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McAlindon TE, Hunnicutt JL, Roberts MB, Haugen IK, Schaefer LF, Driban JB, Lu B, Duryea J, Smith SE, Booth SL, Petty GA, Mathiessen A, Zeng L, Eaton C. Associations of inflammatory and metabolic biomarkers with incident erosive hand osteoarthritis in the osteoarthritis initiative cohort. Osteoarthritis Cartilage 2024:S1063-4584(24)00025-6. [PMID: 38311107 DOI: 10.1016/j.joca.2023.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 10/19/2023] [Accepted: 10/30/2023] [Indexed: 02/06/2024]
Abstract
OBJECTIVE Erosive hand osteoarthritis (eHOA) is a subtype of hand osteoarthritis (OA) that develops in finger joints with pre-existing OA and is differentiated by clinical characteristics (hand pain/disability, inflammation, and erosions) that suggest inflammatory or metabolic processes. METHOD This was a longitudinal nested case-cohort design among Osteoarthritis Initiative participants who had hand radiographs at baseline and 48-months, and biospecimens collected at baseline. We classified incident radiographic eHOA in individuals with ≥1 joint with Kellgren-Lawrence ≥2 and a central erosion present at 48-months but not at baseline. We used a random representative sample (n = 1282) for comparison. We measured serum biomarkers of inflammation, insulin resistance and dysglycemia, and adipokines using immunoassays and enzymatic colorimetric procedures, blinded to case status. RESULTS Eighty-six participants developed incident radiographic eHOA. In the multivariate analyses adjusted for age, gender, race, smoking, and body mass index, and after adjustment for multiple analyses, incident radiographic eHOA was associated with elevated levels of interleukin-7 (risk ratio (RR) per SD = 1.30 [95% confidence interval (CI) 1.09, 1.55] p trend 0.01). CONCLUSION This exploratory study suggests an association of elevated interleukin-7, an inflammatory cytokine, with incident eHOA, while other cytokines or biomarkers of metabolic inflammation were not associated. Interleukin-7 may mediate inflammation and tissue damage in susceptible osteoarthritic finger joints and participate in erosive progression.
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Affiliation(s)
- Timothy E McAlindon
- Division of Rheumatology, Allergy, and Immunology, Tufts Medical Center, Boston, MA, USA.
| | | | - Mary B Roberts
- Care New England Medical Group/Primary Care and Specialty Services, Pawtucket, RI, USA.
| | - Ida K Haugen
- Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway.
| | - Lena F Schaefer
- Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
| | - Jeffrey B Driban
- Division of Rheumatology, Allergy, and Immunology, Tufts Medical Center, Boston, MA, USA.
| | - Bing Lu
- UConn Health, University of Connecticut, Farmington, CT, USA.
| | - Jeffrey Duryea
- Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
| | - Stacy E Smith
- Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
| | - Sarah L Booth
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA.
| | - Gayle A Petty
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA.
| | - Alexander Mathiessen
- Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
| | - Li Zeng
- Department of Integrative Physiology and Pathobiology, School of Medicine, Tufts University, Boston, MA, USA.
| | - Charles Eaton
- Care New England Medical Group/Primary Care and Specialty Services, Pawtucket, RI, USA.
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Logli AL, Evans CH, Duryea J, Larson DR, Bakri K, Carlsen BT, Dennison DG, Karim KE, Pulos NA, Rhee PC, Rizzo M, Shin AY, Elhassan BT, Kakar S. Investigation Into the Effects of Intra-Articular Steroid on Post-Traumatic Osteoarthritis in Distal Radius Fractures: A Randomized Controlled Pilot Study. J Hand Surg Am 2024:S0363-5023(23)00645-7. [PMID: 38180412 DOI: 10.1016/j.jhsa.2023.11.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 11/21/2023] [Accepted: 11/22/2023] [Indexed: 01/06/2024]
Abstract
PURPOSE The aim of this prospective, randomized, controlled, double-blinded pilot study was to determine the rates of post-traumatic osteoarthritis and assess joint space width in the presence or absence of a single intra-articular injection of corticosteroid after an acute, intra-articular distal radius fracture (DRF). METHODS Forty patients received a single, intra-articular, radiocarpal joint injection of 4 mg of dexamethasone (DEX) (n = 19) or normal saline placebo (n = 21) within 2 weeks of a surgically or nonsurgically treated intra-articular DRF. The primary outcome measure was minimum radiocarpal joint space width (mJSW) on noncontrast computed tomography scans at 2 years postinjection. Secondary outcomes were obtained at 3 months, 6 months, 1 year, and 2 years postinjection and included Disabilities of the Arm, Shoulder, and Hand; Michigan Hand Questionnaire; Patient-Rated Wrist Evaluation; wrist range of motion; and grip strength. RESULTS At 2-year follow-up, there was no difference in mean mJSW between the DEX group (2.2 mm; standard deviation, 0.6; range, 1.4-3.2) and the placebo group (2.3 mm; standard deviation, 0.7; range, 0.9-3.9). Further, there were no differences in any secondary outcome measures at any postinjection follow-up interval. CONCLUSIONS Radiocarpal joint injection of corticosteroid within 2 weeks of an intra-articular DRF does not appear to affect the development of post-traumatic osteoarthritis within 2 years follow-up in a small pilot cohort. TYPE OF STUDY/LEVEL OF EVIDENCE Therapeutic II.
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Affiliation(s)
| | | | - Jeffrey Duryea
- Department of Orthopedic Radiology, Harvard Medical School, Boston, MA
| | - Dirk R Larson
- Department of Clinical Trials and Biostatistics, Mayo Clinic, Rochester, MN
| | - Karim Bakri
- Department of Plastic and Reconstructive Surgery, Mayo Clinic, Rochester, MN
| | - Brian T Carlsen
- Department of Plastic and Reconstructive Surgery, Mayo Clinic, Rochester, MN
| | | | - Kristin E Karim
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN
| | | | - Peter C Rhee
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN
| | - Marco Rizzo
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN
| | | | - Bassem T Elhassan
- Department of Orthopedic Surgery, Harvard Medical School, Boston, MA
| | - Sanjeev Kakar
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN.
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Smith SE, Bahouth SM, Duryea J. Quantitative bone marrow lesion, meniscus, and synovitis measurement: current status. Skeletal Radiol 2023; 52:2123-2135. [PMID: 36928478 DOI: 10.1007/s00256-023-04311-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 02/21/2023] [Accepted: 02/22/2023] [Indexed: 03/18/2023]
Abstract
Imaging plays a pivotal role in osteoarthritis research, particularly in epidemiological and clinical trials of knee osteoarthritis (KOA), with the ultimate goal being the development of an effective drug treatment for future prevention or cessation of disease. Imaging assessment methods can be semi-quantitative, quantitative, or a combination, with quantitative methods usually relying on software to assist. The software generally attempts image segmentation (outlining of relevant structures). New techniques using artificial intelligence (AI) or deep learning (DL) are currently a frequent topic of research. This review article provides an overview of the literature to date, focusing primarily on the current status of quantitative software-based assessment techniques of KOA using magnetic resonance (MR) imaging. We will concentrate on the imaging evaluation of three specific structural imaging biomarkers: bone marrow lesions (BMLs), meniscus, and synovitis consisting of effusion synovitis (ES) and Hoffa's synovitis (HS). A brief clinical and imaging background review of osteoarthritis evaluation, particularly relating to these three structural markers, is provided as well as a general summary of the software methods. A summary of the literature with respect to each KOA assessment method will be presented overall as well as with respect to each specific biomarker individually. Novel techniques, as well as future goals and directions using quantitative imaging assessment, will be discussed.
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Affiliation(s)
- Stacy E Smith
- Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Neil and Elise Wallace STRATUS Center for Medical Simulation, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Sara M Bahouth
- Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Jeffrey Duryea
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
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Mathiessen A, Onuoha I, Luh R, Driban JB, Roberts MB, Eaton CB, McAlindon TE, Duryea J. Radiographic joint space width in individuals with hand osteoarthritis: Are their "healthy" joints really healthy? Osteoarthritis Cartilage 2023:S1063-4584(23)00947-0. [PMID: 37865135 DOI: 10.1016/j.joca.2023.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 10/08/2023] [Accepted: 10/09/2023] [Indexed: 10/23/2023]
Abstract
OBJECTIVES We aimed to investigate the systemic nature of hand osteoarthritis (OA). We hypothesized that people who suffer from hand OA would display narrower radiographic joint space width (JSW) - not only in joints with apparent radiographic OA but also in their unaffected "healthy" joints. METHOD We examined 3394 participants from the Osteoarthritis Initiative with available dominant hand radiographs at baseline. Cases were defined as having interphalangeal OA (IPOA) based on a Kellgren and Lawrence (KL) score of ≥2 in two or more finger joints, whereas controls did not have IPOA. We used custom software to make JSW measurements of the metacarpophalangeal, proximal interphalangeal, and distal interphalangeal joints in fingers 2-5 per hand. In joint-level analyses, we included only KL score=0, allowing us to compare all joints without IPOA in cases and controls. We used generalized estimating equation models to compare JSW between both groups, adjusted for age, gender, metacarpal length, and joint type. RESULTS Finger joints without radiographic OA had significantly narrower JSW in the IPOA group compared to finger joints in the control group (p < 0.001). The differences were significant across all joint types and for both total JSW measurements as well as for central and lateral sub-regions within each joint group (p < 0.001). CONCLUSION Unaffected finger joints in people with IPOA had narrower joint space than joints of healthy controls. This implies a systemic nature of hand OA, in which people may have a predisposition for general cartilage deterioration.
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Affiliation(s)
- Alexander Mathiessen
- Brigham and Women's Hospital, Boston, MA, USA; Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
| | | | - Rebecca Luh
- Brigham and Women's Hospital, Boston, MA, USA
| | | | - Mary B Roberts
- Center for Primary Care and Prevention, Kent Hospital, Warwick, RI, USA
| | - Charles B Eaton
- Department of Family Medicine Warren Alpert Medical School of Brown University, Providence, RI, USA; Department of Epidemiology, School of Public Health of Brown University, Providence, RI, USA
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Torres AJF, Duryea J, McDonald OG. Pancreatic cancer epigenetics: adaptive metabolism reprograms starving primary tumors for widespread metastatic outgrowth. Cancer Metastasis Rev 2023; 42:389-407. [PMID: 37316634 PMCID: PMC10591521 DOI: 10.1007/s10555-023-10116-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 06/05/2023] [Indexed: 06/16/2023]
Abstract
Pancreatic cancer is a paradigm for adaptation to extreme stress. That is because genetic drivers are selected during tissue injury with epigenetic imprints encoding wound healing responses. Ironically, epigenetic memories of trauma that facilitate neoplasia can also recreate past stresses to restrain malignant progression through symbiotic tumor:stroma crosstalk. This is best exemplified by positive feedback between neoplastic chromatin outputs and fibroinflammatory stromal cues that encase malignant glands within a nutrient-deprived desmoplastic stroma. Because epigenetic imprints are chemically encoded by nutrient-derived metabolites bonded to chromatin, primary tumor metabolism adapts to preserve malignant epigenetic fidelity during starvation. Despite these adaptations, stromal stresses inevitably awaken primordial drives to seek more hospitable climates. The invasive migrations that ensue facilitate entry into the metastatic cascade. Metastatic routes present nutrient-replete reservoirs that accelerate malignant progression through adaptive metaboloepigenetics. This is best exemplified by positive feedback between biosynthetic enzymes and nutrient transporters that saturate malignant chromatin with pro-metastatic metabolite byproducts. Here we present a contemporary view of pancreatic cancer epigenetics: selection of neoplastic chromatin under fibroinflammatory pressures, preservation of malignant chromatin during starvation stresses, and saturation of metastatic chromatin by nutritional excesses that fuel lethal metastasis.
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Affiliation(s)
- Arnaldo J Franco Torres
- Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine, Rosenstiel Medical Sciences Building Room 4086A, Miami, FL, USA
| | - Jeffrey Duryea
- Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine, Rosenstiel Medical Sciences Building Room 4086A, Miami, FL, USA
| | - Oliver G McDonald
- Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine, Rosenstiel Medical Sciences Building Room 4086A, Miami, FL, USA.
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA.
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Gilles G, Vohra A, Robles D, Taljanovic MS, Ashbeck EL, Caruso C, Duryea J, Bedrick EJ, Guermazi A, Kwoh CK. Reliability and Validity of Single Axial Slice vs. Multiple Slice Quantitative Measurement of the Volume of Effusion-Synovitis on 3T Knee MRI in Knees with Osteoarthritis. J Clin Med 2023; 12:jcm12072691. [PMID: 37048775 PMCID: PMC10095125 DOI: 10.3390/jcm12072691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 03/18/2023] [Accepted: 03/28/2023] [Indexed: 04/07/2023] Open
Abstract
Effusion-synovitis (ES) is recognized as a component of osteoarthritis, creating a need for rapid methods to assess ES on MRI. We describe the development and reliability of an efficient single-slice semi-automated quantitative approach to measure ES. We used two samples from the Osteoarthritis Initiative (OAI): 50 randomly selected OAI participants with radiographic osteoarthritis (i.e., Kellgren–Lawrence (KL) grade 2 or 3) and a subset from the Foundation for the National Institutes of Health Osteoarthritis Biomarker study. An experienced musculoskeletal radiologist trained four non-expert readers to use custom semi-automated software to measure ES on a single axial slice and then read scans blinded to prior assessments. The estimated intraclass correlation coefficient (ICC) for intra-reader reliability of the single-slice ES method in the KL 2–3 sample was 0.96 (95% CI: 0.93, 0.97), and for inter-reader reliability, the ICC was 0.90 (95% CI: 0.87, 0.95). The intra-reader mean absolute difference (MAD) was 35 mm3 (95% CI: 28, 44), and the inter-reader MAD was 61 mm3 (95% CI: 48, 76). Our single-slice quantitative knee ES measurement offers a reliable, valid, and efficient surrogate for multi-slice quantitative and semi-quantitative assessment.
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Affiliation(s)
- Greg Gilles
- University of Arizona Arthritis Center, University of Arizona College of Medicine, Tucson, AZ 85724, USA
| | - Arjun Vohra
- University of Arizona Arthritis Center, University of Arizona College of Medicine, Tucson, AZ 85724, USA
| | - Dagoberto Robles
- University of Arizona Arthritis Center, University of Arizona College of Medicine, Tucson, AZ 85724, USA
| | - Mihra S. Taljanovic
- University of Arizona Arthritis Center, University of Arizona College of Medicine, Tucson, AZ 85724, USA
- Departments of Medical Imaging and Orthopaedic Surgery, University of Arizona, Tucson, AZ 85719, USA
- Department of Radiology, University of New Mexico Health Sciences, Albuquerque, NM 87131, USA
| | - Erin L. Ashbeck
- University of Arizona Arthritis Center, University of Arizona College of Medicine, Tucson, AZ 85724, USA
| | - Chelsea Caruso
- University of Arizona Arthritis Center, University of Arizona College of Medicine, Tucson, AZ 85724, USA
- Tualatin Imaging P.C., Tualatin, OR 97062, USA
| | - Jeffrey Duryea
- Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Edward J. Bedrick
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA
| | - Ali Guermazi
- VA Boston Healthcare System, West Roxbury, Boston, MA 02132, USA
- Department of Radiology, Boston University School of Medicine, Boston, MA 02118, USA
| | - C. Kent Kwoh
- University of Arizona Arthritis Center, University of Arizona College of Medicine, Tucson, AZ 85724, USA
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Segal NA, Nevitt MC, Morales Aquino M, McFadden E, Ho M, Duryea J, Tolstykh I, Cheng H, He J, Lynch JA, Felson DT, Anderson DD. Improved responsiveness to change in joint space width over 24-month follow-up: comparison of 3D JSW on weight-bearing CT vs 2D JSW on radiographs in the MOST study. Osteoarthritis Cartilage 2023; 31:406-413. [PMID: 36526151 PMCID: PMC9974913 DOI: 10.1016/j.joca.2022.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 11/13/2022] [Accepted: 12/06/2022] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Radiographic joint space width (JSW) has been a standard for measuring knee osteoarthritis (OA) structural change. Limitations in the responsiveness of this approach might be overcome by instead measuring 3D JSW on weight-bearing CT (WBCT). This study compared the responsiveness of 3D JSW measurements using WBCT with the responsiveness of radiographic 2D JSW. DESIGN Standing, fixed-flexion knee radiographs (XR) and WBCT were acquired ancillary to the 144- and 168-month Multicenter Osteoarthritis Study visits. Tibiofemoral JSW was measured on both XR and WBCT. Responsiveness to change was defined by the standardized response mean (SRM) for change in JSW (1) at predetermined mediolateral locations (JSWx) on both modalities and (2) in the following subregions measured on WBCT images: central medial and lateral femur (CMF/CLF) and tibia (CMT/CLT), and anterior and posterior tibia (AMT/ALT, PMT/MLT). RESULTS Baseline and 24-month follow-up JSWx measurements were completed for 265 participants (58.1% women). Responsiveness of 3D JSWx for medial tibiofemoral compartment on coronal WBCT (SRM range: -0.18, -0.24) exceeded that for 2D JSWx (-0.10, -0.16). Responsiveness of 3D JSW subregional mean (-0.06, -0.36) and maximal (-1.14, -1.75) CMF and CMT and maximal CLF/CLT 3D JSW changes were statistically significantly greater in comparison with respective medial and lateral 2D JSWx (P ≤ 0.002). CONCLUSIONS Subregional 3D JSW on WBCT is substantially more responsive to 24-month changes in tibiofemoral joint structure compared to radiographic measurements. Use of subregional 3D JSW on WBCT could enable improved detection of OA structural progression over a 24-month duration in comparison with measurements made on XR.
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Affiliation(s)
- N A Segal
- University of Kansas Medical Center, Kansas City, KS, USA; The University of Iowa, Iowa City, IA, USA.
| | - M C Nevitt
- University of California-San Francisco, San Francisco, CA, USA
| | | | - E McFadden
- The University of Iowa, Iowa City, IA, USA
| | - M Ho
- The University of Iowa, Iowa City, IA, USA
| | - J Duryea
- Harvard University, Cambridge, MA, USA
| | - I Tolstykh
- University of California-San Francisco, San Francisco, CA, USA
| | - H Cheng
- University of Kansas Medical Center, Kansas City, KS, USA
| | - J He
- University of Kansas Medical Center, Kansas City, KS, USA
| | - J A Lynch
- University of California-San Francisco, San Francisco, CA, USA
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Nelson AE, Smith JA, Alvarez C, Arbeeva L, Renner JB, Murphy LB, Jordan JM, Golightly YM, Duryea J. Associations Between Baseline and Longitudinal Semiautomated Quantitative Joint Space Width at the Hip and Incident Hip Osteoarthritis: Data From a Community-Based Cohort. Arthritis Care Res (Hoboken) 2022; 74:1978-1988. [PMID: 34219398 PMCID: PMC8727661 DOI: 10.1002/acr.24742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Revised: 06/17/2021] [Accepted: 07/01/2021] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To evaluate quantitative joint space width (JSW) at 10-, 30-, and 50-degree locations in relation to incident radiographic and symptomatic hip osteoarthritis (HOA) in a community-based cohort. METHODS Data were from Johnston County OA Project participants with supine hip radiographs at each of 4 time points; all had Kellgren/Lawrence (K/L) grades and quantitative JSW. We assessed covariates (age, race, height, weight, body mass index [BMI]) associated with quantitative JSW and hip-level associations between quantitative JSW and HOA over time using sex-stratified and multivariable-adjusted linear mixed models. A cluster analysis with logistic regression estimated associations between quantitative JSW trajectory groups and incident radiographic HOA and symptomatic HOA. RESULTS At baseline, 397 participants (784 hips, 41% men, 24% Black, mean age 57 years) had a mean BMI of 29 kg/m2 . Over a mean of 18 years, 20% and 12% developed incident K/L grade-defined radiographic HOA or symptomatic HOA, respectively. Quantitative JSW was more sensitive to changes over time at 50 degrees. Values were stable among men but declined over time in women. Heavier women lost more quantitative JSW; changes in quantitative JSW were not significantly associated with race, education, or injury in women or men. In women only, loss of quantitative JSW over time was associated with 2-3 times higher odds of radiographic HOA and symptomatic HOA; among women and men, narrower baseline quantitative JSW was associated with these outcomes. CONCLUSION Hip quantitative JSW demonstrates marked differences in respect to sex, with significant loss over time only in women. Loss of quantitative JSW over time in women and narrower baseline quantitative JSW in men and women were associated with incident radiographic HOA and symptomatic HOA.
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Affiliation(s)
- Amanda E. Nelson
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Jacquelyn A. Smith
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Rheumatology Associates, Louisville, KY
| | - Carolina Alvarez
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Liubov Arbeeva
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Jordan B. Renner
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Louise B. Murphy
- Centers for Disease Control and Prevention, Atlanta, GA; Optum Life Sciences, Inc., Eden Prairie, MN
| | - Joanne M. Jordan
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Yvonne M. Golightly
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Department of Epidemiology-Gillings School of Global Public Health, Injury Prevention Research Center, and Division of Physical Therapy-Department of Allied Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Jeffrey Duryea
- Department of Radiology, Brigham and Women’s Hospital, Boston, MA
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Mathiessen A, Ashbeck EL, Huang E, Bedrick EJ, Kwoh CK, Duryea J. Cartilage Topography Assessment With Local-Area Cartilage Segmentation for Knee Magnetic Resonance Imaging. Arthritis Care Res (Hoboken) 2022; 74:2013-2023. [PMID: 34219396 PMCID: PMC8727638 DOI: 10.1002/acr.24745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 06/09/2021] [Accepted: 07/01/2021] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Local-area cartilage segmentation (LACS) software was developed to segment medial femur (MF) cartilage on magnetic resonance imaging (MRI). Our objectives were 1) to extend LACS to the lateral femur (LF), medial tibia (MT), and lateral tibia (LT), 2) to compare LACS to an established manual segmentation method, and 3) to visualize cartilage responsiveness over each cartilage plate. METHODS Osteoarthritis Initiative participants with symptomatic knee osteoarthritis (OA) were selected, including knees selected at random (n = 40) and knees identified with loss of cartilage based on manual segmentation (Chondrometrics GmbH), an enriched sample of 126 knees. LACS was used to segment cartilage in the MF, LF, MT, and LT on sagittal 3D double-echo steady-state MRI scans at baseline and at 2-year follow-up. We compared LACS and Chondrometrics average thickness measures by estimating the correlation in each cartilage plate and estimating the standardized response mean (SRM) for 2-year cartilage change. We illustrated cartilage loss topographically with SRM heatmaps. RESULTS The estimated correlation between LACS and Chondrometrics measures was r = 0.91 (95% confidence interval [95% CI] 0.86, 0.94) for LF, r = 0.93 (95% CI 0.89, 0.95) for MF, r = 0.97 (95% CI 0.96, 0.98) for LT, and r = 0.87 (95% CI 0.81, 0.91) for MT. Estimated SRMs for LACS and Chondrometrics measures were similar in the random sample, and SRM heatmaps identified subregions of LACS-measured cartilage loss. CONCLUSION LACS cartilage thickness measurement in the MF and LF and tibia correlated well with established manual segmentation-based measurement, with similar responsiveness to change, among knees with symptomatic knee OA. LACS measurement of cartilage plate topography enables spatiotemporal analysis of cartilage loss in future knee OA studies.
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Affiliation(s)
- Alexander Mathiessen
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Diakonhjemmet Hospital, Department of Rheumatology, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Erin L. Ashbeck
- University of Arizona Arthritis Center, the University of Arizona College of Medicine, Tucson, AZ, USA
| | - Emily Huang
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Edward John Bedrick
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - C. Kent Kwoh
- University of Arizona Arthritis Center, the University of Arizona College of Medicine, Tucson, AZ, USA
| | - Jeffrey Duryea
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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Johnson GL, Glasser MB, Charles JF, Duryea J, Lehoczky JA. En1 and Lmx1b do not recapitulate embryonic dorsal-ventral limb patterning functions during mouse digit tip regeneration. Cell Rep 2022; 41:111701. [PMID: 36417876 PMCID: PMC9727699 DOI: 10.1016/j.celrep.2022.111701] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 09/09/2022] [Accepted: 10/31/2022] [Indexed: 11/23/2022] Open
Abstract
The mouse digit tip regenerates following amputation. How the regenerate is patterned is unknown, but a long-standing hypothesis proposes developmental patterning mechanisms are re-used during regeneration. The digit tip bone exhibits dorsal-ventral (DV) polarity, so we focus on En1 and Lmx1b, two factors necessary for DV patterning during limb development. We investigate whether they are re-expressed during regeneration in a developmental-like pattern and whether they direct DV morphology of the regenerate. We find that both En1 and Lmx1b are expressed in the regenerating digit tip epithelium and mesenchyme, respectively, but without DV polarity. Conditional genetics and quantitative analysis of digit tip bone morphology determine that genetic deletion of En1 or Lmx1b in adult digit tip regeneration modestly reduces bone regeneration but does not affect DV patterning. Collectively, our data suggest that, while En1 and Lmx1b are re-expressed during mouse digit tip regeneration, they do not define the DV axis during regeneration.
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Affiliation(s)
- Gemma L. Johnson
- Department of Orthopedic Surgery, Brigham and Women’s Hospital, Boston, MA 02115, USA,Department of Systems Biology, Harvard Medical School, Boston, MA 02115, USA
| | - Morgan B. Glasser
- Department of Orthopedic Surgery, Brigham and Women’s Hospital, Boston, MA 02115, USA
| | - Julia F. Charles
- Department of Orthopedic Surgery, Brigham and Women’s Hospital, Boston, MA 02115, USA,Department of Medicine, Brigham and Women’s Hospital, Boston, MA 02115, USA
| | - Jeffrey Duryea
- Department of Radiology, Brigham and Women’s Hospital, Boston, MA 02115, USA
| | - Jessica A. Lehoczky
- Department of Orthopedic Surgery, Brigham and Women’s Hospital, Boston, MA 02115, USA,Lead contact,Correspondence:
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11
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Marqueen K, Lei X, Schlembach P, Bloom E, Ku K, Duryea J, Smith B. Association of Dosimetric Parameters and Boost Volume with Quantitative Cosmetic Outcomes in a Randomized Trial of Conventionally Fractionated vs. Hypofractionated Whole Breast Irradiation. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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12
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Driban JB, Lo GH, Roberts MB, Harkey MS, Schaefer LF, Haugen IK, Smith SE, Duryea J, Lu B, Eaton CB, Hochberg MC, Jackson RD, Kwoh CK, Nevitt MC, McAlindon TE. Racket or Bat Sports: No Association With Thumb-Base Osteoarthritis. J Athl Train 2022; 57:341-351. [PMID: 35439314 PMCID: PMC9020592 DOI: 10.4085/1062-6050-0208.21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Repetitive joint use is a risk factor for osteoarthritis, which is a leading cause of disability. Sports requiring a racket or bat to perform repetitive high-velocity impacts may increase the risk of thumb-base osteoarthritis. However, this hypothesis remains untested. OBJECTIVE To determine if a history of participation in racket or bat sports was associated with the prevalence of thumb-base osteoarthritis. DESIGN Descriptive epidemiologic study. SETTING Four US clinical sites associated with the Osteoarthritis Initiative. PATIENTS OR OTHER PARTICIPANTS We recruited 2309 men and women from the community. Eligible participants had dominant-hand radiographic readings, hand symptom assessments, and historical physical activity survey data. MAIN OUTCOME MEASURE(S) A history of exposure to racket or bat sports (badminton, baseball or softball, racketball or squash, table tennis [or ping pong], tennis [doubles], or tennis [singles]) was based on self-reported recall data covering 3 age ranges (12-18, 19-34, and 35-49 years). Prevalent radiographic thumb-base osteoarthritis was defined as Kellgren-Lawrence grade >2 in the first carpometacarpal joint or scaphotrapezoidal joint at the Osteoarthritis Initiative baseline visit. Symptomatic thumb-base osteoarthritis was defined as radiographic osteoarthritis and hand or finger symptoms. RESULTS Radiographic or symptomatic thumb-base osteoarthritis was present in 355 (34%) and 56 (5%), respectively, of men (total = 1049) and 535 (42%) and 170 (13%), respectively, of women (total = 1260). After adjusting for age, race, and education level, we found no significant associations between a history of any racket or bat sport participation and thumb-base osteoarthritis (radiographic or symptomatic; odds ratios ranged from 0.82 to 1.34). CONCLUSIONS In a community-based cohort, a self-reported history of participation in racket or bat sports was not associated with increased odds of having radiographic or symptomatic thumb-base osteoarthritis in the dominant hand.
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Affiliation(s)
- Jeffrey B. Driban
- Division of Rheumatology, Allergy, and Immunology, Tufts Medical Center, Boston, MA
| | - Grace H. Lo
- Department of Medicine, Baylor College of Medicine, Houston, TX
| | - Mary B. Roberts
- Center for Primary Care and Prevention, Alpert Medical School of Brown University, Pawtucket, RI
| | | | | | - Ida K. Haugen
- Department of Rheumatology and Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Stacy E. Smith
- Department of
Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Jeffrey Duryea
- Department of
Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Bing Lu
- Department of
Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Charles B. Eaton
- Center for Primary Care and Prevention, Alpert Medical School of Brown University, Pawtucket, RI
| | - Marc C. Hochberg
- Departments of Medicine and Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore
| | - Rebecca D. Jackson
- Division of Endocrinology, Diabetes and Metabolism, The Ohio State University Medical Center, Columbus
| | | | - Michael C. Nevitt
- Department of Epidemiology and Biostatistics, University of California, San Francisco
| | - Timothy E. McAlindon
- Division of Rheumatology, Allergy, and Immunology, Tufts Medical Center, Boston, MA
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13
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Eaton CB, Schaefer L, Duryea J, Driban JB, Lo GH, Roberts MB, Haugen IK, Lu B, Nevitt MC, Hochberg MC, Jackson RD, Kwoh KC, McAlindon TE. Prevalence, Incidence, and Progression of Radiographic and Symptomatic Hand Osteoarthritis: The Osteoarthritis Initiative. Arthritis Rheumatol 2022; 74:992-1000. [PMID: 35077023 DOI: 10.1002/art.42076] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 11/09/2021] [Accepted: 01/21/2022] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To describe prevalence, incidence, and progression of radiographic and symptomatic hand osteoarthritis (OA), and evaluate age, sex, race and risk factors differences. METHODS We assessed both radiographic and symptomatic hand OA at baseline and year 4 for incident disease. A modified poisson regression with a robust variance estimator was used to account for clustering of joints within fingers within persons to estimate the prevalence ratios and relative risk estimates associated with participant characteristics. RESULTS Of 3588 participants, the prevalence hand OA was 41.4% for radiographic hand OA and 12.4 % for symptomatic hand OA. The incidence of hand OA over 48 months was 5.6 % for radiographic hand OA, and 16.9 % for symptomatic hand OA. Over 48 months, 27.3 % participants exhibited OA progression. We found complex differences by age, sex and race with both men and women having increasing prevalent hand OA with age, but women peaking at age 55-65, for incident disease. Women have more symptomatic hand OA than men but only non-significantly higher rates for incident radiographic hand OA. Women have more distal interphalangeal joint disease while men have more metacarpal joint OA. Black men and women have less hand OA than whites but black men have more hand OA than black women at younger ages. CONCLUSION Hand OA is a heterogeneous disease with complex differences by age, sex and race, hand symptoms and patterns of specific joints. Further research investigating the mechanisms behind these differences whether mechanical, metabolic, hormonal, or constitutional is warranted.
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Affiliation(s)
- C B Eaton
- Department of Family Medicine, Alpert Medical School of Brown University, Providence, RI.,Center for Primary Care and Prevention, Pawtucket, Rhode, Island.,Department of Epidemiology, Brown University School of Public Health Providence, RI
| | - L Schaefer
- Radiology Department, Klinikum Nürnberg Süd, Breslauer Straße 201, 90471, Nürnberg
| | - J Duryea
- Department of Radiology, Brigham & Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - J B Driban
- Division of Rheumatology, Allergy, and Immunology, Tufts Medical Center, Boston, Massachusetts
| | - G H Lo
- Medical Care Line and Research Care Line, Houston Health Services Research and Development Center of Excellence Michael E. DeBakey VAMC, Houston, Texas. Section of Immunology, Allergy, and Rheumatology, Baylor College of Medicine, Houston, Texas
| | - M B Roberts
- Center for Primary Care and Prevention, Pawtucket, Rhode, Island
| | - I K Haugen
- Dept. of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
| | - B Lu
- Section of Clinical Sciences, Division of Rheumatology, Immunology & Allergy, Brigham & Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - M C Nevitt
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA
| | - M C Hochberg
- Departments of Medicine and Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD
| | - R D Jackson
- Division of Endocrinology, Diabetes and Metabolism, The Ohio State University, Columbus, OH
| | - K C Kwoh
- University of Arizona Arthritis Center, University of Arizona, Tucson, AZ
| | - T E McAlindon
- Division of Rheumatology, Allergy, and Immunology, Tufts Medical Center, Boston, Massachusetts
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14
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McAlindon TE, Driban JB, Roberts MB, Duryea J, Haugen IK, Schaefer LF, Smith SE, Mathiessen A, Eaton C. Erosive Hand Osteoarthritis: Incidence and Predictive Characteristics among Participants in the Osteoarthritis Initiative. Arthritis Rheumatol 2021; 73:2015-2024. [PMID: 33844453 DOI: 10.1002/art.41757] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 04/01/2021] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To evaluate age, sex, race, osteoarthritis severity, metabolic factors, and bone health as risk factors for incident erosive hand osteoarthritis (EHOA) at baseline and over 48-month period. METHODS This study was a longitudinal cohort design including participants from the Osteoarthritis Initiative with complete hand radiographs from baseline and 48-month visits who were eligible at baseline for incident EHOA. Individuals were classified as having EHOA if they had Kellgren-Lawrence (KL) grade≥2 in at least one interphalangeal joint on two different fingers and central erosion in at least one joint. RESULTS Of the 3365 individuals identified without prevalent EHOA at baseline, 86 (2.6%) developed EHOA during the 48-month period. Risk factors included being older [relative risk (RR) per standard deviation=0.76 (95% confidence interval 0.59, 0.98)], female [RR=1.73 (1.05, 2.85)], greater osteoarthritis severity (sum of KL grade 13.9 vs. 5.3, p<0.001) and less cortical width (1.38 vs 1.52 mm, p<0.001). After 48 months, people who developed EHOA were characterized by greater progressions of radiographic osteoarthritis (i.e., joint space narrowing, KL grade progression [RRs = 1.35 to 1.9] and loss of cortical thickness [RR = 1.23], adjusted for age, sex, race, body mass index, and baseline osteoarthritis severity (sum KL scores). CONCLUSION These findings present EHOA as a disorder of advanced age and female sex, strongly associated with severity of articular structural damage and its progression. Individuals who develop EHOA have thinner bones prior to EHOA development and as it progresses, suggesting EHOA as a disorder of skeletal frailty.
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Affiliation(s)
- Timothy E McAlindon
- Division of Rheumatology, Allergy, and Immunology, Tufts Medical Center, Boston, MA, USA
| | - Jeffrey B Driban
- Division of Rheumatology, Allergy, and Immunology, Tufts Medical Center, Boston, MA, USA
| | - Mary B Roberts
- Care New England Medical Group/Primary Care and Specialty Services, Pawtucket, RI, USA
| | - Jeffrey Duryea
- Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Ida K Haugen
- Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
| | - Lena F Schaefer
- Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Stacy E Smith
- Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Alexander Mathiessen
- Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
| | - Charles Eaton
- Care New England Medical Group/Primary Care and Specialty Services, Pawtucket, RI, USA
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15
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Smith SE, Hosseinzadeh S, Maetani T, Shilpa P, Collins JE, Kwoh CK, Duryea J. Association of quantitative measures of effusion-synovitis and hoffa-synovitis with radiographic and pain progression: Data from the FNIH OA biomarkers consortium. Osteoarthritis and Cartilage Open 2021; 3:100138. [DOI: 10.1016/j.ocarto.2021.100138] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 01/05/2021] [Accepted: 01/06/2021] [Indexed: 12/30/2022] Open
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16
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Jarraya M, Heiss R, Duryea J, Nagel AM, Lynch JA, Guermazi A, Weber MA, Arkudas A, Horch RE, Uder M, Roemer FW. Bone Structure Analysis of the Radius Using Ultrahigh Field (7T) MRI: Relevance of Technical Parameters and Comparison with 3T MRI and Radiography. Diagnostics (Basel) 2021; 11:110. [PMID: 33445536 PMCID: PMC7826934 DOI: 10.3390/diagnostics11010110] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 01/06/2021] [Accepted: 01/06/2021] [Indexed: 12/29/2022] Open
Abstract
Bone fractal signature analysis (FSA-also termed bone texture analysis) is a tool that assesses structural changes that may relate to clinical outcomes and functions. Our aim was to compare bone texture analysis of the distal radius in patients and volunteers using radiography and 3T and 7T magnetic resonance imaging (MRI)-a patient group (n = 25) and a volunteer group (n = 25) were included. Participants in the patient group had a history of chronic wrist pain with suspected or confirmed osteoarthritis and/or ligament instability. All participants had 3T and 7T MRI including T1-weighted turbo spin echo (TSE) sequences. The 7T MRI examination included an additional high-resolution (HR) T1 TSE sequence. Radiographs of the wrist were acquired for the patient group. When comparing patients and volunteers (unadjusted for gender and age), we found a statistically significant difference of horizontal and vertical fractal dimensions (FDs) using 7T T1 TSE-HR images in low-resolution mode (horizontal: p = 0.04, vertical: p = 0.01). When comparing radiography to the different MRI sequences, we found a statistically significant difference for low- and high-resolution horizontal FDs between radiography and 3T T1 TSE and 7T T1 TSE-HR. Vertical FDs were significantly different only between radiographs and 3T T1 TSE in the high-resolution mode; FSA measures obtained from 3T and 7T MRI are highly dependent on the sequence and reconstruction resolution used, and thus are not easily comparable between MRI systems and applied sequences.
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Affiliation(s)
- Mohamed Jarraya
- Department of Radiology, Massachusetts General Hospital, Harvard University, Boston, MA 02114, USA
| | - Rafael Heiss
- Department of Radiology, Friedrich Alexander University Erlangen-Nürnberg (FAU) & Universitätsklinikum Erlangen, 91054 Erlangen, Germany; (R.H.); (A.M.N.); (M.U.); (F.W.R.)
| | - Jeffrey Duryea
- Department of Radiology, Brigham and Women’s Hospital, Harvard University, Boston, MA 02114, USA;
| | - Armin M. Nagel
- Department of Radiology, Friedrich Alexander University Erlangen-Nürnberg (FAU) & Universitätsklinikum Erlangen, 91054 Erlangen, Germany; (R.H.); (A.M.N.); (M.U.); (F.W.R.)
- Medical Physics in Radiology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
| | - John A. Lynch
- Department of Epidemiology and Biostatistics, University of California San Francisco (UCSF), San Francisco, CA 94143, USA;
| | - Ali Guermazi
- Department of Radiology, Boston University School of Medicine, Boston, MA 02118, USA;
- Department of Radiology, Boston Veteran Affairs Healthcare System, West Roxbury, MA 02132, USA
| | - Marc-André Weber
- Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Center Rostock, D-18057 Rostock, Germany;
| | - Andreas Arkudas
- Department of Plastic and Hand Surgery, Friedrich Alexander University Erlangen-Nürnberg (FAU) & Universitätsklinikum Erlangen, 91054 Erlangen, Germany; (A.A.); (R.E.H.)
| | - Raymund E. Horch
- Department of Plastic and Hand Surgery, Friedrich Alexander University Erlangen-Nürnberg (FAU) & Universitätsklinikum Erlangen, 91054 Erlangen, Germany; (A.A.); (R.E.H.)
| | - Michael Uder
- Department of Radiology, Friedrich Alexander University Erlangen-Nürnberg (FAU) & Universitätsklinikum Erlangen, 91054 Erlangen, Germany; (R.H.); (A.M.N.); (M.U.); (F.W.R.)
| | - Frank W. Roemer
- Department of Radiology, Friedrich Alexander University Erlangen-Nürnberg (FAU) & Universitätsklinikum Erlangen, 91054 Erlangen, Germany; (R.H.); (A.M.N.); (M.U.); (F.W.R.)
- Department of Radiology, Boston University School of Medicine, Boston, MA 02118, USA;
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17
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Duryea J, Gravallese EM, Wortman JR, Xu C, Lu B, Kay J, Solomon DH. Healing of erosions in rheumatoid arthritis remains elusive: results with 24 months of the anabolic agent teriparatide. Scand J Rheumatol 2020; 50:11-14. [PMID: 32757870 DOI: 10.1080/03009742.2020.1772362] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Objective: Erosion healing in rheumatoid arthritis (RA) is difficult to demonstrate. This extension study aimed to determine whether 2 years of teriparatide (TPTD) produces erosion healing. Method: Subjects in a previous 12 month randomized controlled trial of TPTD in RA were invited to receive 12 additional months of open-label TPTD. Eleven of the 24 original subjects were enrolled in the extension study, six of whom received TPTD in the final 12 months only. Subjects receiving 24 months of TPTD were assessed for reduction in erosion volume from baseline using computed tomography. We also compared erosion volumes between 12 and 24 months of TPTD. Large erosions in subjects receiving TPTD for 24 months were examined for volume change. Results: In the six patients who received 24 months of TPTD, there was no significant change in erosion volume at the metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints compared with baseline. The six subjects who received 24 months of TPTD had similar changes in erosion volume to the five who received 12 months of TPTD, in MCP (p = 0.17) and PIP (p = 0.63) joints. Assessment of large erosions in those receiving TPTD for 24 months showed no evidence of erosion healing. Conclusion: While this extension study was too small to be conclusive, we observed no evidence of reduction in erosion volume with the addition of TPTD for 24 months in subjects with RA in whom disease activity was controlled on a tumour necrosis factor inhibitor. This is consistent with our negative findings at 12 months.
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Affiliation(s)
- J Duryea
- Department of Radiology, Brigham and Women's Hospital , Boston, MA, USA
| | - E M Gravallese
- Division of Rheumatology, University of Massachusetts Medical School , Worcester, MA, USA
| | - J R Wortman
- Department of Radiology, Brigham and Women's Hospital , Boston, MA, USA
| | - C Xu
- Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital , Boston, MA, USA
| | - B Lu
- Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital , Boston, MA, USA
| | - J Kay
- Division of Rheumatology, University of Massachusetts Medical School , Worcester, MA, USA
| | - D H Solomon
- Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital , Boston, MA, USA
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18
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Caetano-Lopes J, Henke K, Urso K, Duryea J, Charles JF, Warman ML, Harris MP. Correction: Unique and non-redundant function of csf1r paralogues in regulation and evolution of post-embryonic development of the zebrafish. Development 2020; 147:147/10/dev192211. [PMID: 32423978 DOI: 10.1242/dev.192211] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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19
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Caetano-Lopes J, Henke K, Urso K, Duryea J, Charles JF, Warman ML, Harris MP. Unique and non-redundant function of csf1r paralogues in regulation and evolution of post-embryonic development of the zebrafish. Development 2020; 147:dev.181834. [PMID: 31932352 DOI: 10.1242/dev.181834] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 12/19/2019] [Indexed: 01/26/2023]
Abstract
Evolution is replete with reuse of genes in different contexts, leading to multifunctional roles of signaling factors during development. Here, we explore osteoclast regulation during skeletal development through analysis of colony-stimulating factor 1 receptor (csf1r) function in the zebrafish. A primary role of Csf1r signaling is to regulate the proliferation, differentiation and function of myelomonocytic cells, including osteoclasts. We demonstrate the retention of two functional paralogues of csf1r in zebrafish. Mutant analysis indicates that the paralogues have shared, non-redundant roles in regulating osteoclast activity during the formation of the adult skeleton. csf1ra, however, has adopted unique roles in pigment cell patterning not seen in the second paralogue. We identify a unique noncoding element within csf1ra of fishes that is sufficient for controlling gene expression in pigment cells during development. As a role for Csf1r signaling in pigmentation is not observed in mammals or birds, it is likely that the overlapping roles of the two paralogues released functional constraints on csf1ra, allowing the signaling capacity of Csf1r to serve a novel function in the evolution of pigment pattern in fishes.
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Affiliation(s)
- Joana Caetano-Lopes
- Orthopaedic Research Laboratories, Boston Children's Hospital, Boston, MA 02115, USA.,Department of Genetics, Harvard Medical School, Boston, MA 02115, USA
| | - Katrin Henke
- Orthopaedic Research Laboratories, Boston Children's Hospital, Boston, MA 02115, USA.,Department of Genetics, Harvard Medical School, Boston, MA 02115, USA
| | - Katia Urso
- Departments of Orthopaedics and Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA.,Harvard Medical School, Boston, MA 02115, USA
| | - Jeffrey Duryea
- Department of Radiology, Brigham and Women's Hospital, Boston, MA 02115, USA
| | - Julia F Charles
- Departments of Orthopaedics and Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA.,Harvard Medical School, Boston, MA 02115, USA
| | - Matthew L Warman
- Orthopaedic Research Laboratories, Boston Children's Hospital, Boston, MA 02115, USA.,Department of Genetics, Harvard Medical School, Boston, MA 02115, USA
| | - Matthew P Harris
- Orthopaedic Research Laboratories, Boston Children's Hospital, Boston, MA 02115, USA .,Department of Genetics, Harvard Medical School, Boston, MA 02115, USA
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20
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Wallace IJ, Felson DT, Worthington S, Duryea J, Clancy M, Aliabadi P, Eick GN, Snodgrass JJ, Baggish AL, Lieberman DE. Knee osteoarthritis risk in non-industrial societies undergoing an energy balance transition: evidence from the indigenous Tarahumara of Mexico. Ann Rheum Dis 2019; 78:1693-1698. [PMID: 31519654 PMCID: PMC10609556 DOI: 10.1136/annrheumdis-2019-215886] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 08/29/2019] [Accepted: 08/30/2019] [Indexed: 01/06/2023]
Abstract
Non-industrial societies with low energy balance levels are expected to be less vulnerable than industrial societies to diseases associated with obesity including knee osteoarthritis. However, as non-industrial societies undergo rapid lifestyle changes that promote positive energy balance, individuals whose metabolisms are adapted to energetic scarcity are encountering greater energy abundance, increasing their propensity to accumulate abdominal adipose tissue and thus potentially their sensitivity to obesity-related diseases. OBJECTIVES Here, we propose that knee osteoarthritis is one such disease for which susceptibility is amplified by this energy balance transition. METHODS Support for our hypothesis comes from comparisons of knee radiographs, knee pain and anthropometry among men aged ≥40 years in two populations: Tarahumara subsistence farmers in Mexico undergoing the energy balance transition and urban Americans from Framingham, Massachusetts. RESULTS We show that despite having markedly lower obesity levels than the Americans, the Tarahumara appear predisposed to accrue greater abdominal adiposity (ie, larger abdomens) for a given body weight, and are more vulnerable to radiographic and symptomatic knee osteoarthritis at lower levels of body mass index. Also, proportionate increases in abdomen size in the two groups are associated with greater increases in radiographic knee osteoarthritis risk among the Tarahumara than the Americans, implying that the abdominal adipose tissue of the Tarahumara is a more potent stimulus for knee degeneration. CONCLUSIONS Heightened vulnerability to knee osteoarthritis among non-industrial societies experiencing rapid lifestyle changes is a concern that warrants further investigation since such groups represent a large but understudied fraction of the global population.
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Affiliation(s)
- Ian J Wallace
- Department of Human Evolutionary Biology, Peabody Museum, Harvard University, Cambridge, Massachusetts, USA
| | - David T Felson
- Rheumatology Section, Boston University School of Medicine, Boston, Massachusetts, USA
- NIHR Manchester Musculoskeletal Biomedical Research Centre, Manchester University Hospitals NHS Foundation Trust, Manchester, UK
| | - Steven Worthington
- Institute for Quantitative Social Science, Harvard University, Cambridge, Massachusetts, USA
| | - Jeffrey Duryea
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Margaret Clancy
- Rheumatology Section, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Piran Aliabadi
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Geeta N Eick
- Department of Anthropology, University of Oregon, Eugene, Oregon, USA
| | - J Josh Snodgrass
- Department of Anthropology, University of Oregon, Eugene, Oregon, USA
| | - Aaron L Baggish
- Cardiovascular Performance Program, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Daniel E Lieberman
- Department of Human Evolutionary Biology, Peabody Museum, Harvard University, Cambridge, Massachusetts, USA
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21
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Price LL, Harkey MS, Ward RJ, MacKay JW, Zhang M, Pang J, Davis JE, McAlindon TE, Lo GH, Amin M, Eaton CB, Lu B, Duryea J, Barbe MF, Driban JB. Role of Magnetic Resonance Imaging in Classifying Individuals Who Will Develop Accelerated Radiographic Knee Osteoarthritis. J Orthop Res 2019; 37:2420-2428. [PMID: 31297900 PMCID: PMC6778707 DOI: 10.1002/jor.24413] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 07/05/2019] [Indexed: 02/04/2023]
Abstract
We assessed whether adding magnetic resonance (MR)-based features to a base model of clinically accessible participant characteristics (i.e., serological, radiographic, demographic, symptoms, and physical function) improved classification of adults who developed accelerated radiographic knee osteoarthritis (AKOA) or not over the subsequent 4 years. We conducted a case-control study using radiographs from baseline and the first four annual visits of the osteoarthritis initiative to define groups. Eligible individuals had no radiographic KOA in either knee at baseline (Kellgren-Lawrence [KL] grade <2). We classified two groups matched on sex (i) AKOA: at least one knee developed advanced-stage KOA (KL = 3 or 4) within 48 months and (ii) did not develop AKOA within 48 months. The MR-based features were assessments of bone, effusion/synovitis, tendons, ligaments, cartilage, and menisci. All characteristics and MR-based features were from the baseline visit. Classification and regression tree analyses were performed to determine classification rules and identify statistically important variables. The CART models with and without MR features each explained approximately 40% of the variability. Adding MR-based features to the model yielded modest improvements in specificity (0.90 vs. 0.82) but lower sensitivity (0.62 vs. 0.70) than the base model. There was consistent evidence that serum glucose, effusion-synovitis volume, and cruciate ligament degeneration are statistically important variables in classifying individuals who will develop AKOA. We found common MR-based measures failed to dramatically improve classification. These findings also show a complex interplay among participant characteristics and a need to identify novel characteristics to improve classification. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 37:2420-2428, 2019.
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Affiliation(s)
- Lori Lyn Price
- Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA,Tufts Clinical and Translational Science Institute, Tufts University, Boston, MA
| | - Matthew S. Harkey
- Division of Rheumatology, Allergy, and Immunology, Tufts Medical Center, Boston, MA,Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School,
Worcester, MA, USA
| | - Robert J. Ward
- Department of Radiology, Tufts Medical Center, Boston, MA, USA
| | - James W. MacKay
- University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Ming Zhang
- Division of Rheumatology, Allergy, and Immunology, Tufts Medical Center, Boston, MA
| | - Jincheng Pang
- Internal Medicine Research Unit, Pfizer, Cambridge, MA, USA
| | - Julie E. Davis
- Division of Rheumatology, Allergy, and Immunology, Tufts Medical Center, Boston, MA
| | - Timothy E. McAlindon
- Division of Rheumatology, Allergy, and Immunology, Tufts Medical Center, Boston, MA
| | - Grace H. Lo
- Medical Care Line and Research Care Line, Houston Health Services Research and Development Center of
Excellence Michael E. DeBakey VAMC, Houston, TX, USA,Section of Immunology, Allergy, and Rheumatology, Baylor College of Medicine, Houston, TX, USA
| | - Mamta Amin
- Temple University School of Medicine, Philadelphia, PA, USA
| | | | - Bing Lu
- Brigham & Women’s Hospital and Harvard Medical School, Boston, MA
| | - Jeffrey Duryea
- Department of Radiology, Brigham & Women’s Hospital and Harvard Medical School, Boston, MA,
USA
| | - Mary F. Barbe
- Temple University School of Medicine, Philadelphia, PA, USA
| | - Jeffrey B. Driban
- Division of Rheumatology, Allergy, and Immunology, Tufts Medical Center, Boston, MA
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22
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Urso K, Caetano-Lopes J, Lee PY, Yan J, Henke K, Sury M, Liu H, Zgoda M, Jacome-Galarza C, Nigrovic PA, Duryea J, Harris MP, Charles JF. A role for G protein-coupled receptor 137b in bone remodeling in mouse and zebrafish. Bone 2019; 127:104-113. [PMID: 31173907 PMCID: PMC6708790 DOI: 10.1016/j.bone.2019.06.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 06/02/2019] [Accepted: 06/03/2019] [Indexed: 12/11/2022]
Abstract
G protein-coupled receptor 137b (GPR137b) is an orphan seven-pass transmembrane receptor of unknown function. In mouse, Gpr137b is highly expressed in osteoclasts in vivo and is upregulated during in vitro differentiation. To elucidate the role that GPR137b plays in osteoclasts, we tested the effect of GPR137b deficiency on osteoclast maturation and resorbing activity. We used CRISPR/Cas9 gene editing in mouse-derived ER-Hoxb8 immortalized myeloid progenitors to generate GPR137b-deficient osteoclast precursors. Decreasing Gpr137b in these precursors led to increased osteoclast differentiation and bone resorption activity. To explore the role of GPR137b during skeletal development, we generated zebrafish deficient for the ortholog gpr137ba. Gpr137ba-deficient zebrafish are viable and fertile and do not display overt morphological defects as adults. However, analysis of osteoclast function in gpr137ba-/- mutants demonstrated increased bone resorption. Micro-computed tomography evaluation of vertebral bone mass and morphology demonstrated that gpr137ba-deficiency altered the angle of the neural arch, a skeletal site with high osteoclast activity. Vital staining of gpr137ba-/- fish with calcein and alizarin red indicated that bone formation in the mutants is also increased, suggesting high bone turnover. These results identify GPR137b as a conserved negative regulator of osteoclast activity essential for normal resorption and patterning of the skeleton. Further, these data suggest that coordination of osteoclast and osteoblast activity is a conserved process among vertebrates and may have similar regulation.
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Affiliation(s)
- K Urso
- Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - J Caetano-Lopes
- Department of Orthopedic Research, Boston Children's Hospital, Boston, MA, USA; Department of Genetics, Harvard Medical School, Boston, MA, USA
| | - P Y Lee
- Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Division of Immunology, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA
| | - J Yan
- Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - K Henke
- Department of Orthopedic Research, Boston Children's Hospital, Boston, MA, USA; Department of Genetics, Harvard Medical School, Boston, MA, USA
| | - M Sury
- Department of Orthopedic Research, Boston Children's Hospital, Boston, MA, USA; Department of Genetics, Harvard Medical School, Boston, MA, USA; Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - H Liu
- Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - M Zgoda
- Department of Orthopedics, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - C Jacome-Galarza
- Department of Orthopedics, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - P A Nigrovic
- Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Division of Immunology, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA
| | - J Duryea
- Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - M P Harris
- Department of Orthopedic Research, Boston Children's Hospital, Boston, MA, USA; Department of Genetics, Harvard Medical School, Boston, MA, USA
| | - J F Charles
- Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Department of Orthopedics, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
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23
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Van Ginckel A, Hinman RS, Wrigley TV, Hunter DJ, Marshall CJ, Duryea J, Melo L, Simic M, Kasza J, Robbins SR, Wallis JA, Bennell KL. Effect of cane use on bone marrow lesion volume in people with medial tibiofemoral knee osteoarthritis: randomized clinical trial. Osteoarthritis Cartilage 2019; 27:1324-1338. [PMID: 31121294 DOI: 10.1016/j.joca.2019.05.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2018] [Revised: 04/17/2019] [Accepted: 05/03/2019] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To evaluate effects of daily cane use for 3 months on medial tibiofemoral bone marrow lesion (BML) volumes in people with medial tibiofemoral osteoarthritis (OA). DESIGN In this randomized controlled trial (RCT), 79 participants with medial tibiofemoral OA were randomized to either a cane group (using a cane whenever walking) or control group (not using any gait aid) for 3 months. The cane group received a single training session by a physiotherapist, using a biofeedback cane to teach optimal technique and body weight support and motor learning principles to facilitate retention of learning. The primary outcome was change in total medial tibiofemoral BML volume (per unit bone volume) measured from magnetic resonance imaging (MRI) at 3 months. Secondary outcomes were BML volumes (per unit bone volume) of the medial tibia and femur, and patient-reported outcomes of overall knee pain, knee pain on walking, physical function, perceived global symptom changes and health-related quality of life. MRI analyses were performed by a blinded assessor. RESULTS Seventy-eight participants (99%) completed the primary outcome. Mean (standard deviation) daily cane use was 2.3 (1.7) hours over 3 months. No evidence of between-group differences was found for change in total medial tibiofemoral BML volume (mean difference: -0.0010 (95% confidence intervals: -0.0022, 0.0003)). Most secondary outcomes showed minimal differences between groups. CONCLUSION Daily use of a cane during walking for 3 months aiming to reduce knee joint loading did not change medial tibiofemoral BML volumes compared to no use of gait aids. CLINICAL TRIAL REGISTRATION Australian New Zealand Clinical Trial Registry (ACTRN12614000909628).
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Affiliation(s)
- A Van Ginckel
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium; Centre for Health, Exercise and Sports Medicine, The University of Melbourne, Parkville, Australia.
| | - R S Hinman
- Centre for Health, Exercise and Sports Medicine, The University of Melbourne, Parkville, Australia.
| | - T V Wrigley
- Centre for Health, Exercise and Sports Medicine, The University of Melbourne, Parkville, Australia.
| | - D J Hunter
- Centre for Health, Exercise and Sports Medicine, The University of Melbourne, Parkville, Australia.
| | - C J Marshall
- Centre for Health, Exercise and Sports Medicine, The University of Melbourne, Parkville, Australia.
| | - J Duryea
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, USA.
| | - L Melo
- Institute of Bone and Joint Research, Kolling Institute, The University of Sydney, Sydney, Australia; Department of Rheumatology, Royal North Shore Hospital, St Leonards, Australia.
| | - M Simic
- Discipline of Physiotherapy, Musculoskeletal Research Group, Faculty of Health Sciences, The University of Sydney, Sydney, Australia.
| | - J Kasza
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.
| | - S R Robbins
- Institute of Bone and Joint Research, Kolling Institute, The University of Sydney, Sydney, Australia; Department of Rheumatology, Royal North Shore Hospital, St Leonards, Australia.
| | - J A Wallis
- Department of Physical Therapy, Eastern Health. Department of Physical Therapy, La Trobe University, Melbourne, Australia.
| | - K L Bennell
- Centre for Health, Exercise and Sports Medicine, The University of Melbourne, Parkville, Australia.
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24
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McAlindon T, Roberts M, Driban J, Schaefer L, Haugen IK, Smith SE, Duryea J, Cunha D, Blanco F, Fernández-Garcia JL, Eaton C. Incident hand OA is strongly associated with reduced peripheral blood leukocyte telomere length. Osteoarthritis Cartilage 2018; 26:1651-1657. [PMID: 30172836 PMCID: PMC6345164 DOI: 10.1016/j.joca.2018.08.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 07/23/2018] [Accepted: 08/10/2018] [Indexed: 02/08/2023]
Abstract
OBJECTIVE To evaluate the relationship of telomere length to the prevalence and incidence of hand osteoarthritis in a longitudinal cohort. DESIGN We conducted a cross-sectional and longitudinal analysis of data from a subset of participants in the Osteoarthritis Initiative (OAI) recruited between February 2004 and May 2006. 274 individuals were eligible for the study based on availability of both baseline and 48-month hand radiographs and peripheral blood leucocyte telomere length data. Mean telomere length of peripheral blood leukocytes (PBL)s from the DNA samples was determined using a validated quantitative polymerase chain reaction (PCR)-based assay, and hand radiographs were analyzed and graded using the Kellgren-Lawrence scale. RESULTS In joint -level analyses, prevalent Interphalangeal Joint Osteoarthritis (IPJOA) was significantly associated with PBL telomere length in the baseline sample in unadjusted analyses (RR = 2.84; 95% CI:0.87-9.29) or in models adjusted for age, sex, and body mass index (aRR = 1.10; 95% CI: 0.96-1.27). The association in crude and adjusted analyses appeared slightly stronger with incident IPJOA, especially in the subset with normal hands at baseline (aRR = 1.62; 95% CI: 1.02-2.57). PBL telomere length was also associated with prevalent HOA at baseline (significant in unadjusted analysis: RR = 1.22; 95% CI 1.06-1.42), but not after adjusting for covariates: aRR = 1.12; 95% CI: 0.96-1.30). The magnitude of association was stronger for incident HOA, especially incident symptomatic HOA (aRR = 1.53; 95% CI: 1.09-2.15). CONCLUSIONS In summary, the results of this exploratory analysis are confirmatory of previous work showing a cross-sectional relationship between telomere length and HOA and add to the field by demonstrating an even stronger association with incident IPJOA, both radiographic and symptomatic.
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Affiliation(s)
- T McAlindon
- Division of Rheumatology, Tufts Medical Center, Boston, MA, USA.
| | - M Roberts
- Center for Primary Care & Prevention, Alpert Medical School of Brown University, Pawtucket, RI, USA.
| | - J Driban
- Division of Rheumatology, Tufts Medical Center, Boston, MA, USA.
| | - L Schaefer
- Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
| | - I K Haugen
- Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.
| | - S E Smith
- Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
| | - J Duryea
- Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
| | - D Cunha
- Division of Rheumatology, Tufts Medical Center, Boston, MA, USA.
| | - F Blanco
- INIBIC - Complexo Hospitalario Universitario A Coruña, Rheumatology Division, As Xubias 84, 15006, A Coruña, Spain.
| | - J-L Fernández-Garcia
- INIBIC - Complexo Hospitalario Universitario A Coruña, Genetics Unit, As Xubias 84, 15006, A Coruña, Spain.
| | - C Eaton
- Center for Primary Care & Prevention, Alpert Medical School of Brown University, Pawtucket, RI, USA.
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25
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Davis JE, Schaefer LF, McAlindon TE, Eaton CB, Roberts MB, Haugen IK, Smith SE, Duryea J, Lu B, Driban JB. Characteristics of Accelerated Hand Osteoarthritis: Data from the Osteoarthritis Initiative. J Rheumatol 2018; 46:422-428. [PMID: 30504506 DOI: 10.3899/jrheum.180240] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/15/2018] [Indexed: 01/30/2023]
Abstract
OBJECTIVE We aimed to determine whether hand joints develop an accelerated form of osteoarthritis (OA) and to characterize individuals who develop accelerated hand osteoarthritis (AHOA). METHODS We evaluated 3519 participants in the Osteoarthritis Initiative with complete data for baseline and 48-month radiographic hand osteoarthritis (HOA). One reader scored posteroanterior radiographs of the dominant hand using a modified Kellgren-Lawrence (KL) scale and another reader scored the presence of central or marginal erosions. A third reader read images flagged for signs of diseases other than OA. We defined AHOA as ≥ 1 joints that progressed from a KL grade of 0 or 1 at baseline to KL grade 3 or 4 at 48 months. RESULTS The definition of AHOA was met by 1% over 4 years: 37 hands had 1 joint affected and 1 hand had 2 joints affected. At baseline, adults who developed AHOA were more likely to have hand pain (37% vs 22%), radiographic HOA (71% vs 36%), as well as central (22% vs 7%) and marginal erosions (11% vs 2%) in other joints compared to those without AHOA. Adults with AHOA were more likely to develop new erosions over 48 months (central 35%, marginal 5%) than those without AHOA (central 5%, marginal 1%). The most common locations of accelerated OA were the second metacarpophalangeal and first carpometacarpal joint. CONCLUSION Accelerated OA can occur in the hand, especially among digits commonly used for pinching and fine motor skills.
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Affiliation(s)
- Julie E Davis
- From the Division of Rheumatology, Tufts Medical Center; Department of Radiology, Brigham and Women's Hospital and Harvard Medical School; Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; Center for Primary Care and Prevention, Alpert Medical School of Brown University, Pawtucket, Rhode Island, USA; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.,J.E. Davis, BS, Research Assistant II, Division of Rheumatology, Tufts Medical Center; L.F. Schaefer, MD, Radiology Fellow, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School; T.E. McAlindon, MD, MPH, Chief of Rheumatology, Division of Rheumatology, Tufts Medical Center; C.B. Eaton, MD, MS, Professor of Family Medicine and Epidemiology, Director of Center for Primary Care and Prevention, Alpert Medical School of Brown University; M.B. Roberts, MSc, Statistical Programmer, Center for Primary Care and Prevention, Alpert Medical School of Brown University; I.K. Haugen, MD, PhD, Rheumatology Fellow, Department of Rheumatology, Diakonhjemmet Hospital; S.E. Smith, MD, Section Head and Weissman Distinguished Chair of Musculoskeletal Radiology, Associate Radiology Residency Program Director, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School; J. Duryea, PhD, Associate Research Associate, Associate Professor of Radiology, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School; B. Lu, DrPH, MD, Assistant Professor of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital and Harvard Medical School; J.B. Driban, PhD, ATC, CSCS, Associate Professor, Division of Rheumatology, Tufts Medical Center
| | - Lena F Schaefer
- From the Division of Rheumatology, Tufts Medical Center; Department of Radiology, Brigham and Women's Hospital and Harvard Medical School; Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; Center for Primary Care and Prevention, Alpert Medical School of Brown University, Pawtucket, Rhode Island, USA; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.,J.E. Davis, BS, Research Assistant II, Division of Rheumatology, Tufts Medical Center; L.F. Schaefer, MD, Radiology Fellow, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School; T.E. McAlindon, MD, MPH, Chief of Rheumatology, Division of Rheumatology, Tufts Medical Center; C.B. Eaton, MD, MS, Professor of Family Medicine and Epidemiology, Director of Center for Primary Care and Prevention, Alpert Medical School of Brown University; M.B. Roberts, MSc, Statistical Programmer, Center for Primary Care and Prevention, Alpert Medical School of Brown University; I.K. Haugen, MD, PhD, Rheumatology Fellow, Department of Rheumatology, Diakonhjemmet Hospital; S.E. Smith, MD, Section Head and Weissman Distinguished Chair of Musculoskeletal Radiology, Associate Radiology Residency Program Director, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School; J. Duryea, PhD, Associate Research Associate, Associate Professor of Radiology, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School; B. Lu, DrPH, MD, Assistant Professor of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital and Harvard Medical School; J.B. Driban, PhD, ATC, CSCS, Associate Professor, Division of Rheumatology, Tufts Medical Center
| | - Timothy E McAlindon
- From the Division of Rheumatology, Tufts Medical Center; Department of Radiology, Brigham and Women's Hospital and Harvard Medical School; Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; Center for Primary Care and Prevention, Alpert Medical School of Brown University, Pawtucket, Rhode Island, USA; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.,J.E. Davis, BS, Research Assistant II, Division of Rheumatology, Tufts Medical Center; L.F. Schaefer, MD, Radiology Fellow, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School; T.E. McAlindon, MD, MPH, Chief of Rheumatology, Division of Rheumatology, Tufts Medical Center; C.B. Eaton, MD, MS, Professor of Family Medicine and Epidemiology, Director of Center for Primary Care and Prevention, Alpert Medical School of Brown University; M.B. Roberts, MSc, Statistical Programmer, Center for Primary Care and Prevention, Alpert Medical School of Brown University; I.K. Haugen, MD, PhD, Rheumatology Fellow, Department of Rheumatology, Diakonhjemmet Hospital; S.E. Smith, MD, Section Head and Weissman Distinguished Chair of Musculoskeletal Radiology, Associate Radiology Residency Program Director, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School; J. Duryea, PhD, Associate Research Associate, Associate Professor of Radiology, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School; B. Lu, DrPH, MD, Assistant Professor of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital and Harvard Medical School; J.B. Driban, PhD, ATC, CSCS, Associate Professor, Division of Rheumatology, Tufts Medical Center
| | - Charles B Eaton
- From the Division of Rheumatology, Tufts Medical Center; Department of Radiology, Brigham and Women's Hospital and Harvard Medical School; Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; Center for Primary Care and Prevention, Alpert Medical School of Brown University, Pawtucket, Rhode Island, USA; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.,J.E. Davis, BS, Research Assistant II, Division of Rheumatology, Tufts Medical Center; L.F. Schaefer, MD, Radiology Fellow, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School; T.E. McAlindon, MD, MPH, Chief of Rheumatology, Division of Rheumatology, Tufts Medical Center; C.B. Eaton, MD, MS, Professor of Family Medicine and Epidemiology, Director of Center for Primary Care and Prevention, Alpert Medical School of Brown University; M.B. Roberts, MSc, Statistical Programmer, Center for Primary Care and Prevention, Alpert Medical School of Brown University; I.K. Haugen, MD, PhD, Rheumatology Fellow, Department of Rheumatology, Diakonhjemmet Hospital; S.E. Smith, MD, Section Head and Weissman Distinguished Chair of Musculoskeletal Radiology, Associate Radiology Residency Program Director, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School; J. Duryea, PhD, Associate Research Associate, Associate Professor of Radiology, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School; B. Lu, DrPH, MD, Assistant Professor of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital and Harvard Medical School; J.B. Driban, PhD, ATC, CSCS, Associate Professor, Division of Rheumatology, Tufts Medical Center
| | - Mary B Roberts
- From the Division of Rheumatology, Tufts Medical Center; Department of Radiology, Brigham and Women's Hospital and Harvard Medical School; Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; Center for Primary Care and Prevention, Alpert Medical School of Brown University, Pawtucket, Rhode Island, USA; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.,J.E. Davis, BS, Research Assistant II, Division of Rheumatology, Tufts Medical Center; L.F. Schaefer, MD, Radiology Fellow, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School; T.E. McAlindon, MD, MPH, Chief of Rheumatology, Division of Rheumatology, Tufts Medical Center; C.B. Eaton, MD, MS, Professor of Family Medicine and Epidemiology, Director of Center for Primary Care and Prevention, Alpert Medical School of Brown University; M.B. Roberts, MSc, Statistical Programmer, Center for Primary Care and Prevention, Alpert Medical School of Brown University; I.K. Haugen, MD, PhD, Rheumatology Fellow, Department of Rheumatology, Diakonhjemmet Hospital; S.E. Smith, MD, Section Head and Weissman Distinguished Chair of Musculoskeletal Radiology, Associate Radiology Residency Program Director, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School; J. Duryea, PhD, Associate Research Associate, Associate Professor of Radiology, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School; B. Lu, DrPH, MD, Assistant Professor of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital and Harvard Medical School; J.B. Driban, PhD, ATC, CSCS, Associate Professor, Division of Rheumatology, Tufts Medical Center
| | - Ida K Haugen
- From the Division of Rheumatology, Tufts Medical Center; Department of Radiology, Brigham and Women's Hospital and Harvard Medical School; Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; Center for Primary Care and Prevention, Alpert Medical School of Brown University, Pawtucket, Rhode Island, USA; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.,J.E. Davis, BS, Research Assistant II, Division of Rheumatology, Tufts Medical Center; L.F. Schaefer, MD, Radiology Fellow, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School; T.E. McAlindon, MD, MPH, Chief of Rheumatology, Division of Rheumatology, Tufts Medical Center; C.B. Eaton, MD, MS, Professor of Family Medicine and Epidemiology, Director of Center for Primary Care and Prevention, Alpert Medical School of Brown University; M.B. Roberts, MSc, Statistical Programmer, Center for Primary Care and Prevention, Alpert Medical School of Brown University; I.K. Haugen, MD, PhD, Rheumatology Fellow, Department of Rheumatology, Diakonhjemmet Hospital; S.E. Smith, MD, Section Head and Weissman Distinguished Chair of Musculoskeletal Radiology, Associate Radiology Residency Program Director, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School; J. Duryea, PhD, Associate Research Associate, Associate Professor of Radiology, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School; B. Lu, DrPH, MD, Assistant Professor of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital and Harvard Medical School; J.B. Driban, PhD, ATC, CSCS, Associate Professor, Division of Rheumatology, Tufts Medical Center
| | - Stacy E Smith
- From the Division of Rheumatology, Tufts Medical Center; Department of Radiology, Brigham and Women's Hospital and Harvard Medical School; Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; Center for Primary Care and Prevention, Alpert Medical School of Brown University, Pawtucket, Rhode Island, USA; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.,J.E. Davis, BS, Research Assistant II, Division of Rheumatology, Tufts Medical Center; L.F. Schaefer, MD, Radiology Fellow, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School; T.E. McAlindon, MD, MPH, Chief of Rheumatology, Division of Rheumatology, Tufts Medical Center; C.B. Eaton, MD, MS, Professor of Family Medicine and Epidemiology, Director of Center for Primary Care and Prevention, Alpert Medical School of Brown University; M.B. Roberts, MSc, Statistical Programmer, Center for Primary Care and Prevention, Alpert Medical School of Brown University; I.K. Haugen, MD, PhD, Rheumatology Fellow, Department of Rheumatology, Diakonhjemmet Hospital; S.E. Smith, MD, Section Head and Weissman Distinguished Chair of Musculoskeletal Radiology, Associate Radiology Residency Program Director, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School; J. Duryea, PhD, Associate Research Associate, Associate Professor of Radiology, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School; B. Lu, DrPH, MD, Assistant Professor of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital and Harvard Medical School; J.B. Driban, PhD, ATC, CSCS, Associate Professor, Division of Rheumatology, Tufts Medical Center
| | - Jeffrey Duryea
- From the Division of Rheumatology, Tufts Medical Center; Department of Radiology, Brigham and Women's Hospital and Harvard Medical School; Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; Center for Primary Care and Prevention, Alpert Medical School of Brown University, Pawtucket, Rhode Island, USA; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.,J.E. Davis, BS, Research Assistant II, Division of Rheumatology, Tufts Medical Center; L.F. Schaefer, MD, Radiology Fellow, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School; T.E. McAlindon, MD, MPH, Chief of Rheumatology, Division of Rheumatology, Tufts Medical Center; C.B. Eaton, MD, MS, Professor of Family Medicine and Epidemiology, Director of Center for Primary Care and Prevention, Alpert Medical School of Brown University; M.B. Roberts, MSc, Statistical Programmer, Center for Primary Care and Prevention, Alpert Medical School of Brown University; I.K. Haugen, MD, PhD, Rheumatology Fellow, Department of Rheumatology, Diakonhjemmet Hospital; S.E. Smith, MD, Section Head and Weissman Distinguished Chair of Musculoskeletal Radiology, Associate Radiology Residency Program Director, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School; J. Duryea, PhD, Associate Research Associate, Associate Professor of Radiology, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School; B. Lu, DrPH, MD, Assistant Professor of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital and Harvard Medical School; J.B. Driban, PhD, ATC, CSCS, Associate Professor, Division of Rheumatology, Tufts Medical Center
| | - Bing Lu
- From the Division of Rheumatology, Tufts Medical Center; Department of Radiology, Brigham and Women's Hospital and Harvard Medical School; Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; Center for Primary Care and Prevention, Alpert Medical School of Brown University, Pawtucket, Rhode Island, USA; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.,J.E. Davis, BS, Research Assistant II, Division of Rheumatology, Tufts Medical Center; L.F. Schaefer, MD, Radiology Fellow, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School; T.E. McAlindon, MD, MPH, Chief of Rheumatology, Division of Rheumatology, Tufts Medical Center; C.B. Eaton, MD, MS, Professor of Family Medicine and Epidemiology, Director of Center for Primary Care and Prevention, Alpert Medical School of Brown University; M.B. Roberts, MSc, Statistical Programmer, Center for Primary Care and Prevention, Alpert Medical School of Brown University; I.K. Haugen, MD, PhD, Rheumatology Fellow, Department of Rheumatology, Diakonhjemmet Hospital; S.E. Smith, MD, Section Head and Weissman Distinguished Chair of Musculoskeletal Radiology, Associate Radiology Residency Program Director, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School; J. Duryea, PhD, Associate Research Associate, Associate Professor of Radiology, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School; B. Lu, DrPH, MD, Assistant Professor of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital and Harvard Medical School; J.B. Driban, PhD, ATC, CSCS, Associate Professor, Division of Rheumatology, Tufts Medical Center
| | - Jeffrey B Driban
- From the Division of Rheumatology, Tufts Medical Center; Department of Radiology, Brigham and Women's Hospital and Harvard Medical School; Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; Center for Primary Care and Prevention, Alpert Medical School of Brown University, Pawtucket, Rhode Island, USA; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway. .,J.E. Davis, BS, Research Assistant II, Division of Rheumatology, Tufts Medical Center; L.F. Schaefer, MD, Radiology Fellow, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School; T.E. McAlindon, MD, MPH, Chief of Rheumatology, Division of Rheumatology, Tufts Medical Center; C.B. Eaton, MD, MS, Professor of Family Medicine and Epidemiology, Director of Center for Primary Care and Prevention, Alpert Medical School of Brown University; M.B. Roberts, MSc, Statistical Programmer, Center for Primary Care and Prevention, Alpert Medical School of Brown University; I.K. Haugen, MD, PhD, Rheumatology Fellow, Department of Rheumatology, Diakonhjemmet Hospital; S.E. Smith, MD, Section Head and Weissman Distinguished Chair of Musculoskeletal Radiology, Associate Radiology Residency Program Director, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School; J. Duryea, PhD, Associate Research Associate, Associate Professor of Radiology, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School; B. Lu, DrPH, MD, Assistant Professor of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital and Harvard Medical School; J.B. Driban, PhD, ATC, CSCS, Associate Professor, Division of Rheumatology, Tufts Medical Center.
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Schaefer LF, Nikac V, Lynch J, Duryea J. Quantitative measurement of cartilage volume is possible using two-dimensional magnetic resonance imaging data sets. Osteoarthritis Cartilage 2018; 26:920-923. [PMID: 29704559 PMCID: PMC6015652 DOI: 10.1016/j.joca.2018.04.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 04/09/2018] [Accepted: 04/11/2018] [Indexed: 02/02/2023]
Abstract
PURPOSE 3D Magnetic resonance imaging (MRI) scans are generally used for quantitative cartilage measurements in knee osteoarthritis. However, a great deal of MRI data is from 2D scans, often thought to be unsuitable for quantitative cartilage assessment. The goal of our study was to demonstrate that mLACS, a modified version of the Local Area Cartilage Segmentation (LACS) method, could be used to measure cartilage volume on 2D MRI images. METHODS We studied 301 randomly selected subjects from the OA Biomarkers Consortium FNIH Study, a nested case-control study within the Osteoarthritis Initiative (OAI). The study comprised four subgroups based on radiographic and pain progression. We compared mLACS applied to 2D TSE scans to LACS on 3D DESS data. The Pearson's correlation coefficient was used to establish agreement between LACS and mLACS, standardized response means (SRMs) for responsiveness, and intra-class correlation coefficients (ICCs) to measure reader precision. Logistic regression in a case/control analysis was used to compare the clinical validity between the two methods. RESULTS We found R2 = 0.76 for the correlation between LACS and mLACs. For LACS, the responsiveness was SRM = 0.49 compared to 0.39 for mLACS. The odds ratios (OR) for the primary case/control analyses were 1.62 for LACS and 1.78 for mLACS. The intra and inter reader reproducibility values for mLACS were ICC = 0.90 and 0.86, respectively. CONCLUSION This study has demonstrated that a reproducible, responsive, and clinically valid quantitative measurement of cartilage volume can be made using 2D TSE scans with a modest loss of responsiveness compared to 3D scans.
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Affiliation(s)
- L. F. Schaefer
- Brigham and Women’s Hospital, Harvard Medical School. Boston, MA
| | - V. Nikac
- Brigham and Women’s Hospital, Harvard Medical School. Boston, MA
| | - J.A. Lynch
- University of California, San Francisco. San Francisco, CA
| | - J. Duryea
- Brigham and Women’s Hospital, Harvard Medical School. Boston, MA
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Driban JB, McAlindon TE, Amin M, Price LL, Eaton CB, Davis JE, Lu B, Lo GH, Duryea J, Barbe MF. Risk factors can classify individuals who develop accelerated knee osteoarthritis: Data from the osteoarthritis initiative. J Orthop Res 2018; 36:876-880. [PMID: 28776751 PMCID: PMC5797506 DOI: 10.1002/jor.23675] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Accepted: 08/01/2017] [Indexed: 02/04/2023]
Abstract
We assessed which combinations of risk factors can classify adults who develop accelerated knee osteoarthritis (KOA) or not and which factors are most important. We conducted a case-control study using data from baseline and the first four annual visits of the Osteoarthritis Initiative. Participants had no radiographic KOA at baseline (Kellgren-Lawrence [KL]<2). We classified three groups (matched on sex): (i) accelerated KOA: >1 knee developed advance-stage KOA (KL = 3 or 4) within 48 months; (ii) typical KOA: >1 knee increased in radiographic scoring (excluding those with accelerated KOA); and (iii) No KOA: no change in KL grade by 48 months. We selected eight predictors: Serum concentrations for C-reactive protein, glycated serum protein (GSP), and glucose; age; sex; body mass index; coronal tibial slope, and femorotibial alignment. We performed a classification and regression tree (CART) analysis to determine rules for classifying individuals as accelerated KOA or not (no KOA and typical KOA). The most important baseline variables for classifying individuals with incident accelerated KOA (in order of importance) were age, glucose concentrations, BMI, and static alignment. Individuals <63.5 years were likely not to develop accelerated KOA, except when overweight. Individuals >63.5 years were more likely to develop accelerated KOA except when their glucose levels were >81.98 mg/dl and they did not have varus malalignment. The unexplained variance of the CART = 69%. These analyses highlight the complex interactions among four risk factors that may classify individuals who will develop accelerated KOA but more research is needed to uncover novel risk factors. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:876-880, 2018.
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Affiliation(s)
| | | | - Mamta Amin
- Department of Anatomy and Cell Biology, Temple University School of Medicine, Philadelphia, PA, USA
| | - Lori Lyn Price
- The Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA,Tufts Clinical and Translational Science Institute, Tufts University, Boston, MA, USA
| | - Charles B. Eaton
- Center for Primary Care and Prevention, Alpert Medical School of Brown University, Pawtucket, RI, USA
| | - Julie E. Davis
- Division of Rheumatology, Tufts Medical Center, Boston, MA, USA
| | - Bing Lu
- Division of Rheumatology, Immunology & Allergy, Brigham & Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Grace H. Lo
- Medical Care Line and Research Care Line, Houston Health Services Research and Development (HSR&D) Center of Excellence Michael E. DeBakey VAMC, Houston, TX, USA,Section of Immunology, Allergy, and Rheumatology, Baylor College of Medicine, Houston, TX, USA
| | - Jeffrey Duryea
- Department of Radiology, Brigham & Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Mary F. Barbe
- Department of Anatomy and Cell Biology, Temple University School of Medicine, Philadelphia, PA, USA
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Gravallese EM, Kay J, Duryea J, Solomon DH. Reply. Arthritis Rheumatol 2018; 70:476. [DOI: 10.1002/art.40387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Ellen M. Gravallese
- UMass Memorial Medical Center; Worcester MA
- University of Massachusetts Medical School; Worcester MA
| | - Jonathan Kay
- UMass Memorial Medical Center; Worcester MA
- University of Massachusetts Medical School; Worcester MA
| | - Jeffrey Duryea
- Brigham and Women's Hospital; Boston MA
- Harvard Medical School; Boston MA
| | - Daniel H. Solomon
- Brigham and Women's Hospital; Boston MA
- Harvard Medical School; Boston MA
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Lo GH, Merchant MG, Driban JB, Duryea J, Price LL, Eaton CB, McAlindon TE. Knee Alignment Is Quantitatively Related to Periarticular Bone Morphometry and Density, Especially in Patients With Osteoarthritis. Arthritis Rheumatol 2018; 70:212-221. [PMID: 28940779 DOI: 10.1002/art.40325] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 09/13/2017] [Indexed: 01/16/2023]
Abstract
OBJECTIVE Static alignment influences knee loading and predicts osteoarthritis (OA) progression. Periarticular bone is important in dispersing forces across the knee, and there is substantial evidence for molecular crosstalk between cartilage and subchondral bone. The aim of this study was to evaluate the relationship between periarticular trabecular bone morphology and bone mineral density (BMD) and knee alignment in OA. METHODS This was a cross-sectional analysis of participants in the Osteoarthritis Initiative Bone Ancillary Study. Dual x-ray absorptiometry (DXA) was performed to measure tibial periarticular bone mineral density (paBMD). Magnetic resonance imaging of knee trabecular bone was performed to calculate the apparent bone volume fraction (aBVF), apparent trabecular number (aTbN), apparent trabecular spacing (aTbSp), and apparent trabecular thickness (aTbTh). Static alignment was assessed by measuring the hip-knee-ankle (HKA) angle on long-limb films. RESULTS The study group comprised 436 participants (mean ± SD age 65.4 ± 9.2 years, 46% female, mean ± SD body mass index 29.6 ± 4.6 kg/m2 ), 71% of whom had OA. Correlations between the HKA angle and medial:lateral paBMD, medial paBMD, aBVF, aTbN, aTbTh, and aTbSp were -0.63, -0.34, -0.29, -0.32, -0.22, and 0.30, respectively. More varus alignment was associated with higher medial:lateral paBMD, medial paBMD, aBVF, aTbN, aTbTh, and lower aTbSp. In OA knees, the results were more pronounced. In non-OA knees, the most consistent association was with medial:lateral paBMD. CONCLUSION Static alignment was associated with medial:lateral paBMD in all knees and with medial paBMD and trabecular morphometry in OA knees only. Aberrant knee loading may lead to increased relative subchondral bone density, which is partly related to a higher aBVF and a greater number of thicker trabeculae with smaller intertrabecular spacing. Knee DXA may be a useful early biomarker of knee OA.
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Affiliation(s)
- Grace H Lo
- Baylor College of Medicine and Houston VA Health Services Research & Development Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Medical Center, Houston, Texas
| | - Mehveen G Merchant
- Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
| | | | | | - Lori Lyn Price
- Tufts Medical Center and Tufts University, Boston, Massachusetts
| | - Charles B Eaton
- Memorial Hospital of Rhode Island and Alpert Medical School of Brown University, Pawtucket, Rhode Island
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30
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Schaefer LF, McAlindon TE, Eaton CB, Roberts MB, Haugen IK, Smith SE, Duryea J, Driban JB. The associations between radiographic hand osteoarthritis definitions and hand pain: data from the osteoarthritis initiative. Rheumatol Int 2017; 38:403-413. [PMID: 29270642 DOI: 10.1007/s00296-017-3913-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Accepted: 12/12/2017] [Indexed: 11/30/2022]
Abstract
The goal of our study was to evaluate the associations between various definitions of radiographic hand osteoarthritis (OA) and self-reported hand pain. We conducted a cross-sectional study with 3604 participants from the Osteoarthritis Initiative (OAI). Posteroanterior radiographs of the dominant hand were read using a modified Kellgren-Lawrence (KL) scale. For our primary analysis, hand OA at person level was defined as two or more finger joints with KL grade 2 or higher. In addition, for the purpose of exploratory analyses, we explored more conservative definitions of hand OA as well as different sum scores and digit- and row-based scores. The majority of definitions of radiographic hand OA were statistically significantly associated with self-reported hand pain. In our main analysis, persons with two or more finger joints with KL grade > 2 were approximately two times more likely to self-report hand pain than persons without radiographic hand OA. Increasing KL grades and increasing number of joints affected lead to stronger associations. Almost all definitions of hand OA were related to pain. Individuals with more severely affected joints or with higher number of affected joints are more likely to report hand pain than their peers. Specifically, individuals with hand joints with KL 3 or 4 have the greatest likelihood of hand pain.
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Affiliation(s)
- Lena F Schaefer
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA.
| | | | - Charles B Eaton
- Center for Primary Care, Prevention, Alpert Medical School of Brown University, Providence, USA
| | - Mary B Roberts
- Center for Primary Care, Prevention, Alpert Medical School of Brown University, Providence, USA
| | - Ida K Haugen
- Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
| | - Stacy E Smith
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA
| | - Jeffrey Duryea
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA
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Mehta N, Duryea J, Badger GJ, Akelman MR, Jones MH, Spindler KP, Fleming BC. Comparison of 2 Radiographic Techniques for Measurement of Tibiofemoral Joint Space Width. Orthop J Sports Med 2017; 5:2325967117728675. [PMID: 28989937 PMCID: PMC5624356 DOI: 10.1177/2325967117728675] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Background: No consensus is available regarding the best method for measuring tibiofemoral joint space width (JSW) on radiographs to quantify joint changes after injury. Studies that track articular cartilage thickness after injury frequently use patients’ uninjured contralateral knees as controls, although the literature supporting this comparison is limited. Purpose: (1) To compare JSW measurements using 2 established measurement techniques in healthy control participants and (2) to determine whether the mean JSW of the uninjured contralateral knee in a cohort with anterior cruciate ligament (ACL) reconstruction is different from that obtained from a true control population. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: Medial and lateral JSWs were measured on standardized, bilateral, semiflexed metatarsophalangeal positioning, posteroanterior radiographs of 60 healthy individuals (26 females; mean ± SD age, 25 ± 6.2 years; no history of knee injury) via 2 published techniques: a computerized surface-delineation method (surface-fit method) and a manual digitization method (midpoint method). Bland-Altman method was used to examine the agreement between JSW measurements obtained with the 2 methods and to examine the agreement between measurements obtained on left and right knees within a participant for each measurement method. Within- and between-participant variance components and intraclass correlation coefficients (ICCs) were computed for JSW measurements corresponding to each method. Two-sample t tests were used to compare the surface-fit method measurements of mean JSW of the true control group (n = 60) with the previously published mean JSW measurements from the Multicenter Orthopaedics Outcomes Network (MOON) nested cohort of 262 contralateral uninjured knees 2 to 3 years after ACL reconstruction. Results: For JSW in the medial compartment, the surface-fit method had lower within-participant interknee variability (σ2within, 0.064; 95% CI, 0.04-0.09) compared with the midpoint method (σ2within, 0.28; 95% CI, 0.20-0.43) and a higher ICC (0.93 vs 0.65; P < .001). Lateral JSW values were similar for the surface-fit method (σ2within, 0.27; 95% CI, 0.18-0.43) and the midpoint method (σ2within, 0.20; 95% CI, 0.14-0.31), with ICCs of 0.75 and 0.77, respectively (P = .80). With the surface-fit method, mean JSW measurements of the medial and lateral compartments of a control population were not significantly different from the contralateral uninjured knees of patients after ACL reconstruction. Conclusion: For measuring medial JSW, the surface-fit method was less variable across knees within a participant than the midpoint method, as evidenced by larger ICCs and lower interknee variability. For measuring lateral JSW, the 2 methods were similar. The JSW measurements of uninjured contralateral knees of patients with ACL reconstruction at 2 to 3 years postsurgery were not significantly different from those of a cohort of healthy control participants. Future work should be performed to demonstrate the validity of these methods for documenting change over time in the ACL-reconstructed knee.
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Affiliation(s)
- Nabil Mehta
- Department of Orthopaedics, The Warren Alpert Medical School of Brown University/Rhode Island Hospital, Providence, Rhode Island, USA
| | - Jeffrey Duryea
- Department of Radiology, Brigham and Women's Hospital/Harvard University, Boston Massachusetts, USA
| | - Gary J Badger
- Department of Medical Biostatistics, University of Vermont, Burlington, Vermont, USA
| | - Matthew R Akelman
- Department of Orthopaedics, The Warren Alpert Medical School of Brown University/Rhode Island Hospital, Providence, Rhode Island, USA
| | - Morgan H Jones
- Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio, USA
| | - Kurt P Spindler
- Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio, USA
| | - Braden C Fleming
- Department of Orthopaedics, The Warren Alpert Medical School of Brown University/Rhode Island Hospital, Providence, Rhode Island, USA
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Charles JF, Sury M, Tsang K, Urso K, Henke K, Huang Y, Russell R, Duryea J, Harris MP. Utility of quantitative micro-computed tomographic analysis in zebrafish to define gene function during skeletogenesis. Bone 2017; 101:162-171. [PMID: 28476577 PMCID: PMC5512604 DOI: 10.1016/j.bone.2017.05.001] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Revised: 04/23/2017] [Accepted: 05/01/2017] [Indexed: 11/16/2022]
Abstract
The zebrafish is a powerful experimental model to investigate the genetic and morphologic basis of vertebrate development. Analysis of skeletogenesis in this fish is challenging as a result of the small size of the developing and adult zebrafish. Many of the bones of small fishes such as the zebrafish and medaka are quite thin, precluding many standard assays of bone quality and morphometrics commonly used on bones of larger animals. Microcomputed tomography (microCT) is a common imaging technique used for detailed analysis of the skeleton of the zebrafish and determination of mutant phenotypes. However, the utility of this modality for analysis of the zebrafish skeleton, and the effect of inherent variation among individual zebrafish, including variables such as sex, age and strain, is not well understood. Given the increased use and accessibility of microCT, we set out to define the sensitivity of microCT methods in developing and adult zebrafish. We assessed skeletal shape and density measures in the developing vertebrae and parasphenoid of the skull base. We found most skeletal variables are tightly correlated to standard length, but that at later growth stages (>3months) there are age dependent effects on some skeletal measures. Further we find modest strain but not sex differences in skeletal measures. These data suggest that the appropriate control for assessing mutant phenotypes should be age and strain matched, ideally a wild-type sibling. By analyzing two mutants exhibiting skeletal dysplasia, we show that microCT imaging can be a sensitive method to quantify distinct skeletal parameters of adults. Finally, as developing zebrafish skeletons remain difficult to resolve by radiographic means, we define a contrast agent specific for bone that enhances resolution at early stages, permitting detailed morphometric analysis of the forming skeleton. This increased capability for detection extends the use of this imaging modality to leverage the zebrafish model to understand the development causes of skeletal dysplasias.
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Affiliation(s)
- Julia F Charles
- Department of Medicine, Brigham and Women's Hospital, United States.
| | - Meera Sury
- Department of Genetics, Harvard Medical School, United States; Department of Orthopaedics, Boston Children's Hospital, United States; Department of Radiology, Brigham and Women's Hospital, United States
| | - Kelly Tsang
- Department of Radiology, Brigham and Women's Hospital, United States
| | - Katia Urso
- Department of Medicine, Brigham and Women's Hospital, United States
| | - Katrin Henke
- Department of Genetics, Harvard Medical School, United States; Department of Orthopaedics, Boston Children's Hospital, United States
| | - Yue Huang
- Department of Genetics, Harvard Medical School, United States; Department of Orthopaedics, Boston Children's Hospital, United States
| | - Ruby Russell
- Department of Radiology, Brigham and Women's Hospital, United States
| | - Jeffrey Duryea
- Department of Radiology, Brigham and Women's Hospital, United States
| | - Matthew P Harris
- Department of Genetics, Harvard Medical School, United States; Department of Orthopaedics, Boston Children's Hospital, United States.
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Solomon DH, Kay J, Duryea J, Lu B, Bolster MB, Yood RA, Han R, Ball S, Coleman C, Lo E, Wohlfahrt A, Sury M, Yin M, Yu Z, Zak A, Gravallese EM. Effects of Teriparatide on Joint Erosions in Rheumatoid Arthritis: A Randomized Controlled Trial. Arthritis Rheumatol 2017; 69:1741-1750. [PMID: 28544807 DOI: 10.1002/art.40156] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 05/16/2017] [Indexed: 01/01/2023]
Abstract
OBJECTIVE Articular erosions correlate with disability in rheumatoid arthritis (RA). Biologic agents reduce erosion progression in RA, but erosion healing occurs infrequently. This study was undertaken to assess the effects of the anabolic agent teriparatide on joint erosion volume in RA patients treated with a tumor necrosis factor inhibitor (TNFi). METHODS We conducted a randomized controlled trial in 24 patients with erosive RA, osteopenia, and disease activity controlled by TNFi treatment for at least 3 months. Half were randomized to receive teriparatide for 1 year and the others constituted a wait-list control group. Subjects and primary rheumatologists were not blinded with regard to treatment assignment, but all outcomes were assessed in a blinded manner. The primary outcome measure was change in erosion volume determined by computed tomography at 6 anatomic sites. Significance within each hand and anatomic site was based on a 2-tailed test, with P values less than 0.05 considered significant. RESULTS Baseline characteristics of the treatment groups were well balanced. After 52 weeks, the median change in erosion volume in the teriparatide group was -0.4 mm3 (interquartile range [IQR] -34.5, 29.6) and did not differ significantly from that in controls (median change +9.1 mm3 [IQR -29.6, 26.4]) (P = 0.28). No significant difference in change in erosion volume was noted at the radius, ulna, or metacarpophalangeal joints. Bone mineral density improved at the femoral neck and lumbar spine in the teriparatide group. CONCLUSION Our findings indicate that teriparatide treatment for 1 year does not significantly reduce erosion volume in the hands or wrists of patients with established RA with disease activity controlled by TNFi treatment.
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Affiliation(s)
- D H Solomon
- Brigham and Women's Hospital, Boston, Massachusetts
| | - J Kay
- University of Massachusetts Memorial Medical Center, Worcester
| | - J Duryea
- Brigham and Women's Hospital, Boston, Massachusetts
| | - B Lu
- Brigham and Women's Hospital, Boston, Massachusetts
| | | | - R A Yood
- Reliant Medical Group, Worcester, Massachusetts
| | - R Han
- Brigham and Women's Hospital, Boston, Massachusetts
| | - S Ball
- University of Massachusetts Memorial Medical Center, Worcester
| | - C Coleman
- Brigham and Women's Hospital, Boston, Massachusetts
| | - E Lo
- Brigham and Women's Hospital, Boston, Massachusetts
| | - A Wohlfahrt
- Brigham and Women's Hospital, Boston, Massachusetts
| | - M Sury
- Brigham and Women's Hospital, Boston, Massachusetts
| | - M Yin
- Brigham and Women's Hospital, Boston, Massachusetts
| | - Z Yu
- Brigham and Women's Hospital, Boston, Massachusetts
| | - A Zak
- Brigham and Women's Hospital, Boston, Massachusetts
| | - E M Gravallese
- University of Massachusetts Memorial Medical Center, Worcester
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Segal NA, Frick E, Duryea J, Nevitt MC, Niu J, Torner JC, Felson DT, Anderson DD. Comparison of tibiofemoral joint space width measurements from standing CT and fixed flexion radiography. J Orthop Res 2017; 35:1388-1395. [PMID: 27504863 PMCID: PMC5299055 DOI: 10.1002/jor.23387] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 07/29/2016] [Indexed: 02/04/2023]
Abstract
The objective of this project was to determine the relationship between medial tibiofemoral joint space width measured on fixed-flexion radiographs and the three-dimensional joint space width distribution on low-dose, standing CT (SCT) imaging. At the 84-month visit of the Multicenter Osteoarthritis Study, 20 participants were recruited. A commercial SCT scanner for the foot and ankle was modified to image knees while standing. Medial tibiofemoral joint space width was assessed on radiographs at fixed locations from 15% to 30% of compartment width using validated software and on SCT by mapping the distances between three-dimensional subchondral bone surfaces. Individual joint space width values from radiographs were compared with three-dimensional joint space width values from corresponding sagittal plane locations using paired t-tests and correlation coefficients. For the four medial-most tibiofemoral locations, radiographic joint space width values exceeded the minimal joint space width on SCT by a mean of 2.0 mm and were approximately equal to the 61st percentile value of the joint space width distribution at each respective sagittal-plane location. Correlation coefficients at these locations were 0.91-0.97 and the offsets between joint space width values from radiographs and SCT measurements were consistent. There were greater offsets and variability in the offsets between modalities closer to the tibial spine. Joint space width measurements on fixed-flexion radiographs are highly correlated with three-dimensional joint space width from SCT. In addition to avoiding bony overlap obscuring the joint, a limitation of radiographs, the current study supports a role for SCT in the evaluation of tibiofemoral OA. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:1388-1395, 2017.
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Affiliation(s)
- Neil A. Segal
- Department of Rehabilitation, The University of Kansas (Kansas City, KS)
- Department of Epidemiology, The University of Iowa College of Public Health (Iowa City, IA)
| | - Eric Frick
- Department of Orthopaedics & Rehabilitation, The University of Iowa (Iowa City, IA)
| | - Jeffrey Duryea
- Brigham and Women's Hospital/Harvard Medical School (Boston, MA, USA)
| | - Michael C. Nevitt
- Department of Epidemiology & Biostatistics, University of California, San Francisco (San Francisco, CA)
| | - Jingbo Niu
- Clinical Epidemiology Research & Training Unit, Boston University School of Medicine (Boston, MA)
| | - James C. Torner
- Department of Epidemiology, The University of Iowa College of Public Health (Iowa City, IA)
| | - David T. Felson
- Clinical Epidemiology Research & Training Unit, Boston University School of Medicine (Boston, MA)
| | - Donald D. Anderson
- Department of Orthopaedics & Rehabilitation, The University of Iowa (Iowa City, IA)
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Schaefer LF, Sury M, Yin M, Jamieson S, Donnell I, Smith SE, Lynch JA, Nevitt MC, Duryea J. Quantitative measurement of medial femoral knee cartilage volume - analysis of the OA Biomarkers Consortium FNIH Study cohort. Osteoarthritis Cartilage 2017; 25:1107-1113. [PMID: 28153788 PMCID: PMC5466831 DOI: 10.1016/j.joca.2017.01.010] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Revised: 01/17/2017] [Accepted: 01/22/2017] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Large studies of knee osteoarthritis (KOA) require well-characterized efficient methods to assess progression. We previously developed the local-area cartilage segmentation (LACS) software method, to measure cartilage volume on magnetic resonance imaging (MRI) scans. The present study further validates this method in a larger patient cohort and assesses predictive validity in a case-control study. METHOD The OA Biomarkers Consortium FNIH Project, a case-control study of KOA progression nested within the Osteoarthritis Initiative (OAI), includes 600 subjects in four subgroups based on radiographic and pain progression. Our software tool measured change in medial femoral cartilage volume in a central weight-bearing region. Different sized regions of cartilage were assessed to explore their sensitivity to change. The readings were performed on MRI scans at the baseline and 24-month visits. We used standardized response means (SRMs) for responsiveness and logistic regression for predictive validity. RESULTS Cartilage volume change was associated strongly with radiographic progression (odds ratios (OR) = 4.66; 95% confidence intervals (CI) = 2.85-7.62). OR were significant but of lesser magnitude for the combined radiographic and pain progression outcome (OR = 1.70; 95% CI = 1.40-2.07). For the full 600 subjects, theSRM was -0.51 for the largest segmented area. Smaller areas of cartilage segmentation were also able to predict the case-control status. The average reader time for the largest area was less than 20 min per scan. Smaller areas could be assessed with less reader time. CONCLUSION We demonstrated that the LACS method is fast, responsive, and associated with radiographic and pain progression, and is appropriate for existing and future large studies of KOA.
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Affiliation(s)
- Lena F. Schaefer
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Meera Sury
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Ming Yin
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Scott Jamieson
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Isaac Donnell
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Stacy E. Smith
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | | | | | - Jeffrey Duryea
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA
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Segal NA, Frick E, Duryea J, Roemer F, Guermazi A, Nevitt MC, Torner JC, Felson DT, Anderson DD. Correlations of Medial Joint Space Width on Fixed-Flexed Standing Computed Tomography and Radiographs With Cartilage and Meniscal Morphology on Magnetic Resonance Imaging. Arthritis Care Res (Hoboken) 2017; 68:1410-6. [PMID: 26991547 DOI: 10.1002/acr.22888] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Revised: 01/11/2016] [Accepted: 03/15/2016] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To assess whether medial tibiofemoral joint space width (JSW) on 3-dimensional (3-D) standing computed tomography (SCT) correlates more closely with magnetic resonance imaging cartilage morphology (CM) and meniscal scores than does radiographic 2-D JSW. METHODS Participants in the Multicenter Osteoarthritis Study, who had standing fixed-flexion posteroanterior knee radiographs, were recruited. Medial tibiofemoral 3-D JSW on SCT and 2-D JSW on fixed-flexion radiographs were compared with medial tibiofemoral cartilage and meniscal morphology using the Whole-Organ Magnetic Resonance Imaging Score (WORMS). Associations between the area of the articular surface with 3-D JSW <2.5 mm on SCT, radiographic minimal 2-D JSW, and the WORMS-CM and meniscal scores were assessed using Spearman's rho. RESULTS For the 19 participants included (33 knees), mean ± SD age was 66.9 ± 5.4 years, body mass index was 29.5 ± 4.4 kg/m(2) , 42.1% of participants were female, and the Kellgren/Lawrence grades were 0 (21.2%), 1 (36.4%), 2 (18.2%), and 3 (24.2%). The articular surface area with 3-D JSW <2.5 mm on SCT correlated with WORMS-CM scores for the central medial tibia (rs = 0.84, P < 0.001), central medial femur (rs = 0.60, P < 0.007), and posterior medial meniscal tear (rs = 0.39, P < 0.026), as did other cut points for 3-D JSW. Correlations with radiographic minimal 2-D JSW were -0.66, -0.52, and -0.40, respectively, differing from SCT only for tibial cartilage (P = 0.001). CONCLUSION Greater surface area with a low JSW, measured by SCT, correlates more strongly with the severity of tibial cartilage lesions, while correlating with medial femoral cartilage and meniscal damage to a similar extent as radiographic minimal JSW. SCT may enable valid stratification of participants in clinical trials, through quickly and inexpensively characterizing osteoarthritis features.
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Affiliation(s)
- N A Segal
- University of Kansas, Kansas City, and University of Iowa, Iowa City.
| | - E Frick
- University of Iowa, Iowa City
| | - J Duryea
- Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - F Roemer
- Boston University, Boston, Massachusetts
| | - A Guermazi
- Boston University, Boston, Massachusetts
| | | | | | - D T Felson
- Boston University, Boston, Massachusetts
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Duryea J, Cheng C, Schaefer L, Smith S, Madore B. Integration of accelerated MRI and post-processing software: a promising method for studies of knee osteoarthritis. Osteoarthritis Cartilage 2016; 24:1905-1909. [PMID: 27296293 PMCID: PMC7608695 DOI: 10.1016/j.joca.2016.06.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2015] [Revised: 04/30/2016] [Accepted: 06/04/2016] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Magnetic resonance imaging (MRI) is a widely used imaging modality for studies of knee osteoarthritis (OA). Compared to radiography, MRI offers exceptional soft tissue imaging and true three-dimensional (3D) visualization. However, MRI is expensive both due to the cost of acquisition and evaluation of the images. The goal of our study is to develop a new method to address the cost of MRI by combining innovative acquisition methods and automated post-processing software. METHODS Ten healthy volunteers were scanned with three different MRI protocols: A standard 3D dual-echo steady state (DESS) pulse sequence, an accelerated DESS (DESSAcc), acquired at approximately half the time compared to DESS, and a multi-echo time DESS (DESSMTE), which is capable of producing measurements of T2 relaxation time. A software tool was used to measure cartilage volume. Accuracy was quantified by comparing DESS to DESSAcc and DESSMTE and precision was measured using repeat readings and acquisitions. T2 precision was determined using duplicate DESSMTE acquisitions. Intra-class correlation coefficients (ICCs), root-mean square standard deviation (RMSSD), and the coefficient of variation (CoV) were used to quantify accuracy and precision. RESULTS The accuracies of DESSAcc and DESSMTE were CoV = 3.7% and CoV = 6.6% respectively, while precision was 3.8%, 3.0%, and 3.1% for DESS, DESSAcc and DESSMTE. T2 repositioning precision was 5.8%. CONCLUSION The results demonstrate that accurate and precise quantification of cartilage volume is possible using a combination of substantially faster MRI acquisition and post-processing software. Precise measurements of cartilage T2 and volume can be made using the same acquisition.
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Affiliation(s)
- J. Duryea
- Address correspondence and reprint requests to: J.
Duryea, Radiology, Brigham and Women’s Hospital, Harvard Medical School,
75 Francis Street, Boston, MA 02115, USA,
(J. Duryea)
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Driban JB, Stout AC, Duryea J, Lo GH, Harvey WF, Price LL, Ward RJ, Eaton CB, Barbe MF, Lu B, McAlindon TE. Coronal tibial slope is associated with accelerated knee osteoarthritis: data from the Osteoarthritis Initiative. BMC Musculoskelet Disord 2016; 17:299. [PMID: 27432004 PMCID: PMC4950083 DOI: 10.1186/s12891-016-1158-9] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Accepted: 06/03/2016] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Accelerated knee osteoarthritis may be a unique subset of knee osteoarthritis, which is associated with greater knee pain and disability. Identifying risk factors for accelerated knee osteoarthritis is vital to recognizing people who will develop accelerated knee osteoarthritis and initiating early interventions. The geometry of an articular surface (e.g., coronal tibial slope), which is a determinant of altered joint biomechanics, may be an important risk factor for incident accelerated knee osteoarthritis. We aimed to determine if baseline coronal tibial slope is associated with incident accelerated knee osteoarthritis or common knee osteoarthritis. METHODS We conducted a case-control study using data and images from baseline and the first 4 years of follow-up in the Osteoarthritis Initiative. We included three groups: 1) individuals with incident accelerated knee osteoarthritis, 2) individuals with common knee osteoarthritis progression, and 3) a control group with no knee osteoarthritis at any time. We did 1:1:1 matching for the 3 groups based on sex. Weight-bearing, fixed flexion posterior-anterior knee radiographs were obtained at each visit. One reader manually measured baseline coronal tibial slope on the radiographs. Baseline femorotibial angle was measured on the radiographs using a semi-automated program. To assess the relationship between slope (predictor) and incident accelerated knee osteoarthritis or common knee osteoarthritis (outcomes) compared with no knee osteoarthritis (reference outcome), we performed multinomial logistic regression analyses adjusted for sex. RESULTS The mean baseline slope for incident accelerated knee osteoarthritis, common knee osteoarthritis, and no knee osteoarthritis were 3.1(2.0), 2.7(2.1), and 2.6(1.9); respectively. A greater slope was associated with an increased risk of incident accelerated knee osteoarthritis (OR = 1.15 per degree, 95 % CI = 1.01 to 1.32) but not common knee osteoarthritis (OR = 1.04, 95 % CI = 0.91 to 1.19). These findings were similar when adjusted for recent injury. Among knees with varus malalignment a greater slope increases the odds of incident accelerated knee osteoarthritis; there is no significant relationship between slope and incident accelerated knee osteoarthritis among knees with normal alignment. CONCLUSIONS Coronal tibial slope, particularly among knees with malalignment, may be an important risk factor for incident accelerated knee osteoarthritis.
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Affiliation(s)
- Jeffrey B Driban
- Division of Rheumatology, Tufts Medical Center, 800 Washington Street, Box #406, Boston, MA, 02111, USA.
| | - Alina C Stout
- Division of Rheumatology, Tufts Medical Center, 800 Washington Street, Box #406, Boston, MA, 02111, USA
| | - Jeffrey Duryea
- Department of Radiology, Brigham & Women's Hospital and Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA
| | - Grace H Lo
- Medical Care Line and Research Care Line, Houston Health Services Research and Development (HSR&D) Center of Excellence Michael E. DeBakey VAMC, 2002 Holcombe Blvd, Houston, TX, 77030, USA.,Section of Immunology, Allergy, and Rheumatology, Baylor College of Medicine, 1 Baylor Plaza, BCM-285, Houston, TX, 77030, USA
| | - William F Harvey
- Division of Rheumatology, Tufts Medical Center, 800 Washington Street, Box #406, Boston, MA, 02111, USA
| | - Lori Lyn Price
- The Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, 02111, USA.,Tufts Clinical and Translational Science Institute, Tufts University, 800 Washington Street, Box #63, Boston, MA, 02111, USA
| | - Robert J Ward
- Department of Radiology, Tufts Medical Center, 800 Washington Street, Box #299, Boston, MA, 02111, USA
| | - Charles B Eaton
- Center for Primary Care and Prevention, Alpert Medical School of Brown University, 111 Brewster St, Pawtucket, RI, 02860, USA
| | - Mary F Barbe
- Department of Anatomy and Cell Biology, Temple University School of Medicine, 3500 North Broad Street, Philadelphia, PA, 19140, USA
| | - Bing Lu
- Division of Rheumatology, Immunology & Allergy, Brigham & Women's Hospital and Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA
| | - Timothy E McAlindon
- Division of Rheumatology, Tufts Medical Center, 800 Washington Street, Box #406, Boston, MA, 02111, USA
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Akelman MR, Fadale PD, Hulstyn MJ, Shalvoy RM, Garcia A, Chin KE, Duryea J, Badger GJ, Tung GA, Fleming BC. Effect of Matching or Overconstraining Knee Laxity During Anterior Cruciate Ligament Reconstruction on Knee Osteoarthritis and Clinical Outcomes: A Randomized Controlled Trial With 84-Month Follow-up. Am J Sports Med 2016; 44:1660-70. [PMID: 27159308 PMCID: PMC4930731 DOI: 10.1177/0363546516638387] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND The "initial graft tension" applied at the time of graft fixation during anterior cruciate ligament (ACL) reconstruction surgery modulates joint contact mechanics, which in turn may promote posttraumatic osteoarthritis (OA). PURPOSE/HYPOTHESES The study objectives were to compare clinical, functional, patient-reported, and OA imaging outcomes between 2 different initial laxity-based graft tension cohorts and a matched uninjured control group as well as to evaluate the effects of laxity-based graft tension on OA development at 84-month follow-up. The 2 laxity-based tension protocols were (1) to restore normal anteroposterior (AP) laxity at the time of surgery relative to the contralateral uninjured knee (low-tension group) or (2) to overconstrain AP laxity by 2 mm relative to the contralateral uninjured knee (high-tension group). The hypotheses were that (1) the high-tension group would have improved outcomes and decreased OA compared with the low-tension group after 84 months, and (2) the outcomes for the high-tension group would be equivalent to those for an age-, sex-, race-, and activity-matched group of control participants with uninjured knees. STUDY DESIGN Randomized controlled trial; Level of evidence, 1. METHODS Patients had their ACLs reconstructed with either a bone-patellar tendon-bone or 4-stranded hamstring autograft, and outcomes were compared with a matched control group. Outcomes were evaluated preoperatively and at 60 and 84 months postoperatively and included clinical (KT-1000 arthrometer AP laxity measurement and International Knee Documentation Committee [IKDC] examination score), functional (1-legged hop for distance and knee extensor torque), patient-reported (Knee injury and Osteoarthritis Outcome Score [KOOS], Short Form-36 [SF-36], and patient satisfaction survey), and OA imaging (measurement of joint space width [JSW], Osteoarthritis Research Society International [OARSI] radiographic score, and Whole-Organ Magnetic Resonance Imaging Score [WORMS]) components. Repeated-measures analyses of variance were used to evaluate differences in outcomes between the treatment groups and the control group. RESULTS There were significant differences between the 2 tension groups in 1 of 5 KOOS subscales (sports and recreation; P = .04) and 2 of 8 SF-36 subscales (vitality, mental health; P < .04) at 84 and 60 months, respectively. Both tension groups scored significantly worse than the control group in the IKDC examination (P < .001), 1-legged hop (P ≤ .017), KOOS quality of life and symptoms subscales (P < .03), and OARSI radiographic score (P ≤ .02) at 84 months. The low-tension group performed significantly worse than the control group on the KOOS pain subscale (P = .03), SF-36 general health and social functioning (P < .04), OARSI radiographic score (P < .001), and WORMS (P = .001), while the high-tension group had statistically different results than the control group in AP knee laxity (P < .001), radiographic JSW (P = .003), and OARSI radiographic score (P = .02) as well as significantly more subsequent knee injuries (P = .02) at 84 months. CONCLUSION The results do not support the hypotheses that the high-tension group would have improved outcomes when compared with the low-tension group after 84 months of healing or that the outcomes for the high-tension group would be equivalent to those for the matched control group. While there were minor differences in patient-reported outcomes between the 2 laxity-based tension groups, all other outcomes were similar. REGISTRATION NCT00434837.
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Affiliation(s)
- Matthew R. Akelman
- College of Medicine, Medical University of South Carolina, Charleston, SC
| | - Paul D. Fadale
- Dept of Orthopaedics, Brown University/Rhode Island Hospital, Providence, RI
| | - Michael J. Hulstyn
- Dept of Orthopaedics, Brown University/Rhode Island Hospital, Providence, RI
| | - Robert M. Shalvoy
- Dept of Orthopaedics, Brown University/Memorial Hospital, Providence RI
| | - Arlene Garcia
- Dept of Orthopaedics, Brown University/Rhode Island Hospital, Providence, RI
| | - Kaitlyn E. Chin
- Dept of Orthopaedics, Brown University/Rhode Island Hospital, Providence, RI
| | - Jeffrey Duryea
- Dept of Radiology, Brigham and Women’s Hospital/Harvard, Boston MA
| | - Gary J. Badger
- Dept of Medical Biostatistics, University of Vermont, Burlington, VM
| | - Glenn A. Tung
- Dept of Diagnostic Imaging, Brown University/Rhode Island Hospital, Providence, RI
| | - Braden C. Fleming
- Dept of Orthopaedics, Brown University/Rhode Island Hospital, Providence, RI
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Cheng CC, Mei CS, Duryea J, Chung HW, Chao TC, Panych LP, Madore B. Dual-pathway multi-echo sequence for simultaneous frequency and T2 mapping. J Magn Reson 2016; 265:177-87. [PMID: 26923150 PMCID: PMC4818735 DOI: 10.1016/j.jmr.2016.01.019] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2015] [Revised: 01/21/2016] [Accepted: 01/22/2016] [Indexed: 06/05/2023]
Abstract
PURPOSE To present a dual-pathway multi-echo steady state sequence and reconstruction algorithm to capture T2, T2(∗) and field map information. METHODS Typically, pulse sequences based on spin echoes are needed for T2 mapping while gradient echoes are needed for field mapping, making it difficult to jointly acquire both types of information. A dual-pathway multi-echo pulse sequence is employed here to generate T2 and field maps from the same acquired data. The approach might be used, for example, to obtain both thermometry and tissue damage information during thermal therapies, or susceptibility and T2 information from a same head scan, or to generate bonus T2 maps during a knee scan. RESULTS Quantitative T2, T2(∗) and field maps were generated in gel phantoms, ex vivo bovine muscle, and twelve volunteers. T2 results were validated against a spin-echo reference standard: A linear regression based on ROI analysis in phantoms provided close agreement (slope/R(2)=0.99/0.998). A pixel-wise in vivo Bland-Altman analysis of R2=1/T2 showed a bias of 0.034 Hz (about 0.3%), as averaged over four volunteers. Ex vivo results, with and without motion, suggested that tissue damage detection based on T2 rather than temperature-dose measurements might prove more robust to motion. CONCLUSION T2, T2(∗) and field maps were obtained simultaneously, from the same datasets, in thermometry, susceptibility-weighted imaging and knee-imaging contexts.
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Affiliation(s)
- Cheng-Chieh Cheng
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | | | - Jeffrey Duryea
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Hsiao-Wen Chung
- Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan
| | - Tzu-Cheng Chao
- Department of Computer Science and Information Engineering, National Cheng-Kung University, Tainan, Taiwan
| | - Lawrence P Panych
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Bruno Madore
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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Moyer R, Wirth W, Duryea J, Eckstein F. Anatomical alignment, but not goniometry, predicts femorotibial cartilage loss as well as mechanical alignment: data from the Osteoarthritis Initiative. Osteoarthritis Cartilage 2016; 24:254-61. [PMID: 26382108 DOI: 10.1016/j.joca.2015.08.016] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Revised: 08/17/2015] [Accepted: 08/29/2015] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To determine how frontal plane lower limb alignment obtained using a new femorotibial angle (FTA) measurement and non-radiographic handheld goniometry, predict femorotibial cartilage thickness loss in varus and valgus knees, compared with the gold standard mechanical axis (hip-knee-ankle [HKA]). METHODS 934 Osteoarthritis (OA) Initiative knees with radiographic OA had the above alignment measures and 3T knee MRIs acquired. The new FTA measure was compared to the gold standard, with and without adjusting FTA for the sex-specific varus shift. Changes in medial (MFTC) and lateral femorotibial (LFTC) cartilage thickness were quantified over 1-year and 2-years. Adjusted odds ratios (adjORs) were used to compare how the different alignment measures predict medial and lateral cartilage loss in varus and valgus knees. RESULTS Pearson correlation coefficients between 2-year MFTC/LFTC cartilage loss and alignment measures were small to moderate, and were similar for FTA (r = 0.28/-0.30) and for HKA (r = 0.28/-0.29). Using the adjusted FTA measure, varus and valgus predicted MFTC progression (adjOR = 3.73) and LFTC progression (adjOR = 2.55) as well as HKA (adjOR = 3.16 and 2.31) over 1-year, and this relationship was also observed over 2-years. Goniometry was a weak predictor for MFTC and LFTC progression (adjOR1-year = 1.65 and 1.71; adjOR2-year = 0.68 and 1.24). CONCLUSIONS After adjustment, the new FTA measure obtained from short (fixed-flexion) knee films was as good as the gold standard in predicting medial and lateral cartilage loss over 1- or 2-years, without need for obtaining long-limb radiographs for determining the mechanical axis. Goniometry and non-adjusted FTA measures, in contrast, were poor predictors of cartilage loss.
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Affiliation(s)
- R Moyer
- Faculty of Health Sciences, University of Western Ontario, London, Ontario, Canada.
| | - W Wirth
- Institute of Anatomy, Paracelsus Medical University Salzburg & Nuremberg, Salzburg, Austria; Chondrometrics GmbH, Ainring, Germany
| | - J Duryea
- Radiology Department, Brigham and Women's Hospital, Boston, MA, United States
| | - F Eckstein
- Institute of Anatomy, Paracelsus Medical University Salzburg & Nuremberg, Salzburg, Austria; Chondrometrics GmbH, Ainring, Germany
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Duryea J, Russell R, Gravallese EM, Kay J, Han R, Lu B, Solomon DH. Brief Report: Development and Validation of a Semiautomated Method to Measure Erosion Volume in Inflammatory Arthritis by Computed Tomography Scanning. Arthritis Rheumatol 2016; 68:332-6. [DOI: 10.1002/art.39459] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Accepted: 09/29/2015] [Indexed: 11/05/2022]
Affiliation(s)
- Jeffrey Duryea
- Brigham and Women's Hospital, Harvard Medical School; Boston Massachusetts
| | - Ruby Russell
- Brigham and Women's Hospital, Harvard Medical School; Boston Massachusetts
| | | | - Jonathan Kay
- University of Massachusetts Medical School; Worcester
| | - Roger Han
- Brigham and Women's Hospital, Harvard Medical School; Boston Massachusetts
| | - Bing Lu
- Brigham and Women's Hospital, Harvard Medical School; Boston Massachusetts
| | - Daniel H. Solomon
- Brigham and Women's Hospital, Harvard Medical School; Boston Massachusetts
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Hakky M, Jarraya M, Ratzlaff C, Guermazi A, Duryea J. Validity and responsiveness of a new measure of knee osteophytes for osteoarthritis studies: data from the osteoarthritis initiative. Osteoarthritis Cartilage 2015; 23:2199-2205. [PMID: 26187573 DOI: 10.1016/j.joca.2015.07.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2014] [Revised: 06/03/2015] [Accepted: 07/07/2015] [Indexed: 02/02/2023]
Abstract
PURPOSE To validate a novel quantitative MRI method to measure osteophyte volume. METHODS 90 subjects were selected from the Progression Cohort of the Osteoarthritis Initiative (OAI) at baseline and 48 months, and analyzed using a semi-automated software tool. Marginal osteophyte volume was calculated for four compartments of the central weight-bearing region of the tibiofemoral joint. Standardized response mean (SRM) for change in volume was used to quantify responsiveness. Concurrent validity was assessed via a comparison with MRI Osteoarthritis Knee Score (MOAKS) using Kruskal-Wallis analysis and Spearman's correlation coefficient. Intra- and inter-reader reliability was assessed on a subset of 20 knees using intra-class correlation coefficients (ICCs) and the root mean square standard deviation (RMSSD). RESULTS The average change in osteophyte volume (ΔV) was 196 mm(3) (SD = 272 mm(3)), and the baseline to 48-month SRM was 0.72. An increase in osteophyte volume was observed for 84% (76/90) of the subjects. Kruskal-Wallis analysis across the four MOAKS osteophyte categories was significant for medial and lateral compartments of both the tibia and femur (P < 0.001 for all). The intra-reader ICC was 0.98, and RMSSD was 82 mm(3), while inter-reader ICC was 0.97 and RMSSD was 91 mm(3). A statistically significant positive correlation was observed between osteophyte volume and several MOAKS cartilage and BML scores. The reader time was approximately 10 min per knee. CONCLUSIONS The method is responsive, efficient, and precise, making it practical for use in large cohort studies and observational research.
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Affiliation(s)
- M Hakky
- Lahey Hospital and Medical Center, Burlington MA, USA
| | - M Jarraya
- Boston University Medical Center, Boston MA, USA; Mercy Catholic Medical Center, Darby PA, USA
| | - C Ratzlaff
- Brigham and Women's Hospital, Boston MA, USA
| | - A Guermazi
- Boston University Medical Center, Boston MA, USA
| | - J Duryea
- Brigham and Women's Hospital, Boston MA, USA.
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Roemer FW, Jarraya M, Niu J, Duryea J, Lynch JA, Guermazi A. Knee joint subchondral bone structure alterations in active athletes: a cross-sectional case-control study. Osteoarthritis Cartilage 2015; 23:2184-2190. [PMID: 26187571 DOI: 10.1016/j.joca.2015.07.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Revised: 06/12/2015] [Accepted: 07/07/2015] [Indexed: 02/02/2023]
Abstract
OBJECTIVE It has been shown that trabecular bone structure parameters extracted from radiographs known as fractal signature analysis (FSA) are able to predict structural outcomes such as radiographic osteoarthritis (OA) progression. Little is known about their involvement in early disease or about differences between subjects exposed to increased joint loading such as young active athletes compared to non-athletes. Aim was to compare horizontal and vertical dimensions of bone texture considering athlete status, gender, previous anterior cruciate ligament (ACL) surgery and age. DESIGN Included were 685 patients of which 135 consecutive athletes (82% soccer players) 18-36 years old and 550 non-athletes controls in the same age range had knee radiography for assessment of subacute or chronic knee complaints. Regions of interest (ROI) were placed in the subchondral medial and lateral tibial plateaus. Fractal signatures were calculated in the horizontal and vertical dimensions. Curve fitting algorithms were applied taking into account all four risk factors in the same model adjusting for each other. RESULTS For the horizontal dimensions significant differences were observed for gender (estimate (E) 0.098 (95% confidence interval(CI)) (-0.009, 0.008), P < .0001), previous ACL surgery (E -0.031, 95% CI (-0.043, -0.019), P < .0001) and highest age group (E -0.039, 95% CI (-0.048, -0.029), P < .0001). For vertical dimensions, significant differences were shown for athletes (E -0.012, 95% CI (-0.020, -0.004), P < .0001), gender (E 0.056, 95% CI (0.049, 0.062), P < .0001), and age range from 28 to 32 years (E -0.028, 95% CI (-0.037, -0.019), P < .0001). CONCLUSIONS Trabecular bone structure differs between athletes and non-athletes, in regard to previous ACL surgery, gender and higher age.
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Affiliation(s)
- F W Roemer
- Aspetar, Qatar Orthopaedic and Sports Medicine Hospital, Doha, Qatar; Quantitative Imaging Center (QIC), Department of Radiology, Boston University School of Medicine, Boston, MA, USA; Department of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany.
| | - M Jarraya
- Quantitative Imaging Center (QIC), Department of Radiology, Boston University School of Medicine, Boston, MA, USA
| | - J Niu
- Clinical Epidemiology and Training Unit, Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - J Duryea
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - J A Lynch
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
| | - A Guermazi
- Aspetar, Qatar Orthopaedic and Sports Medicine Hospital, Doha, Qatar; Quantitative Imaging Center (QIC), Department of Radiology, Boston University School of Medicine, Boston, MA, USA
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Hunter DJ, Altman RD, Cicuttini F, Crema MD, Duryea J, Eckstein F, Guermazi A, Kijowski R, Link TM, Martel-Pelletier J, Miller CG, Mosher TJ, Ochoa-Albíztegui RE, Pelletier JP, Peterfy C, Raynauld JP, Roemer FW, Totterman SM, Gold GE. OARSI Clinical Trials Recommendations: Knee imaging in clinical trials in osteoarthritis. Osteoarthritis Cartilage 2015; 23:698-715. [PMID: 25952343 DOI: 10.1016/j.joca.2015.03.012] [Citation(s) in RCA: 94] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Revised: 03/09/2015] [Accepted: 03/09/2015] [Indexed: 02/02/2023]
Abstract
Significant advances have occurred in our understanding of the pathogenesis of knee osteoarthritis (OA) and some recent trials have demonstrated the potential for modification of the disease course. The purpose of this expert opinion, consensus driven exercise is to provide detail on how one might use and apply knee imaging in knee OA trials. It includes information on acquisition methods/techniques (including guidance on positioning for radiography, sequence/protocol recommendations/hardware for magnetic resonance imaging (MRI)); commonly encountered problems (including positioning, hardware and coil failures, sequences artifacts); quality assurance (QA)/control procedures; measurement methods; measurement performance (reliability, responsiveness, validity); recommendations for trials; and research recommendations.
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Affiliation(s)
- D J Hunter
- Institute of Bone and Joint Research, Kolling Institute, University of Sydney, Sydney, NSW, Australia; Rheumatology Department, Royal North Shore Hospital, University of Sydney, Sydney, NSW, Australia.
| | - R D Altman
- Department of Medicine, Division of Rheumatology and Immunology, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA, USA
| | - F Cicuttini
- School of Public health and Preventive Medicine, Monash University, Alfred Hospital, Melbourne 3004, Australia
| | - M D Crema
- Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine, Boston, MA, USA; Department of Radiology, Hospital do Coração (HCor) and Teleimagem, São Paulo, SP, Brazil
| | - J Duryea
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Brazil
| | - F Eckstein
- Institute of Anatomy, Paracelsus Medical University Salzburg & Nuremberg, Salzburg, Austria; Chondrometrics GmbH, Ainring, Germany
| | - A Guermazi
- Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine, Boston, MA, USA
| | - R Kijowski
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - T M Link
- Department of Radiology and Biomedical Imaging, UCSF, San Francisco, USA
| | - J Martel-Pelletier
- Osteoarthritis Research Unit, University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada
| | | | - T J Mosher
- Department of Radiology, Penn State University, Hershey, PA, USA; Department of Orthopaedic Surgery, Penn State University, Hershey, PA, USA
| | - R E Ochoa-Albíztegui
- Department of Radiology, The American British Cowdray Medical Center, Mexico City, Mexico
| | - J-P Pelletier
- Osteoarthritis Research Unit, University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada
| | - C Peterfy
- Spire Sciences, Inc., Boca Raton, Florida, USA
| | - J-P Raynauld
- Osteoarthritis Research Unit, University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada
| | - F W Roemer
- Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine, Boston, MA, USA; Department of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany
| | | | - G E Gold
- Department of Radiology, Stanford University, Stanford, CA, USA; Department of Bioengineering, Stanford University, Stanford, CA, USA; Department of Orthopaedic Surgery, Stanford University, Stanford, CA, USA
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Jones MH, Spindler KP, Fleming BC, Duryea J, Obuchowski NA, Scaramuzza EA, Oksendahl HL, Winalski CS, Duong CL, Huston LJ, Parker RD, Kaeding CC, Andrish JT, Flanigan DC, Dunn WR, Reinke EK. Meniscus treatment and age associated with narrower radiographic joint space width 2-3 years after ACL reconstruction: data from the MOON onsite cohort. Osteoarthritis Cartilage 2015; 23:581-8. [PMID: 25559582 PMCID: PMC4601556 DOI: 10.1016/j.joca.2014.12.018] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2014] [Revised: 12/16/2014] [Accepted: 12/23/2014] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To identify risk factors for radiographic signs of post-traumatic osteoarthritis (OA) 2-3 years after anterior cruciate ligament (ACL) reconstruction through multivariable analysis of minimum joint space width (mJSW) differences in a specially designed nested cohort. METHODS A nested cohort within the Multicenter Orthopaedic Outcomes Network (MOON) cohort included 262 patients (148 females, average age 20) injured in sport who underwent ACL reconstruction in a previously uninjured knee, were 35 or younger, and did not have ACL revision or contralateral knee surgery. mJSW on semi-flexed radiographs was measured in the medial compartment using a validated computerized method. A multivariable generalized linear model was constructed to assess mJSW difference between the ACL reconstructed and contralateral control knees while adjusting for potential confounding factors. RESULTS Unexpectedly, we found the mean mJSW was 0.35 mm wider in ACL reconstructed than in control knees (5.06 mm (95% CI 4.96-5.15 mm) vs 4.71 mm (95% CI 4.62-4.80 mm), P < 0.001). However, ACL reconstructed knees with meniscectomy had narrower mJSW compared to contralateral normal knees by 0.64 mm (95% C.I. 0.38-0.90 mm) (P < 0.001). Age (P < 0.001) and meniscus repair (P = 0.001) were also significantly associated with mJSW difference. CONCLUSION Semi-flexed radiographs can detect differences in mJSW between ACL reconstructed and contralateral normal knees 2-3 years following ACL reconstruction, and the unexpected wider mJSW in ACL reconstructed knees may represent the earliest manifestation of post-traumatic osteoarthritis and warrants further study.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | - Warren R. Dunn
- University of Wisconsin School of Medicine and Public Health
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Duryea J, Iranpour-Boroujeni T, Collins JE, Vanwynngaarden C, Guermazi A, Katz JN, Losina E, Russell R, Ratzlaff C. Local area cartilage segmentation: a semiautomated novel method of measuring cartilage loss in knee osteoarthritis. Arthritis Care Res (Hoboken) 2015; 66:1560-5. [PMID: 24664976 DOI: 10.1002/acr.22332] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Revised: 02/25/2014] [Accepted: 03/18/2014] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To assess the responsiveness and reader time of a novel semiautomated tool to detect knee cartilage loss over 2 years in subjects with knee osteoarthritis. METHODS A total of 122 subjects from the Osteoarthritis Initiative progression cohort were selected. A reader used the software method to segment cartilage on double-echo steady-state sequence scans in the medial compartment of the femur from the baseline and 24-month visits. Change in cartilage volume (ΔV) was measured at a fixed weight-bearing (WB) location with respect to the 3-dimensional coordinate system based on cylindrical coordinates. Change was measured for 5 regions of varying WB surface area centered on the fixed point. The average change (ΔV), the SD of ΔV, and the standardized response mean (SRM) are reported. RESULTS The SRM was −0.52 for the largest region and decreased in magnitude as smaller regions of cartilage were probed. The average evaluation time was <20 minutes per knee compartment, split approximately evenly between a technician and a trained reader. CONCLUSION The results establish that measurement of cartilage loss in a local region can be done efficiently and that the resultant measures are responsive to loss of cartilage over time. The coordinate system can potentially be used to objectively examine and establish a consistent location for all knees that is most responsive to change in cartilage volume. This technique can provide rapidly an objective quantitative measure of cartilage loss and could substantially reduce study costs for large trials and data sets.
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Iranpour-Boroujeni T, Li J, Lynch JA, Nevitt M, Duryea J. A new method to measure anatomic knee alignment for large studies of OA: data from the osteoarthritis initiative. Osteoarthritis Cartilage 2014; 22:1668-74. [PMID: 25278076 DOI: 10.1016/j.joca.2014.06.011] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2014] [Revised: 06/03/2014] [Accepted: 06/12/2014] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To develop and validate a new and improved software method to rapidly determine femur-tibia angle (FTA). METHODS Three readers, two skilled and one unskilled, without any formal medical training, measured FTA in 142 subjects from the Osteoarthritis Initiative (OAI). The reader reliability was assessed using the intra-class correlation coefficient (ICC), root mean square standard deviation (RMSSD), and Bland-Altman plots, comparing the existing and new FTA methods. Gender-specific linear regression assessed the relationship of FTA with the hip-knee-ankle angle (HKA). RESULTS The ICC (RMSSD) for intra- and inter-reader reproducibility of the existing FTA method was 0.96 (0.77°) and 0.92 (1.38°), respectively, and for the new technique was 0.98 (0.25°) and 0.98 (0.37°), with similar results for all three readers. Bland-Altman 95% limits of agreement were greater than ±2° for the existing, and ±1° for the new method. The r-value for the relation of FTA to HKA was 0.68 and 0.72 for the existing and new methods, respectively. Varus (HKA ≤ -2°)/neutral (-2° < HKA < 2°)/valgus (HKA ≥ 2°) alignment based on predicted HKA agreed moderately with measured HKA (weighted kappa = 0.53), and had moderate sensitivity (73%) and specificity (84%) for varus malalignment. The new FTA was related to HKA using a linear equation with a slope of 0.98 and an offset of 4.0°. CONCLUSIONS Since it is largely automated and uses unambiguous anatomical landmarks, the new method is highly reproducible and can be made on a standard posteroanterior (PA) knee radiograph by a relatively unskilled reader.
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Affiliation(s)
| | - J Li
- University of California San Francisco, San Francisco, CA, USA
| | - J A Lynch
- University of California San Francisco, San Francisco, CA, USA
| | - M Nevitt
- University of California San Francisco, San Francisco, CA, USA
| | - J Duryea
- Brigham and Women's Hospital, Boston, MA, USA.
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Lu B, Driban JB, Duryea J, McAlindon T, Lapane KL, Eaton CB. Milk consumption and progression of medial tibiofemoral knee osteoarthritis: data from the Osteoarthritis Initiative. Arthritis Care Res (Hoboken) 2014; 66:802-9. [PMID: 24706620 DOI: 10.1002/acr.22297] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2013] [Accepted: 01/28/2014] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Milk consumption has long been recognized for its important role in bone health, but its role in the progression of knee osteoarthritis (OA) is unclear. We examined the prospective association of milk consumption with radiographic progression of knee OA. METHODS In the Osteoarthritis Initiative, 2,148 participants (3,064 knees) with radiographic knee OA and dietary data at baseline were followed up to 12, 24, 36, and 48 months. Milk consumption was assessed with a Block Brief Food Frequency Questionnaire completed at baseline. To evaluate progression of OA, we used quantitative joint space width (JSW) between the medial femur and tibia of the knee based on plain radiographs. The multivariate linear models for repeated measures were used to test the independent association between milk intake and the decrease in JSW over time, while adjusting for baseline disease severity, body mass index, dietary factors, and other potential confounders. RESULTS We observed a significant dose-response relationship between baseline milk intake and adjusted mean decrease of JSW in women (P = 0.014 for trend). With increasing levels of milk intake (none, ≤3, 4-6, and ≥7 glasses/week), the mean decreases of JSW were 0.38 mm, 0.29 mm, 0.29 mm, and 0.26 mm, respectively. In men, we observed no significant association between milk consumption and the decreases of JSW. CONCLUSION Our results suggest that frequent milk consumption may be associated with reduced OA progression in women. Replication of these novel findings in other prospective studies demonstrating the increase in milk consumption leads to delay in knee OA progression are needed.
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Affiliation(s)
- Bing Lu
- Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
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Bloecker K, Wirth W, Hunter DJ, Duryea J, Guermazi A, Kwoh CK, Resch H, Eckstein F. Contribution of regional 3D meniscus and cartilage morphometry by MRI to joint space width in fixed flexion knee radiography--a between-knee comparison in subjects with unilateral joint space narrowing. Eur J Radiol 2013; 82:e832-9. [PMID: 24119428 DOI: 10.1016/j.ejrad.2013.08.041] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2013] [Revised: 07/29/2013] [Accepted: 08/17/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Radiographic joint space width (JSW) is considered the reference standard for demonstrating structural therapeutic benefits in knee osteoarthritis. Our objective was to determine the proportion by which 3D (regional) meniscus and cartilage measures explain between-knee differences of JSW in the fixed flexion radiographs. METHODS Segmentation of the medial meniscus and tibial and femoral cartilage was performed in double echo steady state (DESS) images. Quantitative measures of meniscus size and position, femorotibial cartilage thickness, and radiographic JSW (minimum, and fixed locations) were compared between both knees of 60 participants of the Osteoarthritis Initiative, with strictly unilateral medial joint space narrowing (JSN). Statistical analyses (between-knee, within-person comparison) were performed using regression analysis. RESULTS A strong relationship with side-differences in minimum and a central fixed location JSW was observed for percent tibial plateau coverage by the meniscus (r = .59 and .47; p<.01) and central femoral cartilage thickness (r = .69 and .75; p<.01); other meniscus and cartilage measures displayed lower coefficients. The correlation of central femoral cartilage thickness with JSW (but not that of meniscus measures) was greater (r = .78 and .85; p<.01) when excluding knees with non-optimal alignment between the tibia and X-ray beam. CONCLUSION 3D measures of meniscus and cartilage provide significant, independent information in explaining side-differences in radiographic JSW in fixed flexion radiographs. Tibial coverage by the meniscus and central femoral cartilage explained two thirds of the variability in minimum and fixed location JSW. JSW provides a better representation of (central) femorotibial cartilage thickness, when optimal positioning of the fixed flexion radiographs is achieved.
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Affiliation(s)
- K Bloecker
- Institute of Anatomy and Musculoskeletal Research, Paracelsus Medical University, Strubergasse 21, 5020 Salzburg, Austria; Department of Traumatology and Sports Medicine, Paracelsus Medical University, Müllner Hauptstrasse 48, 5020 Salzburg, Austria.
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