVEL OF EVIDENCE 1 J. MAGN. RESON. IMAGING 2017;45:1523-1533.
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Affiliation(s)
- Valentina Pedoia
- Musculoskeletal Quantitative Imaging Research Group, Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
| | - Matthew C Gallo
- Musculoskeletal Quantitative Imaging Research Group, Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
| | - Richard B Souza
- Musculoskeletal Quantitative Imaging Research Group, Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA.,Department of Physical Therapy and Rehabilitation Science, University of California San Francisco, San Francisco, California, USA
| | - Sharmila Majumdar
- Musculoskeletal Quantitative Imaging Research Group, Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
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Gallo MC, Wyatt C, Pedoia V, Kumar D, Lee S, Nardo L, Link TM, Souza RB, Majumdar S. T1ρ and T2 relaxation times are associated with progression of hip osteoarthritis. Osteoarthritis Cartilage 2016; 24:1399-407. [PMID: 26973330 PMCID: PMC4955678 DOI: 10.1016/j.joca.2016.03.005] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Revised: 01/26/2016] [Accepted: 03/03/2016] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To evaluate whether baseline T1ρ and T2 relaxation times of hip cartilage are associated with magnetic resonance imaging (MRI) based progression of hip osteoarthritis (OA) at 18 months. METHODS 3T MRI studies of the hip were obtained at baseline and 18-month follow-up for 54 subjects without evidence of severe OA at baseline [Kellgren-Lawrence (KL) score of 0-3]. 2D fast spin-echo sequences were used for semi-quantitative morphological scoring of cartilage lesions and a combined T1ρ/T2 sequence was used to quantitatively assess cartilage composition. Progression of hip OA was defined based on incident or progression of morphological semi-quantitative grade at 18 months. Baseline T1ρ and T2 relaxation times were compared between progressors and non-progressors using one-way analysis of variance and Mann-Whitney U tests and used to predict progression with binary logistic regression after adjusting for age, gender, body mass index, and KL score. Additionally, a novel voxel-based relaxometry technique was used to compare the spatial distribution of baseline T1ρ and T2 between progressors and non-progressors. RESULTS Significantly higher baseline T1ρ and T2 values were observed in hip OA progressors compared to non-progressors, particularly in the posterosuperior and anterior aspects of the femoral cartilage. Logistic regression showed that higher baseline T1ρ or T2 values in the femoral cartilage were significantly associated with progression of femoral cartilage lesions at 18 months. CONCLUSION T1ρ and T2 relaxation parameters are associated with morphological cartilage degeneration at 18 months and may serve as potential imaging biomarkers for progression of cartilage lesions in hip OA.
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Affiliation(s)
- Matthew C. Gallo
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA USA
| | - Cory Wyatt
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA USA
| | - Valentina Pedoia
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA USA
| | - Deepak Kumar
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA USA
| | - Sonia Lee
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA USA
| | - Lorenzo Nardo
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA USA
| | - Thomas M. Link
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA USA
| | - Richard B. Souza
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA USA,Department of Orthopaedic Surgery, University of California San Francisco, San Francisco, CA USA,Department of Physical Therapy and Rehabilitation Science, University of California San Francisco, San Francisco, CA USA
| | - Sharmila Majumdar
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA USA,Department of Orthopaedic Surgery, University of California San Francisco, San Francisco, CA USA
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24
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Wang Y, Smith S, Teichtahl AJ, Hodge AM, Wluka AE, Giles GG, Cicuttini FM. Association Between Dietary Intake of Antioxidants and Prevalence of Femoral Head Cartilage Defects and Bone Marrow Lesions in Community-based Adults. J Rheumatol 2016; 43:1885-1890. [PMID: 27481903 DOI: 10.3899/jrheum.160325] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/30/2016] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Although there is evidence for a beneficial effect of dietary antioxidants on knee joint health, the data are sparse for the hip. Our aim was to examine the relationship between dietary antioxidants and early hip structural abnormalities in community-based adults. METHODS The study included 214 participants without diagnosed hip osteoarthritis (OA) who underwent hip magnetic resonance imaging in 2009-2010. The prevalence of femoral head cartilage defects and bone marrow lesions (BML) was assessed. Intakes of antioxidant vitamins and their food sources were estimated from a food frequency questionnaire during 1990-1994. RESULTS Higher intakes of Vitamin E (OR 0.63, 95% CI 0.41-0.96), lutein/zeaxanthin (OR 0.58, 95% CI 0.34-0.99), and lycopene (OR 0.64, 95% CI 0.44-0.95) were associated with a reduced prevalence of femoral head cartilage defects. Higher intakes of α-carotene (OR 0.42, 95% CI 0.19-0.94), β-carotene (OR 0.31, 95% CI 0.13-0.78), and lutein/zeaxanthin (OR 0.42, 95% CI 0.18-0.98) were associated with a reduced prevalence of femoral head BML. Higher vegetable consumption was associated with a reduced prevalence of femoral head cartilage defects (OR 0.65, 95% CI 0.46-0.91) and BML (OR 0.60, 95% CI 0.37-0.97). CONCLUSION Higher carotenoids intake and vegetable consumption were associated with reduced risk of hip cartilage defects and BML, and higher Vitamin E intake was associated with reduced risk of hip cartilage defects. These findings suggest a beneficial effect of dietary antioxidants on hip joint health. Although our findings need to be confirmed in other longitudinal studies, they suggest that the modification of dietary antioxidant intake may be a strategy for the prevention of hip OA.
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Affiliation(s)
- Yuanyuan Wang
- From the Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Melbourne; Baker IDI Heart and Diabetes Institute; Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne; Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Australia.Y. Wang, MBBS, MD, PhD, Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital; S. Smith, MBBS, Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital; A.J. Teichtahl, MBBS, B.Physio, FRACP, PhD, Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, and Baker IDI Heart and Diabetes Institute; A.M. Hodge, BAgrSci, Grad Dip Diet, BSc, MEnvSc, Grad Dip Epi Biostats, Cancer Epidemiology Centre, Cancer Council Victoria; A.E. Wluka, MBBS, FRACP, PhD, Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital; G.G. Giles, PhD, Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, and Cancer Epidemiology Centre, Cancer Council Victoria, and Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne; F.M. Cicuttini, MBBS, FRACP, PhD, Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital.
| | - Sam Smith
- From the Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Melbourne; Baker IDI Heart and Diabetes Institute; Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne; Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Australia.Y. Wang, MBBS, MD, PhD, Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital; S. Smith, MBBS, Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital; A.J. Teichtahl, MBBS, B.Physio, FRACP, PhD, Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, and Baker IDI Heart and Diabetes Institute; A.M. Hodge, BAgrSci, Grad Dip Diet, BSc, MEnvSc, Grad Dip Epi Biostats, Cancer Epidemiology Centre, Cancer Council Victoria; A.E. Wluka, MBBS, FRACP, PhD, Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital; G.G. Giles, PhD, Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, and Cancer Epidemiology Centre, Cancer Council Victoria, and Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne; F.M. Cicuttini, MBBS, FRACP, PhD, Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital
| | - Andrew J Teichtahl
- From the Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Melbourne; Baker IDI Heart and Diabetes Institute; Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne; Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Australia.Y. Wang, MBBS, MD, PhD, Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital; S. Smith, MBBS, Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital; A.J. Teichtahl, MBBS, B.Physio, FRACP, PhD, Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, and Baker IDI Heart and Diabetes Institute; A.M. Hodge, BAgrSci, Grad Dip Diet, BSc, MEnvSc, Grad Dip Epi Biostats, Cancer Epidemiology Centre, Cancer Council Victoria; A.E. Wluka, MBBS, FRACP, PhD, Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital; G.G. Giles, PhD, Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, and Cancer Epidemiology Centre, Cancer Council Victoria, and Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne; F.M. Cicuttini, MBBS, FRACP, PhD, Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital
| | - Allison M Hodge
- From the Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Melbourne; Baker IDI Heart and Diabetes Institute; Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne; Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Australia.Y. Wang, MBBS, MD, PhD, Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital; S. Smith, MBBS, Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital; A.J. Teichtahl, MBBS, B.Physio, FRACP, PhD, Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, and Baker IDI Heart and Diabetes Institute; A.M. Hodge, BAgrSci, Grad Dip Diet, BSc, MEnvSc, Grad Dip Epi Biostats, Cancer Epidemiology Centre, Cancer Council Victoria; A.E. Wluka, MBBS, FRACP, PhD, Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital; G.G. Giles, PhD, Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, and Cancer Epidemiology Centre, Cancer Council Victoria, and Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne; F.M. Cicuttini, MBBS, FRACP, PhD, Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital
| | - Anita E Wluka
- From the Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Melbourne; Baker IDI Heart and Diabetes Institute; Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne; Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Australia.Y. Wang, MBBS, MD, PhD, Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital; S. Smith, MBBS, Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital; A.J. Teichtahl, MBBS, B.Physio, FRACP, PhD, Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, and Baker IDI Heart and Diabetes Institute; A.M. Hodge, BAgrSci, Grad Dip Diet, BSc, MEnvSc, Grad Dip Epi Biostats, Cancer Epidemiology Centre, Cancer Council Victoria; A.E. Wluka, MBBS, FRACP, PhD, Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital; G.G. Giles, PhD, Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, and Cancer Epidemiology Centre, Cancer Council Victoria, and Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne; F.M. Cicuttini, MBBS, FRACP, PhD, Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital
| | - Graham G Giles
- From the Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Melbourne; Baker IDI Heart and Diabetes Institute; Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne; Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Australia.Y. Wang, MBBS, MD, PhD, Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital; S. Smith, MBBS, Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital; A.J. Teichtahl, MBBS, B.Physio, FRACP, PhD, Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, and Baker IDI Heart and Diabetes Institute; A.M. Hodge, BAgrSci, Grad Dip Diet, BSc, MEnvSc, Grad Dip Epi Biostats, Cancer Epidemiology Centre, Cancer Council Victoria; A.E. Wluka, MBBS, FRACP, PhD, Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital; G.G. Giles, PhD, Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, and Cancer Epidemiology Centre, Cancer Council Victoria, and Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne; F.M. Cicuttini, MBBS, FRACP, PhD, Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital
| | - Flavia M Cicuttini
- From the Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Melbourne; Baker IDI Heart and Diabetes Institute; Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne; Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Australia.Y. Wang, MBBS, MD, PhD, Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital; S. Smith, MBBS, Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital; A.J. Teichtahl, MBBS, B.Physio, FRACP, PhD, Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, and Baker IDI Heart and Diabetes Institute; A.M. Hodge, BAgrSci, Grad Dip Diet, BSc, MEnvSc, Grad Dip Epi Biostats, Cancer Epidemiology Centre, Cancer Council Victoria; A.E. Wluka, MBBS, FRACP, PhD, Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital; G.G. Giles, PhD, Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, and Cancer Epidemiology Centre, Cancer Council Victoria, and Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne; F.M. Cicuttini, MBBS, FRACP, PhD, Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital
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Ahedi HG, Aitken DA, Blizzard LC, Ding CHH, Cicuttini FM, Jones G. Correlates of Hip Cartilage Defects: A Cross-sectional Study in Older Adults. J Rheumatol 2016; 43:1406-12. [PMID: 27252427 DOI: 10.3899/jrheum.151001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/12/2016] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Knee cartilage defects are a key feature of osteoarthritis (OA) but correlates of hip defects remain unexplored. The aims of this cross-sectional study were to describe the correlates of hip cartilage defects. METHODS The study included 194 subjects from the Tasmanian Older Adult Cohort who had right hip short-tau inversion recovery magnetic resonance imaging (MRI). Hip cartilage defects were assessed and categorized as grade 0 = no defects, grade 1 = focal blistering or irregularities on cartilage or partial thickness defect, and grade 2 = full thickness defect. Hip pain was determined by Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Hip structural changes were measured on MRI, and hip radiographic OA (ROA) was assessed. Leg strength and physical activity were assessed using dynamometer and pedometers, respectively. Data were analyzed using log binomial and linear regression. RESULTS Of 194 subjects, 24% (n = 48) had no defects, 34% (n = 66) had grade 1, and 41% (n = 80) had grade 2. In multivariable analyses, any hip defects were associated with greater hip pain [prevalence ratio (PR) 1.20, 95% CI 1.02-1.35] and lower mean leg strength (men; mean ratio 0.83, 95% CI 0.67-0.98). Grade 1 defects were associated with hip bone marrow lesions (BML; PR 1.42, 95% CI 1.03-1.96) and high cartilage signal (men; PR 1.84, 95% CI 1.27-2.70), but not with hip pain or other structural findings. Grade 2 defects were associated with greater hip pain (PR 1.40, 95% CI 1.09-1.80), hip BML (PR 1.45, 95% CI 1.15-1.85), hip effusion cross-sectional area (PR 1.14, 95% CI 1.01-1.30), hip ROA (men; PR 1.60, 95% CI 1.13-2.25), and steps/day (PR 0.97, 95% CI 0.96-0.99). CONCLUSION Grade 2 defects in both sexes and grade 1 defects (mostly in men) are associated with clinical, demographic, and structural factors relevant for OA. Damage to the hip cartilage could be one of the major causes of rapid disease progression and pathophysiology of hip defects. The topic needs further study.
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Affiliation(s)
- Harbeer G Ahedi
- From the Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Melbourne, Australia.H.G. Ahedi, BAMS, PgdipBioMedSc, Menzies Institute for Medical Research, University of Tasmania; D.A. Aitken, PhD, Menzies Institute for Medical Research, University of Tasmania; L.C. Blizzard, PhD, Menzies Institute for Medical Research, University Of Tasmania; C.H. Ding, MD, Menzies Institute for Medical Research, University of Tasmania, and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital; F.M. Cicuttini, PhD, FRACP, FAFPHM, Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital; G. Jones, MD, Menzies Institute for Medical Research, University of Tasmania
| | - Dawn A Aitken
- From the Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Melbourne, Australia.H.G. Ahedi, BAMS, PgdipBioMedSc, Menzies Institute for Medical Research, University of Tasmania; D.A. Aitken, PhD, Menzies Institute for Medical Research, University of Tasmania; L.C. Blizzard, PhD, Menzies Institute for Medical Research, University Of Tasmania; C.H. Ding, MD, Menzies Institute for Medical Research, University of Tasmania, and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital; F.M. Cicuttini, PhD, FRACP, FAFPHM, Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital; G. Jones, MD, Menzies Institute for Medical Research, University of Tasmania
| | - Leigh C Blizzard
- From the Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Melbourne, Australia.H.G. Ahedi, BAMS, PgdipBioMedSc, Menzies Institute for Medical Research, University of Tasmania; D.A. Aitken, PhD, Menzies Institute for Medical Research, University of Tasmania; L.C. Blizzard, PhD, Menzies Institute for Medical Research, University Of Tasmania; C.H. Ding, MD, Menzies Institute for Medical Research, University of Tasmania, and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital; F.M. Cicuttini, PhD, FRACP, FAFPHM, Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital; G. Jones, MD, Menzies Institute for Medical Research, University of Tasmania
| | - Chang-Hai H Ding
- From the Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Melbourne, Australia.H.G. Ahedi, BAMS, PgdipBioMedSc, Menzies Institute for Medical Research, University of Tasmania; D.A. Aitken, PhD, Menzies Institute for Medical Research, University of Tasmania; L.C. Blizzard, PhD, Menzies Institute for Medical Research, University Of Tasmania; C.H. Ding, MD, Menzies Institute for Medical Research, University of Tasmania, and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital; F.M. Cicuttini, PhD, FRACP, FAFPHM, Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital; G. Jones, MD, Menzies Institute for Medical Research, University of Tasmania
| | - Flavia M Cicuttini
- From the Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Melbourne, Australia.H.G. Ahedi, BAMS, PgdipBioMedSc, Menzies Institute for Medical Research, University of Tasmania; D.A. Aitken, PhD, Menzies Institute for Medical Research, University of Tasmania; L.C. Blizzard, PhD, Menzies Institute for Medical Research, University Of Tasmania; C.H. Ding, MD, Menzies Institute for Medical Research, University of Tasmania, and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital; F.M. Cicuttini, PhD, FRACP, FAFPHM, Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital; G. Jones, MD, Menzies Institute for Medical Research, University of Tasmania
| | - Graeme Jones
- From the Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Melbourne, Australia.H.G. Ahedi, BAMS, PgdipBioMedSc, Menzies Institute for Medical Research, University of Tasmania; D.A. Aitken, PhD, Menzies Institute for Medical Research, University of Tasmania; L.C. Blizzard, PhD, Menzies Institute for Medical Research, University Of Tasmania; C.H. Ding, MD, Menzies Institute for Medical Research, University of Tasmania, and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital; F.M. Cicuttini, PhD, FRACP, FAFPHM, Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital; G. Jones, MD, Menzies Institute for Medical Research, University of Tasmania.
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Wang Y, Teichtahl AJ, Cicuttini FM. Osteoarthritis year in review 2015: imaging. Osteoarthritis Cartilage 2016; 24:49-57. [PMID: 26707992 DOI: 10.1016/j.joca.2015.07.027] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Accepted: 07/30/2015] [Indexed: 02/02/2023]
Abstract
PURPOSE This narrative review covers original publications related to imaging in osteoarthritis (OA) published in English between 1 April 2014 and 30 April 2015. Novel lessons relating to imaging are described. METHODS An extensive PubMed database search was performed based on, but not limited to the terms "OA" in combination with "Magnetic resonance imaging (MRI)", "Imaging", "Radiography", "Ultrasound", "Computed tomography (CT)" and "Nuclear medicine" to extract relevant studies. In vitro data and animal studies were excluded. This review focuses on the new developments and observations based on the aforementioned imaging modalities, as well as a 'whole-organ' approach by presenting findings from different tissues (bone, meniscus, synovium, muscle and fat) and joints (hip, lumbar spine and hand). RESULTS AND CONCLUSIONS Over the past year, studies using imagine have made a major contribution to the understanding of the pathogenesis of OA. Significant work has continued at the knee, with MRI now being increasingly used to assess structural endpoints in clinical trials. This offers the exciting opportunity to explore potential disease modifying OA therapies. There has been a clear interest in the role of bone in the pathogenesis of OA. There is now a growing body of literature examining the pathogenesis of OA at the hip, lumbar spine and hand. The future of imaging in OA offers the exciting potential to better understand the disease process across all joints and develop more effective preventive and therapeutic interventions.
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Affiliation(s)
- Y Wang
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Melbourne, VIC 3004, Australia
| | - A J Teichtahl
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Melbourne, VIC 3004, Australia; Baker IDI Heart and Diabetes Institute, Commercial Road, Melbourne, VIC 3004, Australia
| | - F M Cicuttini
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Melbourne, VIC 3004, Australia.
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Abstract
OBJECTIVE Imaging of hip cartilage is challenging because of its limited thickness and complex geometry and therefore requires advanced MRI techniques. However, cartilage abnormalities are found in a number of disease entities, and their diagnosis may impact patient management. This article will provide pertinent information about the motivation to image hip cartilage, which imaging techniques to use, and how to analyze cartilage; finally, we will discuss disease entities with regional cartilage lesions, including the typical MRI findings. CONCLUSION Because the detection and quantification of regional cartilage abnormalities are critical for guidance of operative and nonoperative management of hip disorders, radiologists should be familiar with imaging and analysis techniques for assessing hip cartilage.
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Early cartilage abnormalities at the hip are associated with obesity and body composition measures - a 3.0T MRI community-based study. Arthritis Res Ther 2015; 17:107. [PMID: 25897761 PMCID: PMC4462003 DOI: 10.1186/s13075-015-0618-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2014] [Accepted: 04/07/2015] [Indexed: 11/17/2022] Open
Abstract
Introduction Although obesity is a risk factor for hip osteoarthritis (OA), the role of body composition, if any, is unclear. This study examines whether the body mass index (BMI) and body composition are associated with hip cartilage changes using magnetic resonance imaging (MRI) in community-based adults. Methods 141 community-based participants with no clinical hip disease, including OA, had BMI and body composition (fat mass and fat free mass) measured at baseline (1990 to 1994), and BMI measured and 3.0 T MRI performed at follow-up (2009–2010). Femoral head cartilage volume was measured and femoral head cartilage defects were scored in the different hip regions. Results For females, baseline BMI (β = −26 mm3, 95% Confidence interval (CI) -47 to −6 mm3, p = 0.01) and fat mass (β = −11 mm3, 95% CI −21 to −1 mm3, p = 0.03) were negatively associated with femoral head cartilage volume. Also, while increased baseline fat mass was associated with an increased risk of cartilage defects in the central superolateral region of the femoral head (Odds Ratio (OR) = 1.08, 95% CI 1.00–1.15, p = 0.04), increased baseline fat free mass was associated with a reduced risk of cartilage defects in this region (OR = 0.82, 95% CI 0.67–0.99; p = 0.04). For males, baseline fat free mass was associated with increased femoral head cartilage volume (β = 40 mm3, 95% CI 6 to 74 mm3, p = 0.02). Conclusions Increased fat mass was associated with adverse hip cartilage changes for females, while increased fat free mass was associated with beneficial cartilage changes for both genders. Further work is required to determine whether modifying body composition alters the development of hip OA.
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Teichtahl AJ, Smith S, Wang Y, Wluka AE, O'Sullivan R, Giles GG, Cicuttini FM. Occupational risk factors for hip osteoarthritis are associated with early hip structural abnormalities: a 3.0 T magnetic resonance imaging study of community-based adults. Arthritis Res Ther 2015; 17:19. [PMID: 25627648 PMCID: PMC4342869 DOI: 10.1186/s13075-015-0535-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Accepted: 01/21/2015] [Indexed: 11/13/2022] Open
Abstract
Introduction Occupational exposure to heavy lifting and stair climbing are associated with radiographic hip osteoarthritis (OA). This study examined whether these activities are associated with early structural hip joint changes in a community-based population. Methods In total, 198 community-based people with no history of hip disease, including OA, had 3.0 T-magnetic resonance imaging (MRI) to assess hip cartilage volume, defects and bone marrow lesions (BMLs). Recall of occupational exposure to heavy lifting and stair climbing aged 18 to 30 years and in the previous 10 years were collected. A persistence score was defined as exposure at neither time point (0), at one time point (1) or at both time points (2). Results Exposure to heavy lifting when aged 18 to 30 years was associated with BMLs of the central superolateral femoroacetabular region (odds ratio (OR) 3.9, 95% confidence interval (CI) 1.6 to 9.8, P <0.01), with persistence score associated with cartilage defects in the central superolateral region of the femoral head (OR 1.6, 95% CI 1.0 to 2.5, P = 0.04). Exposure to stair climbing aged 18 to 30 years and persistence score were associated with an increased risk of cartilage defects in the central superolateral femoral head and BMLs in the central superolateral and posterior femoroacetabular regions (OR range 2.1 to 3.2, all P ≤0.03). Conclusions Occupational exposure to heavy lifting and stair climbing are associated with hip structural abnormalities. If confirmed by longitudinal data, such associations may explain how occupational activities affect the hip joint and may identify new targets for the prevention of hip OA.
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Affiliation(s)
- Andrew J Teichtahl
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, 99 Commercial Road, Melbourne, VIC, 3004, Australia. .,Baker IDI Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC, 3004, Australia.
| | - Sam Smith
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, 99 Commercial Road, Melbourne, VIC, 3004, Australia.
| | - Yuanyuan Wang
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, 99 Commercial Road, Melbourne, VIC, 3004, Australia.
| | - Anita E Wluka
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, 99 Commercial Road, Melbourne, VIC, 3004, Australia.
| | - Richard O'Sullivan
- MRI Department, Healthcare Imaging Services, Epworth Hospital, 89 Bridge Road, Richmond, VIC, 3121, Australia. .,Department of Medicine, Central Clinical School, Monash University, 55 Commercial Road, Melbourne, VIC, 3004, Australia.
| | - Graham G Giles
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, 99 Commercial Road, Melbourne, VIC, 3004, Australia. .,Cancer Epidemiology Centre, Cancer Council Victoria, 89 Bridge Road, Melbourne, VIC, 3004, Australia. .,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Carlton, VIC, 3053, Australia.
| | - Flavia M Cicuttini
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, 99 Commercial Road, Melbourne, VIC, 3004, Australia.
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