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Nevalainen MT, Uusimaa AP, Saarakkala S. The ultrasound assessment of osteoarthritis: the current status. Skeletal Radiol 2023; 52:2271-2282. [PMID: 37060461 PMCID: PMC10509065 DOI: 10.1007/s00256-023-04342-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 03/17/2023] [Accepted: 04/10/2023] [Indexed: 04/16/2023]
Abstract
Traditionally, osteoarthritis (OA) is diagnosed with the clinical examination supplemented by the conventional radiography (CR). In the research literature, the role of ultrasound (US) imaging in the diagnostics of OA has risen steadily during the last two decades. US imaging is cheap and globally widely available often already in primary healthcare. Here, we reviewed the most essential US literature focusing on OA diagnostics and progression prediction using the various search engines. Starting from the year 2000, our search provided 1 445 journal articles. After reviewing the abstracts, 89 articles were finally included. Most of the reviewed articles focused on the imaging of knee and hand OA, whereas only a minority dealt with the imaging of hip, ankle, midfoot, acromioclavicular, and temporomandibular joints. Overall, during the last 20 years, the use of US imaging for OA assessment has increased in the scientific literature. In knee and hand joints, US imaging has been reported to be a promising tool to evaluate OA changes. Furthermore, the reproducibility of US as well as its association to MRI findings are excellent. Importantly, US seems to even outperform CR in certain aspects, such as detection of osteophytes, joint inflammation, meniscus protrusion, and localized cartilage damage (especially at the medial femoral condyle and sulcus area). Based on the reviewed literature, US can be truly considered as a complementary tool to CR in the clinical setup for OA diagnostics. New technical developments may even enhance the diagnostic value of the US in the future.
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Affiliation(s)
- Mika T Nevalainen
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, POB 5000, FI-90014, Oulu, Finland.
- Department of Diagnostic Radiology, Oulu University Hospital, P.O. Box 50, 90029, Oulu, Finland.
| | - Antti-Pekka Uusimaa
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, POB 5000, FI-90014, Oulu, Finland
| | - Simo Saarakkala
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, POB 5000, FI-90014, Oulu, Finland
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2
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Perrot S, Anne-Priscille T. Pain in osteoarthritis from a symptom to a disease. Best Pract Res Clin Rheumatol 2023; 37:101825. [PMID: 37236892 DOI: 10.1016/j.berh.2023.101825] [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: 04/21/2023] [Accepted: 04/21/2023] [Indexed: 05/28/2023]
Abstract
Pain is the most frequent symptom of osteoarthritis (OA), occurring much more commonly than stiffness or disability. Classically, OA-related pain has been considered to be a nociceptive pain condition and an alarm signal correlated to the intensity of joint degradation. However, OA-related pain is a specific disease, with a complex pathophysiology, including neuropathic peripheral and central abnormalities, together with local inflammation involving all joint structures. Clinical findings emphasize that it is not a stable and linear condition, that pain experience is poorly correlated to structural modifications, and that the quality of pain in OA is important to consider, aside from its intensity. OA-related pain is modulated by many factors, including the individual patient's psychological and genetic factors, as well as the theoretical role of meteorological influences. Recent findings have improved our knowledge about the central mechanisms of OA pain, especially in persistent cases. A specific questionnaire on OA pain is currently being developed to assess more precisely the patient's experience and target specific pain mechanisms. In conclusion, OA-related pain should be analyzed specifically aside from OA, taking into account the complexity of OA pain as a disease, distinguishing different OA pain phenotypes, to guide more precisely analgesic treatment and OA global management.
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Affiliation(s)
- Serge Perrot
- Pain Department, Cochin Hospital, Assistance Publique Hôpitaux de Paris, Paris, France; Paris Cité University, INSERM U987, Paris, France.
| | - Trouvin Anne-Priscille
- Pain Department, Cochin Hospital, Assistance Publique Hôpitaux de Paris, Paris, France; Paris Cité University, INSERM U987, Paris, France
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3
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Karaszewski W, Pekanovic A, Streich NA, Herbort M, Petersen W, Schmidt-Lucke C. Ultrasonography for quantitative assessment of knee joint effusions-useful tool for objective evaluation of rehabilitation progress? INTERNATIONAL ORTHOPAEDICS 2023; 47:955-961. [PMID: 36683051 DOI: 10.1007/s00264-023-05697-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 01/07/2023] [Indexed: 01/24/2023]
Abstract
PURPOSE We sought to externally validate ultrasonography (US) for quantification of suprapatellar effusion size to improve diagnosis and individualised rehabilitation strategies in knee rehabilitation after anterior cruciate ligament reconstruction (ACLR) surgery. METHODS US was performed on 35 patients as part of the ongoing CAMOPED study. Data were collected in ACLR and post surgery in defined intervals up to one year post-operation. The palpatory assessment was graded using the International Knee Documentation Committee (oIKDC). RESULTS In a total of 164 sonographies, a strong correlation between palpatory and US effusion (r = 0.83, p < 0.01) with lower deviations in US quantification compared to palpatory quantification Y = 1.15 + 0.15* x was seen. Threshold values could be determined for the detection of effusions by palpation and for the differentiation between mild and moderate/severe effusions (effusion depth: 2.6 mm and resp. 5.8 mm, respectively). CONCLUSIONS As demonstrated in this multicenter study, the size of suprapatellar effusions can be easily quantified with high accuracy using standardised bedside ultrasound. Especially in moderate to severe effusions, US provides a practical and reliable tool for outcome measurement superior to palpatory assessment with the goal of optimising individual recommendations during the rehabilitation course. Furthermore, for the first time, it has been possible to define sonographic threshold values for the detection of effusion and differentiation of mild vs. moderate/severe effusion by means of palpation.
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Affiliation(s)
- Willi Karaszewski
- MEDIACC (Medico-academic consultings), Berlin, Germany.,Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Ana Pekanovic
- MEDIACC (Medico-academic consultings), Berlin, Germany
| | | | - Mirco Herbort
- Orthopädische Chirurgie München, Munich, Germany.,Research Unit for Orthopaedic Sports Medicine and Injury Prevention (OSMI), Medical Informatics and Technology, Private University for Health Sciences, Innsbruck, Austria
| | | | - Caroline Schmidt-Lucke
- MEDIACC (Medico-academic consultings), Berlin, Germany. .,Charité-Universitätsmedizin Berlin, Berlin, Germany.
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4
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Ishibashi K, Sasaki E, Chiba D, Oyama T, Ota S, Ishibashi H, Yamamoto Y, Tsuda E, Sawada K, Jung S, Ishibashi Y. Effusion detected by ultrasonography and overweight may predict the risk of knee osteoarthritis in females with early knee osteoarthritis: a retrospective analysis of Iwaki cohort data. BMC Musculoskelet Disord 2022; 23:1021. [PMID: 36443725 PMCID: PMC9703762 DOI: 10.1186/s12891-022-05989-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 11/16/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Knee osteoarthritis (OA) has enormous medical and socioeconomic burdens, which early diagnosis and intervention can reduce. We investigated the influence of knee effusion on the progression of knee OA in patients with early knee OA. METHODS A total of 404 participants without radiographic knee OA were assessed from a 3-year longitudinal analysis. Participants were classified into non-OA and early knee OA groups. The effusion area (mm2) was quantified using ultrasonography. Receiver operating characteristic and logistic regression analyses were performed. RESULTS At the 3-year follow-up, 114 of 349 knees (32%) had progressed from non-OA and 32 of 55 knees (58%) had progressed from early knee OA to radiographic knee OA. Logistic regression analysis showed that female sex (odds ratio [OR] 3.36, 95% confidence interval [CIs] 2.98-5.42), early knee OA (OR 2.02, 95% CI 1.08-3.75), body mass index (OR 1.11, 95% CI 1.02-1.19), and effusion area (OR 1.01, 95% CI 1.01-1.02) were significantly correlated with knee OA progression. Women who were overweight (body mass index ≥ 25 kg/m2) with more severe effusion had a higher risk of OA progression (area under the curve = 0.691, OR = 6.00) compared to those not overweight (area under the curve = 0.568, OR = 1.91). CONCLUSION Knee effusion may be an indicator of the progression of early-stage knee OA.
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Affiliation(s)
- Kyota Ishibashi
- grid.257016.70000 0001 0673 6172Department of Orthopedic Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, 036-8562 Hirosaki, Aomori Japan
| | - Eiji Sasaki
- grid.257016.70000 0001 0673 6172Department of Orthopedic Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, 036-8562 Hirosaki, Aomori Japan
| | - Daisuke Chiba
- grid.257016.70000 0001 0673 6172Department of Orthopedic Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, 036-8562 Hirosaki, Aomori Japan
| | - Tetsushi Oyama
- grid.257016.70000 0001 0673 6172Department of Orthopedic Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, 036-8562 Hirosaki, Aomori Japan
| | - Seiya Ota
- grid.257016.70000 0001 0673 6172Department of Orthopedic Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, 036-8562 Hirosaki, Aomori Japan
| | - Hikaru Ishibashi
- grid.257016.70000 0001 0673 6172Department of Orthopedic Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, 036-8562 Hirosaki, Aomori Japan
| | - Yuji Yamamoto
- grid.257016.70000 0001 0673 6172Department of Orthopedic Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, 036-8562 Hirosaki, Aomori Japan
| | - Eiichi Tsuda
- grid.257016.70000 0001 0673 6172Department of Rehabilitation Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori Japan
| | - Kaori Sawada
- grid.257016.70000 0001 0673 6172Department of Social Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori Japan
| | - Songee Jung
- grid.257016.70000 0001 0673 6172Department of Digital Nutrition and Health Sciences, Graduate School of Medicine, Hirosaki University, Hirosaki, Aomori Japan
| | - Yasuyuki Ishibashi
- grid.257016.70000 0001 0673 6172Department of Orthopedic Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, 036-8562 Hirosaki, Aomori Japan
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5
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Dainese P, Wyngaert KV, De Mits S, Wittoek R, Van Ginckel A, Calders P. Association between knee inflammation and knee pain in patients with knee osteoarthritis: a systematic review. Osteoarthritis Cartilage 2022; 30:516-534. [PMID: 34968719 DOI: 10.1016/j.joca.2021.12.003] [Citation(s) in RCA: 38] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 12/07/2021] [Accepted: 12/09/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To systematically review the literature on the relationship between markers of inflammation and pain in patients with knee osteoarthritis (OA). METHODS We searched MEDLINE, Web of Science and EMBASE databases from inception until June 2021. Eligible articles had to report on the association between inflammation (as measured by effusion, synovitis, baker's cysts, cytokines and C-reactive protein) and pain in patients with radiographic knee OA. Two reviewers independently performed a screening on title and abstracts, data extraction and risk of bias assessment using the Newcastle-Ottawa Scale (NOS). A best evidence synthesis was conducted for each inflammatory sign included in this review. RESULTS 37 studies were included. Articles reported on the following measures: effusion or synovitis assessed via ultrasound (n = 9) or magnetic resonance imaging (MRI) (n = 17); baker's cyst (n = 3); cytokine concentrations (n = 11); and C-reactive protein levels (n = 4). The strength of the association between inflammation and pain does not exceed the moderate level (i.e., correlation coefficient values ranging from 0.19 to 0.61). Moderate levels of evidence were found for the association between synovitis (measured with ultrasound or contrast enhanced MRI) and pain. The levels of evidence between effusion (assessed via ultrasound), effusion/synovitis (assessed via non-contrast enhanced MRI), Baker's cyst, cytokines, C-reactive protein and pain were conflicting. CONCLUSIONS Different inflammatory markers are associated with pain but the correlation ranges from weak to moderate, and the quality of evidence from conflicting to moderate. Further research is needed to strengthen the level of evidence and to establish mechanisms.
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Affiliation(s)
- P Dainese
- Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent, Belgium
| | - K V Wyngaert
- Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent, Belgium
| | - S De Mits
- Department of Rheumatology, Ghent University, Ghent, Belgium
| | - R Wittoek
- Department of Rheumatology, Ghent University, Ghent, Belgium
| | - A Van Ginckel
- Belgian Health Care Knowledge Centre, Brussels, Belgium
| | - P Calders
- Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent, Belgium.
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"But it feels swollen!": the frequency and clinical characteristics of people with knee osteoarthritis who report subjective knee swelling in the absence of objective swelling. Pain Rep 2021; 6:e971. [PMID: 34765853 PMCID: PMC8577815 DOI: 10.1097/pr9.0000000000000971] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 09/01/2021] [Accepted: 09/11/2021] [Indexed: 11/27/2022] Open
Abstract
Supplemental Digital Content is Available in the Text. The present results support the coexistence of altered body image (subjective without objective swelling) and pain, disability, and maladaptive beliefs in people with knee osteoarthritis. Introduction: There are complex interactions between pain and perceptions of the painful body part in musculoskeletal disorders, and disruption of various body representations in people with chronic pain. Objectives: The purpose of this study was to investigate how frequently people with knee osteoarthritis (OA) complain of swelling without objective evidence of swelling, and describe the clinical characteristics of this population. Methods: Forty-six people with knee OA (68.1 ± 8.8 years) participated in this cross-sectional study. Subjective and objective swelling was evaluated by knee-specific body perception questionnaire and ultrasonography, respectively. Pain intensity, disability, pain-related beliefs, 2-point discrimination threshold, and quadriceps muscle strength were also evaluated. Results: Approximately 1/3 of participants (n = 15) had subjective feelings of knee swelling in the absence of objective swelling (S only). Fifteen participants had both subjective and objective knee swelling (S + O group) and 16 had neither subjective nor objective knee swelling (No S/O group). Participants in the S only group had similar pain or disability as those in the S + O group but had more severe pain or disability than those with in the No S/O group. Those in the S only group also had larger 2-point discrimination distance threshold at the medial knee (impaired tactile acuity) than those in the S + O group and had more dysfunctional pain catastrophizing and pain-related self-efficacy than both other groups. Conclusion: Our results suggest that about 30% of people with knee OA perceive swelling of the knee in the absence of any objective swelling and that this is accompanied by severe pain and functional disability. Considering altered body image of the knee may reveal relevant treatment-based subgroups in people with knee OA.
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7
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Clason J, Liederbach M, Balkman N, Davis E, Zapata I, Mason NL. The Feasibility of Ultrasound-Guided Knee Arthrocentesis Training Using Formalin-Embalmed. JB JS Open Access 2021; 6:JBJSOA-D-20-00071. [PMID: 34522834 PMCID: PMC8428742 DOI: 10.2106/jbjs.oa.20.00071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The use of ultrasound guidance during knee arthrocentesis has proven to increase operator confidence and accuracy, particularly in novice healthcare providers. Realistic and practical means of teaching this procedure to medical trainees are needed. This study is intended to assess the feasibility and efficacy of using formalin-embalmed human cadavers in the instruction of ultrasound-guided knee arthrocentesis to medical trainees.
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Affiliation(s)
- Joshua Clason
- Rocky Vista University College of Osteopathic Medicine-Southern Utah Campus, Ivins, Utah
| | - Margaret Liederbach
- Rocky Vista University College of Osteopathic Medicine-Southern Utah Campus, Ivins, Utah
| | - Nathan Balkman
- Rocky Vista University College of Osteopathic Medicine-Southern Utah Campus, Ivins, Utah
| | - Edwin Davis
- Rocky Vista University College of Osteopathic Medicine-Southern Utah Campus, Ivins, Utah
| | - Isain Zapata
- Rocky Vista University College of Osteopathic Medicine-Parker Campus, Parker, Colorado
| | - Nena Lundgreen Mason
- Rocky Vista University College of Osteopathic Medicine-Southern Utah Campus, Ivins, Utah
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8
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Relationship between abnormalities detected by magnetic resonance imaging and knee symptoms in early knee osteoarthritis. Sci Rep 2021; 11:15179. [PMID: 34312418 PMCID: PMC8313522 DOI: 10.1038/s41598-021-94382-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 07/06/2021] [Indexed: 12/30/2022] Open
Abstract
We investigated the prevalence of magnetic resonance imaging (MRI) findings and their relationship with knee symptoms in women without radiographic evidence of knee osteoarthritis (KOA). This cross-sectional cohort study included 359 Japanese women without radiographic evidence of KOA (Kellgren‒Lawrence grade < 2). All participants underwent T2-weighted fat-suppressed MRI of their knees. Structural abnormalities (cartilage damage, bone marrow lesions [BMLs], subchondral cysts, bone attrition, osteophytes, meniscal lesions, and synovitis) were scored according to the whole-organ MRI score method. Knee symptoms were evaluated using the Knee Injury and Osteoarthritis Outcome Score. Participants were divided into early and non-KOA groups based on early KOA classification criteria. Logistic regression analysis was performed to evaluate the relationship between MRI abnormalities and knee symptoms. Cartilage damage was the most common abnormality (43.5%). The prevalences of cartilage damage, BMLs, subchondral cysts, bone attrition, meniscal lesions, and synovitis were higher in patients with early KOA than in those without. Synovitis (odds ratio [OR] 2.254, P = 0.002) and meniscal lesions (OR 1.479, P = 0.031) were positively associated with the presence of early KOA. Synovitis was most strongly associated with knee pain and might be a therapeutic target in patients with early KOA.
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9
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Jiang T, Yang T, Zhang W, Doherty M, Zhang Y, Wei J, Sarmanova A, Hall M, Yang Z, Li J, Fernandes GS, Obotiba AD, Gohir SA, Courtney P, Zeng C, Lei G. Prevalence of ultrasound-detected knee synovial abnormalities in a middle-aged and older general population-the Xiangya Osteoarthritis Study. Arthritis Res Ther 2021; 23:156. [PMID: 34078472 PMCID: PMC8170794 DOI: 10.1186/s13075-021-02539-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 05/19/2021] [Indexed: 12/03/2022] Open
Abstract
Background There is paucity of data on the prevalence of ultrasound-detected synovial abnormalities in the general population, and the relationship between synovial changes and knee pain remains unclear. We examined the prevalence of synovial abnormalities on ultrasound and the relationship of these features with knee pain and radiographic osteoarthritis (ROA) in a community sample. Methods Participants aged 50 years or over were from the Xiangya Osteoarthritis Study, a community-based cohort study. Participants were questioned about chronic knee pain and underwent (1) ultrasonography of both knees to determine presence of synovial hypertrophy (≥ 4 mm), effusion (≥ 4 mm), and Power Doppler signal [PDS; yes/no]; and (2) standard radiographs of both knees (tibiofemoral and patellofemoral views) to determine ROA. Results There were 3755 participants (mean age 64.4 years; women 57.4%). The prevalence of synovial hypertrophy, effusion, and PDS were 18.1% (men 20.2%; women 16.5%), 46.6% (men 49.9%; women 44.2%), and 4.9% (men 4.9%; women 5.0%), respectively, and increased with age (P for trend < 0.05). Synovial abnormalities were associated with knee pain, with adjusted odds ratios (aORs) of 2.39 (95% confidence interval [CI] 2.00–2.86) for synovial hypertrophy, 1.58 (95%CI 1.39–1.80) for effusion, and 4.36 (95%CI 3.09–6.17) for PDS. Similar associations with ROA were observed, the corresponding aORs being 4.03 (95%CI 3.38–4.82), 2.01 (95%CI 1.76–2.29), and 6.49 (95%CI 4.51–9.35), respectively. The associations between synovial hypertrophy and effusion with knee pain were more pronounced among knees with ROA than those without ROA, and the corresponding P for interaction were 0.004 and 0.067, respectively. Conclusions Knee synovial hypertrophy and effusion are more common and increase with age, affecting men more than women. All three ultrasound-detected synovial abnormalities associate both with knee pain and ROA, and knee synovial hypertrophy or effusion and ROA may interact to increase the risk of knee pain. Supplementary Information The online version contains supplementary material available at 10.1186/s13075-021-02539-2.
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Affiliation(s)
- Ting Jiang
- Department of Orthopaedics, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan, China.,Department of Ultrasonography, Xiangya Hospital, Central South University, Changsha, China.,Division of Rheumatology, Orthopaedics and Dermatology, University of Nottingham, Nottingham, UK.,Pain Centre Versus Arthritis UK, Nottingham, UK
| | - Tuo Yang
- Division of Rheumatology, Orthopaedics and Dermatology, University of Nottingham, Nottingham, UK.,Pain Centre Versus Arthritis UK, Nottingham, UK.,Health Management Center, Xiangya Hospital, Central South University, Changsha, China
| | - Weiya Zhang
- Division of Rheumatology, Orthopaedics and Dermatology, University of Nottingham, Nottingham, UK.,Pain Centre Versus Arthritis UK, Nottingham, UK
| | - Michael Doherty
- Division of Rheumatology, Orthopaedics and Dermatology, University of Nottingham, Nottingham, UK.,Pain Centre Versus Arthritis UK, Nottingham, UK
| | - Yuqing Zhang
- Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, USA.,The Mongan Institute, Massachusetts General Hospital, Harvard Medical School, Boston, USA
| | - Jie Wei
- Health Management Center, Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Joint Degeneration and Injury, Xiangya Hospital, Central South University, Changsha, China
| | - Aliya Sarmanova
- Musculoskeletal Research Unit, Bristol Medical School, University of Bristol, Bristol, UK
| | - Michelle Hall
- Pain Centre Versus Arthritis UK, Nottingham, UK.,School of Health Sciences, University of Nottingham, Nottingham, UK.,NIHR Nottingham Biomedical Research Centre, School of Medicine, University of Nottingham, Nottingham, UK
| | - Zidan Yang
- Hunan Key Laboratory of Joint Degeneration and Injury, Xiangya Hospital, Central South University, Changsha, China
| | - Jiatian Li
- Department of Orthopaedics, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan, China
| | - Gwen S Fernandes
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Abasiama D Obotiba
- Division of Rheumatology, Orthopaedics and Dermatology, University of Nottingham, Nottingham, UK.,Pain Centre Versus Arthritis UK, Nottingham, UK
| | - Sameer A Gohir
- NIHR Nottingham Biomedical Research Centre, School of Medicine, University of Nottingham, Nottingham, UK
| | - Philip Courtney
- Department of Rheumatology, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Chao Zeng
- Department of Orthopaedics, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan, China. .,Hunan Key Laboratory of Joint Degeneration and Injury, Xiangya Hospital, Central South University, Changsha, China. .,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China.
| | - Guanghua Lei
- Department of Orthopaedics, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan, China. .,Hunan Key Laboratory of Joint Degeneration and Injury, Xiangya Hospital, Central South University, Changsha, China. .,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China.
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10
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Filippou G, Scanu A, Adinolfi A, Toscano C, Gambera D, Largo R, Naredo E, Calvo E, Herrero-Beaumont G, Zufferey P, Bonjour CM, MacCarter DK, Makman S, Weber Z, Figus F, Möller I, Gutierrez M, Pineda C, Clavijo Cornejo D, Garcia H, Ilizaliturri V, Mendoza Torres J, Pichardo R, Rodriguez Delgado LC, Filippucci E, Cipolletta E, Serban T, Cirstoiu C, Vreju FA, Grecu D, Mouterde G, Govoni M, Punzi L, Damjanov NS, Keen HI, Bruyn GA, Terslev L, D'Agostino MA, Scirè CA, Iagnocco A. Criterion validity of ultrasound in the identification of calcium pyrophosphate crystal deposits at the knee: an OMERACT ultrasound study. Ann Rheum Dis 2020; 80:261-267. [PMID: 32988839 DOI: 10.1136/annrheumdis-2020-217998] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 08/03/2020] [Accepted: 08/21/2020] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To evaluate the discriminatory ability of ultrasound in calcium pyrophosphate deposition disease (CPPD), using microscopic analysis of menisci and knee hyaline cartilage (HC) as reference standard. METHODS Consecutive patients scheduled for knee replacement surgery, due to osteoarthritis (OA), were enrolled. Each patient underwent ultrasound examination of the menisci and HC of the knee, scoring each site for presence/absence of CPPD. Ultrasound signs of inflammation (effusion, synovial proliferation and power Doppler) were assessed semiquantitatively (0-3). The menisci and condyles, retrieved during surgery, were examined microscopically by optical light microscopy and by compensated polarised microscopy. CPPs were scored as present/absent in six different samples from the surface and from the internal part of menisci and cartilage. Ultrasound and microscopic analysis were performed by different operators, blinded to each other's findings. RESULTS 11 researchers from seven countries participated in the study. Of 101 enrolled patients, 68 were included in the analysis. In 38 patients, the surgical specimens were insufficient. The overall diagnostic accuracy of ultrasound for CPPD was of 75%-sensitivity of 91% (range 71%-87% in single sites) and specificity of 59% (range 68%-92%). The best sensitivity and specificity were obtained by assessing in combination by ultrasound the medial meniscus and the medial condyle HC (88% and 76%, respectively). No differences were found between patients with and without CPPD regarding ultrasound signs of inflammation. CONCLUSION Ultrasound demonstrated to be an accurate tool for discriminating CPPD. No differences were found between patents with OA alone and CPPD plus OA regarding inflammation.
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Affiliation(s)
- Georgios Filippou
- Section of Rheumatology, Department of Medical Sciences, University of Ferrara, Ferrara, Italy .,Rheumatology Department, Luigi Sacco University Hospital, Milano, Italy
| | - Anna Scanu
- Department of Medicine-DIMED, Rheumatology Unit, University of Padova, Padova, Italy
| | - Antonella Adinolfi
- Rheumatology Department, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | - Carmela Toscano
- Rheumatology Department, Azienda Ospedaliera Regionale San Carlo, Potenza, Italy
| | - Dario Gambera
- Orthopedics Department, Rugani Hospital, Monteriggioni, Italy
| | - Raquel Largo
- Joint and Bone Research Unit, Rheumatology Department, IIS-Fundacion Jimenez Diaz, Madrid, Spain
| | - Esperanza Naredo
- Department of Rheumatology and Joint and Bone Research Unit, Hospital Universitario Fundacion Jimenez Diaz, Madrid, Spain
| | - Emilio Calvo
- Department of Orthopaedic Surgery, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - Gabriel Herrero-Beaumont
- Department of Rheumatology and Joint and Bone Research Unit, Hospital Universitario Fundacion Jimenez Diaz, Madrid, Spain
| | - Pascal Zufferey
- Rheumatology Department, University of Lausanne, CHUV, Lausanne, Switzerland
| | | | - Daryl K MacCarter
- Rheumatology Department, North Valley Hospital, Whitefish, Montana, USA
| | - Stanley Makman
- Rheumatology Department, North Valley Hospital, Whitefish, Montana, USA
| | - Zachary Weber
- Rheumatology Department, North Valley Hospital, Whitefish, Montana, USA
| | - Fabiana Figus
- Rheumatology Unit, Department of Clinical and Biological Sciences, Università degli Studi di Torino, Torino, Italy
| | - Ingrid Möller
- Rheumatology, Instituto Poal de Reumatologia, Barcelona, Spain
| | - Marwin Gutierrez
- Rheumatology Department, Instituto Nacional de Rehabilitacion, Mexico, Mexico
| | - Carlos Pineda
- Rheumatology Department, Instituto Nacional de Rehabilitacion, Mexico, Mexico
| | | | - Hector Garcia
- Rheumatology Department, Instituto Nacional de Rehabilitacion, Mexico, Mexico
| | - Victor Ilizaliturri
- Rheumatology Department, Instituto Nacional de Rehabilitacion, Mexico, Mexico
| | | | - Raul Pichardo
- Rheumatology Department, Instituto Nacional de Rehabilitacion, Mexico, Mexico
| | | | - Emilio Filippucci
- Rheumatology Unit, Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, Ancona, Italy
| | - Edoardo Cipolletta
- Rheumatology Unit, Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, Ancona, Italy
| | - Teodora Serban
- Rheumatology Department, Carol Davila University, Bucharest, Romania
| | - Catalin Cirstoiu
- Rheumatology Department, Carol Davila University, Bucharest, Romania
| | - Florentin Ananu Vreju
- Rheumatology Department, University of Medicine and Pharmacy of Craiova, Craiova, Romania
| | - Dan Grecu
- Rheumatology Department, University of Medicine and Pharmacy of Craiova, Craiova, Romania
| | - Gaël Mouterde
- Rheumatology, University of Montpellier, Montpellier, France
| | - Marcello Govoni
- Section of Rheumatology, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Leonardo Punzi
- Department of Medicine, Ospedale SS Giovanni e Paolo Venezia, Venezia, Italy
| | - Nemanja S Damjanov
- Rheumatology, University of Belgrade School of Medicine, Belgrade, Serbia.,Institute of Rheumatology, University of Belgrade, Belgrade, Serbia
| | - Helen Isobel Keen
- Medicine and Pharmacology Department, The University of Western Australia, Murdoch, Perth, Australia
| | - George Aw Bruyn
- Department of Rheumatology, Reumakliniek Lelystad, Lelystad, The Netherlands
| | - Lene Terslev
- Center for Rheumatology and Spine Diseases, Rigshospitalet, Copenhagen University, Copenhagen, Denmark
| | - Maria-Antonietta D'Agostino
- Infection et inflammation, Laboratory of Excellence INFLAMEX, Université Paris-Saclay, Montigny-Le-Bretonneux, France.,Rheumatology, Ambroise Paré Hospital, Boulogne-Billancourt, France
| | - Carlo Alberto Scirè
- Section of Rheumatology, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Annamaria Iagnocco
- Rheumatology Unit, Department of Clinical and Biological Sciences, Università degli Studi di Torino, Torino, Italy
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Knee effusion evaluated by ultrasonography warns knee osteoarthritis patients to develop their muscle atrophy: a three-year cohort study. Sci Rep 2020; 10:8444. [PMID: 32439881 PMCID: PMC7242413 DOI: 10.1038/s41598-020-65368-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 04/29/2020] [Indexed: 11/08/2022] Open
Abstract
This study aimed to elucidate the relationship between the quantitative value of suprapatellar effusion and the longitudinal changes in lower-extremity muscle mass (MM) in a cohort with knee osteoarthritis (KOA). Fifty-three subjects (106 legs) with bilateral radiographic KOA at baseline (BL) were enrolled. MM was calculated by bioimpedance analysis three times at BL, and at the one-year (1Y) and three-year (3Y) follow-ups. The longitudinal change in the lower-extremity MM was calculated by subtracting MMBL from MM1Y, and MM1Y from MM3Y. Subjects with ≥1.0 z-score loss were defined as having severe MM loss (SMML). Effusion was evaluated as the sagittal area of suprapatellar pouch (mm2) by ultrasonography. The ROC curve was drawn to determine the cut-off of effusion area. General estimating equations (GEEs) were conducted with the prevalence of SMML as the dependent variable and with the cut-off of effusion area as the independent variable. Sixteen legs (15.1%) demonstrated SMMLBL-1Y and another sixteen legs demonstrated SMML1Y-3Y. GEEs revealed that individuals with ≥90 mm2 effusion had significantly higher odds of SMMLBL-1Y prevalence (Odds ratio: 21.561; P-value: 0.003). Individuals with leachate knee effusion at BL had a significant risk of losing MM through the first year of the initial knee effusion assessment.
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Oo WM, Linklater JM, Bennell KL, Pryke D, Yu S, Fu K, Wang X, Duong V, Hunter DJ. Are OMERACT Knee Osteoarthritis Ultrasound Scores Associated With Pain Severity, Other Symptoms, and Radiographic and Magnetic Resonance Imaging Findings? J Rheumatol 2020; 48:270-278. [PMID: 32414954 DOI: 10.3899/jrheum.191291] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/28/2020] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To investigate the associations of Outcome Measures in Rheumatology (OMERACT) ultrasound scores for knee osteoarthritis (OA) with pain severity, other symptoms, and OA severity on radiographs and magnetic resonance imaging (MRI). METHODS Participants with symptomatic and mild to moderate radiographic knee OA underwent baseline dynamic ultrasound (US) assessment according to standardized OMERACT scanning protocol. Using the published US image atlas, a physician operator obtained semiquantitative or binary scores for US pathologies. Clinical severity was measured on numerical rating scale (NRS) and Knee Injury and Osteoarthritis Outcome Score (KOOS) symptoms and pain subscores. OA severity was assessed using the Kellgren-Lawrence (KL) grade on radiographs and MRI Osteoarthritis Knee Score (MOAKS) on noncontrast-enhanced MRI. Separate linear regression models were used to determine associations of US OA pathologies with pain and KOOS subscores, and Spearman correlations were used for US scores with KL grade and MOAKS. RESULTS Eighty-nine participants were included. Greater synovial hypertrophy, power Doppler (PD), and meniscal extrusion scores were associated with worse NRS pain [β 0.92 (95% CI 0.25-1.58), β 0.73 (95% CI 0.11-1.35), and β 1.01 (95% CI 0.22-1.80), respectively]. All greater US scores, except for cartilage grade, demonstrated significant associations with worse KOOS symptoms, whereas only PD and meniscal extrusion were associated with worse KOOS pain. All US scores, except for PD, were significantly correlated with KL grade. US pathologies, except for cartilage, revealed moderate to good correlation with their MOAKS counterparts, with US synovitis having the greatest correlation (0.69, 95% CI 0.60-0.78). CONCLUSION OMERACT US scores revealed significant associations with pain severity, KL grade, and MOAKS.
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Affiliation(s)
- Win Min Oo
- W.M. Oo, PhD, S. Yu, FRACP, K. Fu, PhD, X. Wang, PhD, V. Duong, DPT, D.J. Hunter, PhD, Rheumatology Department, Royal North Shore Hospital and Institute of Bone and Joint Research, Kolling Institute, University of Sydney, Sydney;
| | - James M Linklater
- J.M. Linklater, FRANZCR, D. Pryke, Grad Dip Medical Sonography, Department of Musculoskeletal Imaging, Castlereagh Sports Imaging Center, St. Leonards, Sydney
| | - Kim L Bennell
- K.L. Bennell, PhD, Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, Faculty of Medicine Dentistry & Health Sciences, The University of Melbourne, Melbourne, Australia
| | - Danielle Pryke
- J.M. Linklater, FRANZCR, D. Pryke, Grad Dip Medical Sonography, Department of Musculoskeletal Imaging, Castlereagh Sports Imaging Center, St. Leonards, Sydney
| | - Shirley Yu
- W.M. Oo, PhD, S. Yu, FRACP, K. Fu, PhD, X. Wang, PhD, V. Duong, DPT, D.J. Hunter, PhD, Rheumatology Department, Royal North Shore Hospital and Institute of Bone and Joint Research, Kolling Institute, University of Sydney, Sydney
| | - Kai Fu
- W.M. Oo, PhD, S. Yu, FRACP, K. Fu, PhD, X. Wang, PhD, V. Duong, DPT, D.J. Hunter, PhD, Rheumatology Department, Royal North Shore Hospital and Institute of Bone and Joint Research, Kolling Institute, University of Sydney, Sydney
| | - Xia Wang
- W.M. Oo, PhD, S. Yu, FRACP, K. Fu, PhD, X. Wang, PhD, V. Duong, DPT, D.J. Hunter, PhD, Rheumatology Department, Royal North Shore Hospital and Institute of Bone and Joint Research, Kolling Institute, University of Sydney, Sydney
| | - Vicky Duong
- W.M. Oo, PhD, S. Yu, FRACP, K. Fu, PhD, X. Wang, PhD, V. Duong, DPT, D.J. Hunter, PhD, Rheumatology Department, Royal North Shore Hospital and Institute of Bone and Joint Research, Kolling Institute, University of Sydney, Sydney
| | - David J Hunter
- W.M. Oo, PhD, S. Yu, FRACP, K. Fu, PhD, X. Wang, PhD, V. Duong, DPT, D.J. Hunter, PhD, Rheumatology Department, Royal North Shore Hospital and Institute of Bone and Joint Research, Kolling Institute, University of Sydney, Sydney
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13
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Sánchez Barrancos IM, Manso García S, Lozano Gago P, Hernández Rodríguez T, Conangla Ferrín L, Ruiz Serrano AL, González Santisteban R. [Usefulness and reliabitlity of musculoskeletal point of care ultrasound in family practice (2): Muscle injuries, osteoarthritis, rheumatological diseases and eco-guided procedures]. Aten Primaria 2019; 51:105-117. [PMID: 30591207 PMCID: PMC6837044 DOI: 10.1016/j.aprim.2018.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Accepted: 07/02/2018] [Indexed: 11/30/2022] Open
Abstract
This article is a continuation of the review initiated in the previous issue about the usefulness of musculoskeletal point of care ultrasound in Primary Care, completing the scenarios of muscle injuries, osteoarthritis, rheumatological diseases and eco-guided procedures.
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Affiliation(s)
- Ignacio Manuel Sánchez Barrancos
- Miembro del Grupo de Trabajo de Ecografía de la Sociedad Española de Medicina Familiar y Comunitaria; Consultorio Local de Membrilla, Centro de Salud Manzanares 2, Gerencia de Atención Integrada de Manzanares, Ciudad Real, España.
| | | | - Pedro Lozano Gago
- Miembro del Grupo de Trabajo de Ecografía de la Sociedad Española de Medicina Familiar y Comunitaria; Departamento de Salud Alicante -San Joan, Centro de Salud Mutxamel, Alicante, España
| | - Trinidad Hernández Rodríguez
- Miembro del Grupo de Trabajo de Ecografía de la Sociedad Española de Medicina Familiar y Comunitaria; Sector Sanitario Alcañiz, Centro de Salud Andorral, Terue, España
| | - Laura Conangla Ferrín
- Miembro del Grupo de Trabajo de Ecografía de la Sociedad Española de Medicina Familiar y Comunitaria; EAP Badalona2. Centre Dalt La Villa. Badalona. Barcelona, España
| | - Antonio Lorenzo Ruiz Serrano
- Miembro del Grupo de Trabajo de Ecografía de la Sociedad Española de Medicina Familiar y Comunitaria; Centro de Salud Ciudad Real 3, Gerencia de Atención Integrada de Ciudad Real, Ciudad Real, España
| | - Roberto González Santisteban
- Miembro del Grupo de Trabajo de Ecografía de la Sociedad Española de Medicina Familiar y Comunitaria; Comarca Interior de Osakidetza, Consultorio de Ayala (Luyando-Respladiza), Álava, España
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Mosalem DM, Alghunaim SM, Shehab DK, Baqer AB, Alfeeli AK, Ahmed MM. Soft Tissue Pathology Detected By Ultrasound Seem To Be Risk Factors for Painful Flare in Osteoarthritic Knee. Open Access Maced J Med Sci 2018; 6:1599-1605. [PMID: 30337972 PMCID: PMC6182512 DOI: 10.3889/oamjms.2018.237] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2018] [Revised: 07/23/2018] [Accepted: 07/24/2018] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND: To our knowledge, the importance of US findings, pain (brief pain inventory (BPI)) and disability in osteoarthritic knee (OA) pain patients remain uncertain. AIM: The objectives are to evaluate the correlation of US findings, pain (brief pain inventory (BPI)) and disability in OA pain patients. MATERIALS AND METHODS: Eighty - three patients with OA knee were divided into two groups. The first group was OA as symptomatic knee group and the second group was an asymptomatic control group. The maximum sagittal height of synovial fluid in 12 scans at 0, 30, 60 and 90 degrees flexion knee in 3 major recesses were measured. RESULTS: There were a significant positive correlation between BPI Pain severity index, or BPI function interference index and a maximum height of effusion at 30-degree flexion angle in a supra-patellar recess in painful symptomatic knees. But, there was a significant negative correlation between BPI Pain severity index, and BPI function interference index and cartilage thickness in painful symptomatic knees. CONCLUSION: The increase of maximum height of synovial effusion at different angles of knee and decrease of cartilage thickness associated with pain and disability in OA pain patients and are being predictors for pain severity and disability in OA pain patients.
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Affiliation(s)
- Douaa M Mosalem
- Physical Medicine and Rehabilitation Departments, Al-Razi Hospital, Kuwait
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Evaluation of the Curative Effect of Umbilical Cord Mesenchymal Stem Cell Therapy for Knee Arthritis in Dogs Using Imaging Technology. Stem Cells Int 2018; 2018:1983025. [PMID: 29861739 PMCID: PMC5976915 DOI: 10.1155/2018/1983025] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 03/22/2018] [Accepted: 03/29/2018] [Indexed: 12/24/2022] Open
Abstract
Objective The aim of this study was to assess the efficacy of canine umbilical cord mesenchymal stem cells (UC-MSCs) on the treatment of knee osteoarthritis in dogs. Methods Eight dogs were evenly assigned to two groups. The canine model of knee osteoarthritis was established by surgical manipulation of knee articular cartilage on these eight dogs. UC-MSCs were isolated from umbilical cord Wharton's jelly by 0.1% type collagenase I and identified by immunofluorescence staining and adipogenic and osteogenic differentiation in vitro. A suspension of allogeneic UC-MSCs (1 × 106) and an equal amount of physiological saline was injected into the cavitas articularis in the treated and untreated control groups, respectively, on days 1 and 3 posttreatment. The structure of the canine knee joint was observed by magnetic resonance imaging (MRI), B-mode ultrasonography, and X-ray imaging at the 3rd, 7th, 14th, and 28th days after treatment. Concurrently, the levels of IL-6, IL-7, and TNF-α in the blood of the examined dogs were measured. Moreover, the recovery of cartilage and patella surface in the treated group and untreated group was compared using a scanning electron microscope (SEM) after a 35-day treatment. Results Results revealed that the isolated cells were UC-MSCs, because they were positive for CD44 and negative for CD34 surface markers, and the cells were differentiated into adipocytes and osteoblasts. Imaging technology showed that as treatment time increased, the high signal in the MRI T2-weighted images decreased, the echo-free space in B ultrasonography images disappeared basically, and the continuous linear hypoechoic region at the trochlear sulcus thickened. On X-ray images, the serrate defect at the ventral cortex of the patella improved, and the low-density gap of the ventral patella and trochlear crest gradually increased in the treated group. On the contrary, the high signal in the MRI T2-weighted images and the echo-free space in B ultrasonography images still increased after a 14-day treatment in the untreated control group, and the linear hypoechoic region was discontinuous. On the X-ray images, there was no improvement in the serrate defect of the ventral cortex of the patella. Results for inflammatory factors showed that the blood levels of IL-6, IL-7, and TNF-α of the untreated control group were significantly higher than those of the treated group (P < 0.05) 7-14 days posttreatment. The result of SEM showed that the cartilage neogenesis in the treated group had visible neonatal tissue and more irregular arrangement of new tissue fibers than that of the untreated control group. Furthermore, more vacuoles but without collagen fibers were observed in the cartilage of the untreated control group, and the thickness of the neogenetic cartilage in the treated group (65.13 ± 5.29, 65.30 ± 5.83) and the untreated control group (34.27 ± 5.42) showed a significant difference (P < 0.01). Conclusion Significantly higher improvement in cartilage neogenesis and recovery was observed in the treated group compared to the untreated control group. The joint fluid and the inflammatory response in the treated group decreased. Moreover, improved recovery in the neogenetic cartilage, damaged skin fascia, and muscle tissue around the joints was more significant in the treated group than in the untreated control group. In conclusion, canine UC-MSCs promote the repair of cartilage and patella injury in osteoarthritis, improve the healing of the surrounding tissues, and reduce the inflammatory response.
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Hafezi-Nejad N, Demehri S, Guermazi A, Carrino JA. Osteoarthritis year in review 2017: updates on imaging advancements. Osteoarthritis Cartilage 2018; 26:341-349. [PMID: 29330100 DOI: 10.1016/j.joca.2018.01.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Revised: 12/24/2017] [Accepted: 01/03/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE This narrative review covers original research publications related to imaging advancements in osteoarthritis (OA) published in the English language between 1st April 2016 and 30th April 2017. METHODS Relevant human studies (excluding pre-clinical and in vitro studies), were searched and selected from PubMed database using the search terms of "osteoarthritis (OA)" in combination with "radiography", "magnetic resonance imaging (MRI)", "computed tomography (CT)", "ultrasound", "positron emission tomography (PET)," "single-photon emission computed tomography (SPECT)," and "scintigraphy". The included studies were sorted according to their relevance, novelty, and impact. Original research articles with both imaging advancements and novel clinical information were discussed in this review. RESULTS A large portion of the published studies were focused on MRI-based semi-quantitative and quantitative (morphological and structural) metrics of the knee joint to assess OA-related structural damages. New imaging technologies, such as PET, have been investigated for OA diagnosis and characterization, the delineation of predictive factors for OA progression, and to monitor the treatment responses. CONCLUSION Advanced imaging modalities play a pivotal role in OA research, and make a significant contribution to our understanding of OA diagnosis, pathogenesis, risk stratification, and prognosis.
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Affiliation(s)
- N Hafezi-Nejad
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, MD, USA
| | - S Demehri
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, MD, USA
| | - A Guermazi
- Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine, Boston, MA, India
| | - J A Carrino
- Department of Radiology and Imaging, Hospital for Special Surgery, New York, NY, USA.
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Meniscal extrusion seen on ultrasonography affects the development of radiographic knee osteoarthritis: a 3-year prospective cohort study. Clin Rheumatol 2017; 36:2557-2564. [DOI: 10.1007/s10067-017-3803-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Revised: 08/04/2017] [Accepted: 08/23/2017] [Indexed: 10/18/2022]
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Trouvin AP, Perrot S. Pain in osteoarthritis. Implications for optimal management. Joint Bone Spine 2017; 85:429-434. [PMID: 28889010 DOI: 10.1016/j.jbspin.2017.08.002] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Accepted: 08/24/2017] [Indexed: 02/08/2023]
Abstract
Pain is an ubiquitous symptom in osteoarticular diseases, occurring much more commonly than stiffness or disability. OA of the knee, hand, or hip affects around 20% of adults in various populations and is dramatically increasing in many countries, mostly related to age and obesity, leading to an increased number of people having OA pain, and creating a huge burden related to disability and health care costs. OA-related pain, has been classically considered to be a nociceptive pain condition. Clinicians have considered pain to be an alarm signal, correlated to the intensity of joint degradation. In OA, most authors have focused their studies on joint architecture and local degradation, considering pain as only a symptom, a consequence of joint damage. However, OA-related pain is a specific disease, with a complex pathophysiology, including neuropathic peripheral and central abnormalities, together with local inflammation involving all joint structures. Clinical findings emphasize that it is not a stable and linear condition, that pain experience is independent of structural modifications, and that the quality of pain in OA is important to consider, aside from its intensity. OA-related pain is modulated by many factors, including the individual patient's psychological and genetic factors, as well as the theoretical role of meteorological influences. Recent neuroimaging findings have improved our knowledge about central mechanisms of OA pain, especially in persistent cases.
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Affiliation(s)
- Anne-Priscille Trouvin
- Pain Department, Cochin-Hôtel Dieu Hospital, Assistance Publique-Hôpitaux de Paris, 75014 Paris, France; Inserm U987, Paris Descartes University, 75014 Paris, France
| | - Serge Perrot
- Pain Department, Cochin-Hôtel Dieu Hospital, Assistance Publique-Hôpitaux de Paris, 75014 Paris, France; Inserm U987, Paris Descartes University, 75014 Paris, France.
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Abd El Monaem SM, Hashaad NI, Ibrahim NH. Correlations between ultrasonographic findings, clinical scores, and depression in patients with knee osteoarthritis. Eur J Rheumatol 2017; 4:205-209. [PMID: 28983413 DOI: 10.5152/eurjrheum.2017.160097] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2016] [Accepted: 04/29/2017] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVE This study aimed to explore correlations between the presence of depression, clinical scores, and ultrasonographic (US) grading in osteoarthritis (OA) patients and to clarify if depressive symptoms might cause a discrepancy between US findings and clinical scores. MATERIAL AND METHODS Two hundred patients with primary knee OA and 100 healthy hospital volunteers of the same age and sex not complaining of knee troubles participated in this study. We evaluated depressive symptoms in all participants using the Beck Depression Inventory (BDI) scale. Thorough clinical examination was performed, including assessment using the Western Ontario and McMaster Universities Osteoarthritis index (WOMAC) for disability. All patients underwent US examination of their affected knees. RESULTS Depression was detected in 60 patients with knee OA (30%) and in 5 controls (5%). The mean of BDI score was 12.8±12.2 in OA patients and 5.8±3.2 in controls, and this difference was statistically significant (p=0.03). Correlations of BDI with both body mass index (BMI) (p=0.04) and Numerical Rating Scale of Pain (NRSP) score (p=0.006) were significant, while correlations of BDI with both the ages of our patients (p=0.74) and their disease duration (p=0.88) were insignificant. There were statistically significant correlations between patients' disease duration and US measurements regarding osteophyte length, lateral femoral cartilage thickness, medial femoral cartilage thickness, and thickness of the quadriceps tendon despite of the presence of insignificant correlations between disease duration and both the effusion volume and volume of Baker's cysts. There were statistically significant correlations between patients' disease duration and US measurements except for effusion volume and volume of Baker's cysts. There were statistically significant correlations between the NRSP score in OA patients and BDI (p=0.006) and all US measurements apart from lateral femoral cartilage thickness, medial femoral cartilage thickness, and thickness of quadriceps tendon. There were statistically significant correlations between BDI in OA patients and the WOMAC (p=0.005), Kellgren-Lawrence (KL) grading (p=0.034), and US grading (p=0.041). CONCLUSION The presence of knee effusion, Baker's cysts, osteophytes, and high BMI have a great impact on the pain and disability associated with OA. Higher clinical scores, radiographic scores, and US scores correlate with the emergence of depression in OA patients.
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Affiliation(s)
- Samia M Abd El Monaem
- Department of Rheumatology, Rehabilitation & Physical Medicine, Benha University School of Medicine, Benha, Egypt
| | - Nashwa Ismail Hashaad
- Department of Rheumatology, Rehabilitation & Physical Medicine, Benha University School of Medicine, Benha, Egypt
| | - Noha Hosni Ibrahim
- Department of Rheumatology, Rehabilitation & Physical Medicine, Benha University School of Medicine, Benha, Egypt
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