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Yau MS, Okoro PC, Haugen IK, Lynch JA, Nevitt MC, Lewis CE, Torner JC, Felson DT. Assessing the association of epigenetic age acceleration with osteoarthritis in the Multicenter Osteoarthritis Study (MOST). Osteoarthritis Cartilage 2024; 32:585-591. [PMID: 38242313 DOI: 10.1016/j.joca.2023.11.024] [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: 06/27/2023] [Revised: 10/31/2023] [Accepted: 11/26/2023] [Indexed: 01/21/2024]
Abstract
PURPOSE Advancing age is one of the strongest risk factors for osteoarthritis (OA). DNA methylation-based measures of epigenetic age acceleration may provide insights into mechanisms underlying OA. METHODS We analyzed data from the Multicenter Osteoarthritis Study in a subset of 671 participants ages 45-69 years with no or mild radiographic knee OA. DNA methylation was assessed with the Illumina Infinium MethylationEPIC 850K array. We calculated predicted epigenetic age according to Hannum, Horvath, PhenoAge, and GrimAge epigenetic clocks, then regressed epigenetic age on chronological age to obtain the residuals. Associations between the residuals and knee, hand, and multi-joint OA were assessed using logistic regression, adjusted for chronological age, sex, clinical site, smoking status, and race. RESULTS Twenty-three percent met criteria for radiographic hand OA, 25% met criteria for radiographic knee OA, and 8% met criteria for multi-joint OA. Mean chronological age (SD) was 58.4 (6.7) years. Mean predicted epigenetic age (SD) according to Horvath, Hannum, PhenoAge, and GrimAge epigenetic clocks was 64.9 (6.4), 68.6 (5.9), 50.5 (7.7), and 67.0 (6.2), respectively. Horvath epigenetic age acceleration was not associated with an increased odds of hand OA, odds ratio (95% confidence intervals) = 1.03 (0.99-1.08), with similar findings for knee and multi-joint OA. We found similar magnitudes of associations for Hannum epigenetic age, PhenoAge, and GrimAge acceleration compared to Horvath epigenetic age acceleration. CONCLUSIONS Epigenetic age acceleration as measured by various well-validated epigenetic clocks based on DNA methylation was not associated with increased risk of knee, hand, or multi-joint OA independent of chronological age.
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Affiliation(s)
- Michelle S Yau
- Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, MA, USA; Division of Gerontology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.
| | - Paul C Okoro
- Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, MA, USA
| | - Ida K Haugen
- Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway
| | - John A Lynch
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
| | - Michael C Nevitt
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
| | - Cora E Lewis
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - James C Torner
- Department of Epidemiology, University of Iowa, Iowa City, IA, USA
| | - David T Felson
- Section of Rheumatology, Department of Medicine, Boston University School of Medicine, Boston, MA, USA
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van Buuren MMA, Riedstra NS, van den Berg MA, Boel FDEM, Ahedi H, Arbabi V, Arden NK, Bierma-Zeinstra SMA, Boer CG, Cicuttini F, Cootes TF, Crossley K, Felson D, Gielis WP, Heerey J, Jones G, Kluzek S, Lane NE, Lindner C, Lynch JA, Van Meurs J, Mosler AB, Nelson AE, Nevitt M, Oei E, Runhaar J, Tang J, Weinans H, Agricola R. Cohort profile: Worldwide Collaboration on OsteoArthritis prediCtion for the Hip (World COACH) - an international consortium of prospective cohort studies with individual participant data on hip osteoarthritis. BMJ Open 2024; 14:e077907. [PMID: 38637130 PMCID: PMC11029301 DOI: 10.1136/bmjopen-2023-077907] [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: 07/18/2023] [Accepted: 02/20/2024] [Indexed: 04/20/2024] Open
Abstract
PURPOSE Hip osteoarthritis (OA) is a major cause of pain and disability worldwide. Lack of effective therapies may reflect poor knowledge on its aetiology and risk factors, and result in the management of end-stage hip OA with costly joint replacement. The Worldwide Collaboration on OsteoArthritis prediCtion for the Hip (World COACH) consortium was established to pool and harmonise individual participant data from prospective cohort studies. The consortium aims to better understand determinants and risk factors for the development and progression of hip OA, to optimise and automate methods for (imaging) analysis, and to develop a personalised prediction model for hip OA. PARTICIPANTS World COACH aimed to include participants of prospective cohort studies with ≥200 participants, that have hip imaging data available from at least 2 time points at least 4 years apart. All individual participant data, including clinical data, imaging (data), biochemical markers, questionnaires and genetic data, were collected and pooled into a single, individual-level database. FINDINGS TO DATE World COACH currently consists of 9 cohorts, with 38 021 participants aged 18-80 years at baseline. Overall, 71% of the participants were women and mean baseline age was 65.3±8.6 years. Over 34 000 participants had baseline pelvic radiographs available, and over 22 000 had an additional pelvic radiograph after 8-12 years of follow-up. Even longer radiographic follow-up (15-25 years) is available for over 6000 of these participants. FUTURE PLANS The World COACH consortium offers unique opportunities for studies on the relationship between determinants/risk factors and the development or progression of hip OA, by using harmonised data on clinical findings, imaging, biomarkers, genetics and lifestyle. This provides a unique opportunity to develop a personalised hip OA risk prediction model and to optimise methods for imaging analysis of the hip.
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Affiliation(s)
- Michiel M A van Buuren
- Department of Orthopaedics and Sports Medicine, Erasmus Medical Center, Rotterdam, Zuid-Holland, Netherlands
| | - Noortje S Riedstra
- Department of Orthopaedics and Sports Medicine, Erasmus Medical Center, Rotterdam, Zuid-Holland, Netherlands
| | - Myrthe A van den Berg
- Department of Orthopaedics and Sports Medicine, Erasmus Medical Center, Rotterdam, Zuid-Holland, Netherlands
| | - Fleur D E M Boel
- Department of Orthopaedics and Sports Medicine, Erasmus Medical Center, Rotterdam, Zuid-Holland, Netherlands
| | - Harbeer Ahedi
- Institute for Medical Research, University of Tasmania Menzies, Hobart, Tasmania, Australia
| | - Vahid Arbabi
- Department of Orthopedics, UMC Utrecht, Utrecht, Netherlands
- Orthopaedic-Biomechanics Research Group, Department of Mechanical Engineering, Faculty of Engineering, University of Birjand, Birjand, Iran
| | - Nigel K Arden
- Department of Orthopaedics Rheumatology and Musculoskeletal Sciences, University of Oxford Nuffield, Oxford, Oxfordshire, UK
| | | | - Cindy G Boer
- Department of Internal Medicine, Erasmus Medical Center, Rotterdam, Zuid-Holland, Netherlands
| | - Flavia Cicuttini
- Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Victoria, Australia
| | - Timothy F Cootes
- Centre for Imaging Sciences, The University of Manchester, Manchester, UK
| | - Kay Crossley
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University School of Allied Health Human Services and Sport, Melbourne, Victoria, Australia
| | - David Felson
- Boston University School of Medicine, Boston, Massachusetts, USA
| | - Willem Paul Gielis
- Department of Orthopedics, UMC Utrecht, Utrecht, Netherlands
- Department of Radiology, UMC Utrecht, Utrecht, Netherlands
| | - Joshua Heerey
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University School of Allied Health Human Services and Sport, Melbourne, Victoria, Australia
| | - Graeme Jones
- Institute for Medical Research, University of Tasmania Menzies, Hobart, Tasmania, Australia
| | - Stefan Kluzek
- Department of Orthopaedics Rheumatology and Musculoskeletal Sciences, University of Oxford Nuffield, Oxford, Oxfordshire, UK
| | - Nancy E Lane
- Department of Medicine, University of California Davis School of Medicine, Sacramento, California, USA
| | - Claudia Lindner
- Centre for Imaging Sciences, The University of Manchester, Manchester, UK
| | - John A Lynch
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA
| | - J Van Meurs
- Department of Orthopaedics and Sports Medicine, Erasmus Medical Center, Rotterdam, Zuid-Holland, Netherlands
- Department of Internal Medicine, Erasmus Medical Center, Rotterdam, Zuid-Holland, Netherlands
| | - Andrea B Mosler
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University School of Allied Health Human Services and Sport, Melbourne, Victoria, Australia
| | - Amanda E Nelson
- Thurston Arthritis Research Center, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - M Nevitt
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA
| | - Edwin Oei
- Department of Radiology & Nuclear Medicine, Erasmus Medical Center, Rotterdam, Zuid-Holland, Netherlands
| | - Jos Runhaar
- Department of General Practice, Erasmus Medical Center, Rotterdam, Zuid-Holland, Netherlands
| | - Jinchi Tang
- Department of Orthopaedics and Sports Medicine, Erasmus Medical Center, Rotterdam, Zuid-Holland, Netherlands
| | - Harrie Weinans
- Department of Orthopedics, UMC Utrecht, Utrecht, Netherlands
- Department of Biomechanical Engineering, TU Delft, Delft, Zuid-Holland, Netherlands
| | - Rintje Agricola
- Department of Orthopaedics and Sports Medicine, Erasmus Medical Center, Rotterdam, Zuid-Holland, Netherlands
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Löffler MT, Ngarmsrikam C, Giesler P, Joseph GB, Akkaya Z, Lynch JA, Lane NE, Nevitt M, McCulloch CE, Link TM. Effect of weight loss on knee joint synovitis over 48 months and mediation by subcutaneous fat around the knee: data from the Osteoarthritis Initiative. BMC Musculoskelet Disord 2024; 25:300. [PMID: 38627635 PMCID: PMC11022396 DOI: 10.1186/s12891-024-07397-y] [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: 01/24/2024] [Accepted: 03/29/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Obesity influences the development of osteoarthritis via low-grade inflammation. Progression of local inflammation (= synovitis) increased with weight gain in overweight and obese women compared to stable weight. Synovitis could be associated with subcutaneous fat (SCF) around the knee. Purpose of the study was to investigate the effect of weight loss on synovitis progression and to assess whether SCF around the knee mediates the relationship between weight loss and synovitis progression. METHODS We included 234 overweight and obese participants (body mass index [BMI] ≥ 25 kg/m2) from the Osteoarthritis Initiative (OAI) with > 10% weight loss (n = 117) or stable overweight (< ± 3% change, n = 117) over 48 months matched for age and sex. In magnetic resonance imaging (MRI) at baseline and 48 months, effusion-synovitis and Hoffa-synovitis using the MRI Osteoarthritis Knee Score (MOAKS) and average joint-adjacent SCF (ajSCF) were assessed. Odds-ratios (ORs) for synovitis progression over 48 months (≥ 1 score increase) were calculated in logistic regression models adjusting for age, sex, baseline BMI, Physical Activity Scale for the Elderly (PASE), and baseline SCF measurements. Mediation of the effect of weight loss on synovitis progression by local SCF change was assessed. RESULTS Odds for effusion-synovitis progression decreased with weight loss and ajSCF decrease (odds ratio [OR] = 0.61 and 0.56 per standard deviation [SD] change, 95% confidence interval [CI] 0.44, 0.83 and 0.40, 0.79, p = 0.002 and 0.001, respectively), whereas odds for Hoffa-synovitis progression increased with weight loss and ajSCF decrease (OR = 1.47 and 1.48, CI 1.05, 2.04 and 1.02, 2.13, p = 0.024 and 0.038, respectively). AjSCF decrease mediated 39% of the effect of weight loss on effusion-synovitis progression. CONCLUSIONS Effusion-synovitis progression was slowed by weight loss and decrease in local subcutaneous fat. Hoffa-synovitis characterized by fluid in the infrapatellar fat pad increased at the same time, suggesting a decreasing fat pad rather than active synovitis. Decrease in local subcutaneous fat partially mediated the systemic effect of weight loss on synovitis.
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Affiliation(s)
- Maximilian T Löffler
- Department of Radiology and Biomedical Imaging, University of California, 185 Berry St, Suite 350, Lobby 6, San Francisco, CA, 94143, USA.
- Department of Diagnostic and Interventional Radiology, University Medical Center Freiburg, Freiburg, Germany.
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum Rechts Der Isar, Technical University of Munich, Munich, Germany.
| | - Chotigar Ngarmsrikam
- Department of Radiology and Biomedical Imaging, University of California, 185 Berry St, Suite 350, Lobby 6, San Francisco, CA, 94143, USA
| | - Paula Giesler
- Department of Radiology and Biomedical Imaging, University of California, 185 Berry St, Suite 350, Lobby 6, San Francisco, CA, 94143, USA
- Department of Diagnostic and Interventional Radiology, University Medical Center Freiburg, Freiburg, Germany
| | - Gabby B Joseph
- Department of Radiology and Biomedical Imaging, University of California, 185 Berry St, Suite 350, Lobby 6, San Francisco, CA, 94143, USA
| | - Zehra Akkaya
- Department of Radiology and Biomedical Imaging, University of California, 185 Berry St, Suite 350, Lobby 6, San Francisco, CA, 94143, USA
- Department of Radiology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - John A Lynch
- Department of Radiology and Biomedical Imaging, University of California, 185 Berry St, Suite 350, Lobby 6, San Francisco, CA, 94143, USA
| | - Nancy E Lane
- Department of Medicine and Center for Musculoskeletal Health, University of California, Davis, Sacramento, CA, USA
| | - Michael Nevitt
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Charles E McCulloch
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Thomas M Link
- Department of Radiology and Biomedical Imaging, University of California, 185 Berry St, Suite 350, Lobby 6, San Francisco, CA, 94143, USA
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Casillan A, Florido ME, Galarza-Cornejo J, Bakken S, Lynch JA, Chung WK, Mittendorf KF, Berner ES, Connolly JJ, Weng C, Holm IA, Khan A, Kiryluk K, Limdi NA, Petukhova L, Sabatello M, Wynn J. Participant-guided development of bilingual genomic educational infographics for Electronic Medical Records and Genomics Phase IV study. J Am Med Inform Assoc 2024; 31:306-316. [PMID: 37860921 PMCID: PMC10797276 DOI: 10.1093/jamia/ocad207] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 04/10/2023] [Revised: 09/11/2023] [Accepted: 10/06/2023] [Indexed: 10/21/2023] Open
Abstract
OBJECTIVE Developing targeted, culturally competent educational materials is critical for participant understanding of engagement in a large genomic study that uses computational pipelines to produce genome-informed risk assessments. MATERIALS AND METHODS Guided by the Smerecnik framework that theorizes understanding of multifactorial genetic disease through 3 knowledge types, we developed English and Spanish infographics for individuals enrolled in the Electronic Medical Records and Genomics Network. Infographics were developed to explain concepts in lay language and visualizations. We conducted iterative sessions using a modified "think-aloud" process with 10 participants (6 English, 4 Spanish-speaking) to explore comprehension of and attitudes towards the infographics. RESULTS We found that all but one participant had "awareness knowledge" of genetic disease risk factors upon viewing the infographics. Many participants had difficulty with "how-to" knowledge of applying genetic risk factors to specific monogenic and polygenic risks. Participant attitudes towards the iteratively-refined infographics indicated that design saturation was reached. DISCUSSION There were several elements that contributed to the participants' comprehension (or misunderstanding) of the infographics. Visualization and iconography techniques best resonated with those who could draw on prior experiences or knowledge and were absent in those without. Limited graphicacy interfered with the understanding of absolute and relative risks when presented in graph format. Notably, narrative and storytelling theory that informed the creation of a vignette infographic was most accessible to all participants. CONCLUSION Engagement with the intended audience who can identify strengths and points for improvement of the intervention is necessary to the development of effective infographics.
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Affiliation(s)
- Aimiel Casillan
- Genetic Counseling Graduate Program, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY 10032, United States
| | - Michelle E Florido
- Genetic Counseling Graduate Program, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY 10032, United States
- Department of Genetics and Development, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, 10032, United States
| | - Jamie Galarza-Cornejo
- Department of Pediatrics, Columbia University Irving Medical Center, New York, NY 10032, United States
| | - Suzanne Bakken
- Department of Nursing Scholarship and Research, School of Nursing, Columbia University Irving Medical Center, New York, NY 10032, United States
- Department of Biomedical Informatics, Columbia University Irving Medical Center, New York, NY 10032, United States
| | - John A Lynch
- Department of Communication, School of Communication, Film, and Media Studies, University of Cincinnati, Cincinnati, OH 45221, United States
| | - Wendy K Chung
- Department of Pediatrics, Columbia University Irving Medical Center, New York, NY 10032, United States
| | - Kathleen F Mittendorf
- Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN 37232, United States
| | - Eta S Berner
- Department of Health Services Administration, School of Health Professions, University of Alabama at Birmingham, Birmingham, AL 35294, United States
| | - John J Connolly
- Center for Applied Genomics, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, United States
| | - Chunhua Weng
- Department of Biomedical Informatics, Columbia University Irving Medical Center, New York, NY 10032, United States
| | - Ingrid A Holm
- Division of Genetics and Genomics and Manton Center for Orphan Diseases Research, Boston Children’s Hospital, Boston, MA 02115, United States
- Department of Pediatrics, Harvard Medical School, Boston, MA 02115, United States
| | - Atlas Khan
- Department of Medicine, Columbia University Irving Medical Center, New York, NY 10032, United States
- Department of Medicine, Division of Nephrology, Vagelos College of Physicians & Surgeons, Columbia University, New York, NY 10032, United States
| | - Krzysztof Kiryluk
- Department of Medicine, Division of Nephrology, Vagelos College of Physicians & Surgeons, Columbia University, New York, NY 10032, United States
| | - Nita A Limdi
- Department of Neurology, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35233, United States
| | - Lynn Petukhova
- Department of Epidemiology, Columbia Mailman School of Public Health, New York, NY 10032, United States
- Department of Dermatology, Columbia University Irving Medical Center, New York, NY 10032, United States
| | - Maya Sabatello
- Department of Medicine, Center for Precision Medicine and Genomics, Columbia University Irving Medical Center, New York, NY 10032, United States
- Department of Medical Humanities and Ethics, Division of Ethics, Columbia University Irving Medical Center, New York, NY 10032, United States
| | - Julia Wynn
- Genetic Counseling Graduate Program, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY 10032, United States
- Department of Pediatrics, Columbia University Irving Medical Center, New York, NY 10032, United States
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Manatrakul R, Pirmoazen AM, Bharadwaj UU, Akkaya Z, Giesler PJ, Lynch JA, Nevitt MC, McCulloch CE, Joseph GB, Link TM. Thigh muscle and fat volumes are associated with knee cartilage abnormalities and bone marrow edema-like lesions: data from the osteoarthritis initiative. Skeletal Radiol 2024:10.1007/s00256-024-04565-y. [PMID: 38206355 DOI: 10.1007/s00256-024-04565-y] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Revised: 01/03/2024] [Accepted: 01/03/2024] [Indexed: 01/12/2024]
Abstract
OBJECTIVE To investigate the associations of thigh muscle and fat volumes with structural abnormalities on MRI related to knee osteoarthritis. MATERIALS AND METHODS MRI studies of the thighs and knees from 100 individuals were randomly selected from the Osteoarthritis Initiative Cohort. Whole Organ MR Scoring (WORMS) and effusion-synovitis scoring were performed in all knee MRI. Thigh muscles, intermuscular fat, and subcutaneous fat were manually segmented in 15 consecutive MR thigh images. Radiographic Kellgren-Lawrence grades (KLG) were also obtained in all knee radiographs. Independent t-tests were used to investigate the associations between thigh muscle and fat volumes, and sex. Mixed-effects analyses were obtained to investigate the associations between thigh muscle and fat volumes, KLG, WOMAC pain score, cartilage and bone marrow WORMS, as well as effusion-synovitis scores. RESULTS Women had higher subcutaneous fat volume than men (616.82 vs. 229.13 cm3, p < 0.01) and men had higher muscle volumes than women (p < 0.01). Quadriceps (coef = -2.15, p = 0.01) and vastus medialis (coef = -1.84, p = 0.03) volumes were negatively associated with the WORMS cartilage scores. Intermuscular fat volume (coef = 0.48, p = 0.01) was positively associated with WORMS bone marrow edema-like lesion (BMEL) scores. The quadriceps (coef = -0.99, p < 0.01) and hamstring (coef = -0.59, p = 0.01) volumes were negatively associated with WORMS BMEL scores. No evidence of an association was found between thigh muscle and fat volumes with KLG and effusion-synovitis grading (p > 0.05). CONCLUSION Increased quadriceps and hamstring volumes were negatively associated with cartilage lesion and BMEL scores while no evidence of an association was found between thigh muscle and fat volumes, and radiographic knee osteoarthritis or effusion-synovitis grading.
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Affiliation(s)
- Rawee Manatrakul
- Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry St, Suite 350, San Francisco, CA, 94158, USA.
- Department of Radiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
| | - Amir M Pirmoazen
- Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry St, Suite 350, San Francisco, CA, 94158, USA
- Department of Radiology, University of Florida, Jacksonville, FL, USA
| | - Upasana U Bharadwaj
- Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry St, Suite 350, San Francisco, CA, 94158, USA
| | - Zehra Akkaya
- Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry St, Suite 350, San Francisco, CA, 94158, USA
| | - Paula J Giesler
- Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry St, Suite 350, San Francisco, CA, 94158, USA
- Medical Center, University of Freiburg, Freiburg, Germany
| | - John A Lynch
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
| | - Michael C Nevitt
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
| | - Charles E McCulloch
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
| | - Gabby B Joseph
- Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry St, Suite 350, San Francisco, CA, 94158, USA
| | - Thomas M Link
- Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry St, Suite 350, San Francisco, CA, 94158, USA
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Joseph GB, Takakusagi M, Arcilla G, Lynch JA, Pedoia V, Majumdar S, Lane NE, Nevitt MC, McCulloch CE, Link TM. Associations between weight change, knee subcutaneous fat and cartilage thickness in overweight and obese individuals: 4-Year data from the osteoarthritis initiative. Osteoarthritis Cartilage 2023; 31:1515-1523. [PMID: 37574110 PMCID: PMC10848315 DOI: 10.1016/j.joca.2023.07.011] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 06/16/2023] [Accepted: 07/06/2023] [Indexed: 08/15/2023]
Abstract
OBJECTIVE To assess (i) the impact of changes in body weight on changes in joint-adjacent subcutaneous fat (SCF) and cartilage thickness over 4 years and (ii) the relation between changes in joint-adjacent SCF and knee cartilage thickness. DESIGN Individuals from the Osteoarthritis Initiative (total=399) with > 10% weight gain (n=100) and > 10% weight loss (n=100) over 4 years were compared to a matched control cohort with less than 3% change in weight (n=199). 3.0T Magnetic Resonance Imaging (MRI) of the right knee was performed at baseline and after 4 years to quantify joint-adjacent SCF and cartilage thickness. Linear regression models were used to evaluate the associations between the (i) weight change group and 4-year changes in both knee SCF and cartilage thickness, and (ii) 4-year changes in knee SCF and in cartilage thickness. Analyses were adjusted for age, sex, baseline body mass index (BMI), tibial diameter (and weight change group in analysis (ii)). RESULTS Individuals who lost weight over 4-years had significantly less joint-adjacent SCF (beta range, medial/lateral joint sides: 2.2-4.2 mm, p < 0.001) than controls; individuals who gained weight had significantly greater joint-adjacent SCF than controls (beta range: -1.4 to -3.9 mm, p < 0.001). No statistically significant associations were found between weight change and cartilage thickness change. However, increases in joint-adjacent SCF over 4 years were significantly associated with decreases in cartilage thickness (p = 0.04). CONCLUSIONS Weight change was associated with joint-adjacent SCF, but not with change in cartilage thickness. However, 4-year increases in joint-adjacent SCF were associated with decreases in cartilage thickness independent of baseline BMI and weight change group.
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Affiliation(s)
- Gabby B Joseph
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, United States.
| | - Melia Takakusagi
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, United States
| | - Gino Arcilla
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, United States
| | - John A Lynch
- Department of Epidemiology and Biostatistics, University of California, San Francisco, United States
| | - Valentina Pedoia
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, United States
| | - Sharmila Majumdar
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, United States
| | - Nancy E Lane
- Department of Rheumatology, University of California, Davis, United States
| | - Michael C Nevitt
- Department of Epidemiology and Biostatistics, University of California, San Francisco, United States
| | - Charles E McCulloch
- Department of Epidemiology and Biostatistics, University of California, San Francisco, United States
| | - Thomas M Link
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, United States
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Chambers CC, Lynch JA, Feeley BT, Nevitt MC. Association of Medial Meniscus Root Tears and Nonroot Tears With Worsening of Radiographic Knee Osteoarthritis. Orthop J Sports Med 2023; 11:23259671231195894. [PMID: 37711506 PMCID: PMC10498710 DOI: 10.1177/23259671231195894] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Accepted: 05/04/2023] [Indexed: 09/16/2023] Open
Abstract
Background Medial meniscus root tears (RTs) are associated with the development and worsening of knee osteoarthritis (OA), but little is known about their progression when compared with meniscal tears that spare the root (nonroot tears; NRTs). Purpose To compare radiographic worsening of OA in knees with RTs versus NRTs and to identify factors associated with radiographic worsening of OA in knees with RTs. Study Design Cohort study; Level of evidence, 3. Methods Using the Osteoarthritis Initiative database, we included knees with medial meniscus RTs and NRTs present at the baseline visit (baseline tears) and new RTs and NRTs observed at 12- to 48-month annual follow-up visits (incident tears). Worsening of radiographic OA was defined for baseline tears as an increase in Kellgren-Lawrence grade (KLG) during the subsequent 12 months of follow-up; for incident tears, worsening was defined as either concurrent (increase in KLG over the 12 months preceding tear appearance on magnetic resonance imaging) or subsequent (increase in KLG during the 12 months after tear appearance). Odds ratios (ORs), adjusted for covariates, were calculated for the association of worsening by type of tear. Results Included were 39 knees with baseline RTs, 633 knees with baseline NRTs, 33 knees with incident RTs, and 234 knees with incident NRTs. Radiographic OA worsening subsequent to meniscal tear identification was no different for baseline RTs (15%) or baseline NRTs (14%; adjusted OR, 1.34; 95% CI, 0.52-3.47), nor did subsequent worsening differ for incident RTs (19%) versus incident NRTs (18%; adjusted OR, 0.52; 95% CI, 0.15-1.83). Concurrent radiographic OA worsening was seen at a significantly higher rate for incident RTs (64%) versus incident NRTs (21%; adjusted OR, 3.00; 95% CI, 1.21-7.47). Incident RTs in knees without radiographic OA (KLG 0-1) before the tear had a high rate of worsening (94%, n = 16) and were more likely to worsen than those in knees with radiographic OA (KLG ≥2) present before the tear. Conclusion Compared with NRTs, incident RTs were associated with a significantly increased risk of worsening radiographic OA over a 12-month period concurrent with the appearance of the tear. Incident RTs in knees without radiographic OA at baseline had a high rate of worsening.
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Affiliation(s)
- Caitlin C. Chambers
- Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, Minnesota, USA
| | - John A. Lynch
- Department of Epidemiology and Biostatistics, University of California-San Francisco, San Francisco, California, USA
| | - Brian T. Feeley
- Department of Orthopaedic Surgery, University of California-San Francisco, San Francisco, California, USA
| | - Michael C. Nevitt
- Department of Epidemiology and Biostatistics, University of California-San Francisco, San Francisco, California, USA
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Jarraya M, Guermazi A, Liew JW, Tolstykh I, Lynch JA, Aliabadi P, Felson DT, Clancy M, Nevitt M, Lewis CE, Torner J, Neogi T. Prevalence of intra-articular mineralization on knee computed tomography: the multicenter osteoarthritis study. Osteoarthritis Cartilage 2023; 31:1111-1120. [PMID: 37088266 PMCID: PMC10524737 DOI: 10.1016/j.joca.2023.04.004] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 03/23/2023] [Accepted: 04/12/2023] [Indexed: 04/25/2023]
Abstract
OBJECTIVE The aim of this work was to report the prevalence of computed tomography (CT)-detected intra-articular mineralization. DESIGN We included participants from the Multicenter Osteoarthritis (MOST) Study. At the 12th year visit of the MOST study, bilateral knee CTs were first obtained. All participants also had posteroanterior and lateral radiographs of bilateral knees and completed standard questionnaires. Knee radiographs were assessed for Kellgren & Lawrence grade (KLG) and radiographic evidence of intra-articular mineralization. CT images were scored using the Boston University Calcium Knee Score (BUCKS) for cartilage, menisci, ligaments, capsule, and vasculature. Prevalence of intra-articular mineralization was computed for the total sample, and stratified by age, sex, race, Body Mass Index (BMI), presence of frequent knee pain, and KLG. We also determined distribution of mineralization in the cartilage and meniscus, and co-localization. RESULTS 4140 bilateral knees from 2070 participants were included (56.7% female, mean age 61.1 years, mean BMI: 28.8 kg/m2). On radiographs 240 knees (5.8%) had intraarticular mineralization, while CT-detected mineralization was present in 9.8% of knees. Prevalence of hyaline articular and meniscus mineralization increased with age and KL grade, and was similar by sex, BMI categories, and comparable in subjects with and without frequent knee pain. Mineralization tended to be ubiquitous in the joint, most commonly involving all three (medial/lateral tibiofemoral and patellofemoral) compartments (3.1%), while the patellofemoral compartment was the most involved compartment in isolation (1.4%). CONCLUSIONS CT of the knee provides greater visualization of intra-articular mineralization than radiographs and allows better localization of the crystal deposition within the joint. Further studies should focus on the co-localization of intra-articular crystal deposition and corresponding magnetic resonance imaging (MRI)-features of knee osteoarthritis (OA).
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Affiliation(s)
- M Jarraya
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
| | - A Guermazi
- Department of Radiology, VA Healthcare System, Boston University School of Medicine, Boston, MA, USA
| | - J W Liew
- Department of Medicine, Boston University School of Medicine, Boston University, Boston, MA, USA
| | - I Tolstykh
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - J A Lynch
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - P Aliabadi
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - D T Felson
- Department of Medicine, Boston University School of Medicine, Boston University, Boston, MA, USA
| | - M Clancy
- Department of Medicine, Boston University School of Medicine, Boston University, Boston, MA, USA
| | - M Nevitt
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - C E Lewis
- Department of Epidemiology, University of Alabama at Birmingham, AL, USA
| | - J Torner
- Department of Epidemiology, College of Public Health, University of Iowa, IA, USA
| | - T Neogi
- Department of Medicine, Boston University School of Medicine, Boston University, Boston, MA, 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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Yau MS, Jonsson H, Lynch JA, Lewis CE, Torner JC, Nevitt MC, Felson DT. Do associations with hand OA vary by knee osteoarthritis phenotype? Cross-sectional data from the Multicenter Osteoarthritis Study. Osteoarthr Cartil Open 2023; 5:100331. [PMID: 36605850 PMCID: PMC9807822 DOI: 10.1016/j.ocarto.2022.100331] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 12/07/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022] Open
Abstract
Objective Osteoarthritis (OA) is highly heterogeneous and has both biomechanical and systemic components that may not have the same etiology. We therefore aimed to identify specific knee OA phenotypes that may be more strongly associated with hand OA to refine the criteria used to define multi-joint OA. Design We assessed data from the Multicenter Osteoarthritis Study (MOST). We ascertained hand OA from bilateral hand photographs; scores for each joint row were summed to yield an aggregate hand OA score. Knee OA was ascertained from bilateral posteroanterior knee radiographs read for Kellgren-Lawrence grade and individual radiographic features. We tested associations between hand and knee OA with phenotypes including symptomatic OA, hyper- and atrophic knee OA, and one excluding post-traumatic OA. Associations between hand and knee OA were assessed with logistic regression, adjusted for age. Results We studied 2493 participants with hand and knee OA measures. Median age was 63 years with 57% women. 55% had an aggregate hand OA score ≥2; frequency of knee OA phenotypes ranged from 8% to 34%. The age-adjusted odds ratio (OR) was 1.14 (95% confidence interval (CI) = 1.04-1.26) for knee OA per standard deviation of the hand OA aggregate score. Hand OA associations with symptomatic knee OA and knee OA excluding post-traumatic knee OA were OR = 1.16 (95% CI = 1.03-1.31) and OR = 1.21 (95% CI = 1.08-1.35), respectively. No other knee OA phenotype reached statistical significance. Conclusions Age-adjusted associations between hand and knee OA were modest and were largely similar across knee OA phenotypes.
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Affiliation(s)
- Michelle S. Yau
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, MA, USA
- Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - Helgi Jonsson
- Department of Rheumatology, Landspitalinn University Hospital, University of Iceland, Reykjavik, Iceland
| | - John A. Lynch
- MRI Quality Assurance, Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
| | - Cora E. Lewis
- Division of Preventive Medicine, Department of Epidemiology, University of Alabama, Birmingham, AL, USA
| | - James C. Torner
- Department of Epidemiology, University of Iowa, Iowa City, IA, USA
| | - Michael C. Nevitt
- Department of Epidemiology & Biostatistics, University of California, San Francisco, USA
| | - David T. Felson
- Section of Rheumatology, Department of Medicine, Boston University School of Medicine, USA
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11
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Lynch JA, Idleburg MJ, Butsch Kovacic M, Childers-Buschle KE, Dufendach KR, Lipstein EA, McGowan ML, Myers MF, Prows CA. Developing video education materials for the return of genomic test results to parents and adolescents. PEC Innov 2022; 1:100051. [PMID: 36532300 PMCID: PMC9757811 DOI: 10.1016/j.pecinn.2022.100051] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 05/05/2022] [Accepted: 05/05/2022] [Indexed: 05/25/2023]
Abstract
OBJECTIVE To describe the development, implementation, and revision of a video to provide information about genomic testing and the return of genomic research results to adolescents and parents. METHODS Formative, community-engaged research was conducted in three stages: development, implementation, and revision. Existing research participant advisory groups were used for focus groups and convenience sampling was used for interviews. Participants included parents, young adults without children, and adolescents. Transcripts of recorded sessions were used for formative analysis. RESULTS Video was the preferred format for delivering genomic testing information to adolescents during the development stage. During implementation, adolescents identified video length as an impediment to recall. During the revision stage, participants preferred the video in separate short segments, supported plan to require only one short video and leaving other short videos optional. Participants were divided on whether the required short video provided enough information, but all participants reported that watching additional videos would not have changed their decisions about receiving test results. CONCLUSION Genomic education videos should be brief (<4 mins) to improve the odds that participants will view the entirety of any required video. INNOVATION The development of participant materials should incorporate plans for monitoring implementation and plans for revising materials.
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Affiliation(s)
- John A. Lynch
- Department of Communication, College of Arts & Sciences, University of Cincinnati, Cincinnati, OH 45221, USA
| | - Michaela J. Idleburg
- Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA 15224, USA
| | - Melinda Butsch Kovacic
- Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH 45221, USA
- Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
- Department of Rehabilitation, Exercise, and Nutrition Science, College of Allied Health Sciences, University of Cincinnati, Cincinnati, OH 45267, USA
| | | | - Kevin R. Dufendach
- Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH 45221, USA
- Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
| | - Ellen A. Lipstein
- Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH 45221, USA
- Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
| | - Michelle L. McGowan
- Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH 45221, USA
- Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
- Department of Women’s, Gender & Sexuality Studies, College of Arts & Sciences, University of Cincinnati, Cincinnati, OH 45221, USA
| | - Melanie F. Myers
- Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH 45221, USA
- Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
| | - Cynthia A. Prows
- Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
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Macri EM, Neogi T, Jarraya M, Guermazi A, Roemer F, Lewis CE, Torner JC, Lynch JA, Tolstykh I, Jafarzadeh SR, Stefanik JJ. Magnetic Resonance Imaging-Defined Osteoarthritis Features and Anterior Knee Pain in Individuals With, or at Risk for, Knee Osteoarthritis: A Multicenter Study on Osteoarthritis. Arthritis Care Res (Hoboken) 2022; 74:1533-1540. [PMID: 33768706 PMCID: PMC8463633 DOI: 10.1002/acr.24604] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 01/21/2021] [Accepted: 03/23/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The lack of strong association between knee osteoarthritis (OA) structural features and pain continues to perplex researchers and clinicians. Evaluating the patellofemoral joint in addition to the tibiofemoral joint alone has contributed to explaining this structure-pain discordance, hence justifying a more comprehensive evaluation of whole-knee OA and pain. The present study, therefore, was undertaken to evaluate the association between patellofemoral and tibiofemoral OA features with localized anterior knee pain (AKP) using 2 study designs. METHODS Using cross-sectional data from the Multicenter Osteoarthritis Study, our first approach was a within-person, knee-matched design in which we identified participants with unilateral AKP. We then assessed magnetic resonance imaging (MRI)-derived OA features (cartilage damage, bone marrow lesions [BMLs], osteophytes, and inflammation) in both knees and evaluated the association of patellofemoral and tibiofemoral OA features to unilateral AKP. In our second approach, MRIs from 1 knee per person were scored, and we evaluated the association of OA features to AKP in participants with AKP and participants with no frequent knee pain. RESULTS Using the first approach (n = 71, 66% women, mean ± SD age 69 ± 8 years), lateral patellofemoral osteophytes (odds ratio [OR] 5.0 [95% confidence interval (95% CI) 1.7-14.6]), whole-knee joint effusion-synovitis (OR 4.7 [95% CI 1.3-16.2]), and infrapatellar synovitis (OR 2.8 [95% CI 1.0-7.8]) were associated with AKP. Using the second approach (n = 882, 59% women, mean ± SD age 69 ± 7 years), lateral and medial patellofemoral cartilage damage (prevalence ratio [PR] 2.3 [95% CI 1.3-4.0] and PR 1.9 [95% CI 1.1-3.3], respectively) and lateral patellofemoral BMLs (PR 2.6 [95% CI 1.5-4.7]) were associated with AKP. CONCLUSION Patellofemoral but not tibiofemoral joint OA features and inflammation were associated with AKP.
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Affiliation(s)
- Erin M. Macri
- Erasmus MC, Rotterdam, The Netherlands, and University of DelawareNewark
| | - Tuhina Neogi
- Boston University and Boston Imaging Core LabBostonMassachusetts
| | | | - Ali Guermazi
- Boston University and Boston Imaging Core LabBostonMassachusetts
| | - Frank Roemer
- Boston University, Boston, Massachusetts, and Friedrich‐Alexander University Erlangen‐NurembergErlangenGermany
| | | | | | | | | | | | - Joshua J. Stefanik
- University of Delaware, Newark, and Northeastern UniversityBostonMassachusetts
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Rabe KG, Stockman TJ, Kern AM, Wirth W, Eckstein F, Sharma L, Lynch JA, Nevitt MC, Anderson DD, Segal NA. Longitudinal Relationship Between Tibiofemoral Contact Stress at Baseline and Worsening of Knee Pain Over 84 Months in the Multicenter Osteoarthritis Study. Am J Phys Med Rehabil 2022; 101:726-732. [PMID: 34620738 PMCID: PMC8986881 DOI: 10.1097/phm.0000000000001899] [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] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of the study was to determine whether tibiofemoral contact stress predicts risk for worsening knee pain over 84 ms in adults aged 50-79 yrs with or at elevated risk for knee osteoarthritis. DESIGN Baseline tibiofemoral contact stress was estimated using discrete element analysis. Other baseline measures included weight, height, hip-knee-ankle alignment, Kellgren-Lawrence grade, and Western Ontario and McMaster Universities Osteoarthritis Index pain subscale. Logistic regression models assessed the association between baseline contact stress and 84-mo worsening of Western Ontario and McMaster Universities Osteoarthritis Index pain subscale. RESULTS Data from the dominant knee (72.6% Kellgren-Lawrence grade 0/1 and 27.4% Kellgren-Lawrence grade ≥ 2) of 208 participants (64.4% female, mean ± SD body mass index = 29.6 ± 5.1 kg/m 2 ) were analyzed. Baseline mean and peak contact stress were 3.3 ± 0.9 and 9.4 ± 4.3 MPa, respectively. Forty-seven knees met the criterion for worsening pain. The highest tertiles in comparison with the lowest tertiles of mean (odds ratio [95% confidence interval] = 2.47 [1.03-5.95], P = 0.04) and peak (2.49 [1.03-5.98], P = 0.04) contact stress were associated with worsening pain at 84 mos, after adjustment for age, sex, race, clinic site, and baseline pain. Post hoc sensitivity analyses including adjustment for body mass index and hip-knee-ankle alignment attenuated the effect. CONCLUSIONS These findings suggest that elevated tibiofemoral contact stress can predict the development of worsening of knee pain.
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Affiliation(s)
- Kaitlin G Rabe
- From the University of Kansas Medical Center, Kansas City, Kansas (KGR, NAS); University of Iowa, Iowa City, Iowa (TJS, AMK, DDA, NAS); Department of Imaging and Funktional Musculoskeletal Research, Paracelsus Medical University Salzburg & Nuremberg, Salzburg, Austria (WW, FE); Chondrometrics GmbH, Ainring, Germany (WW, FE); Northwestern University, Chicago, Illinois (LS); and University of California San Francisco, San Francisco, California (JAL, MCN)
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Turmezei TD, Low SB, Rupret S, Treece GM, Gee AH, MacKay JW, Lynch JA, Poole KES, Segal NA. Multiparametric 3-D analysis of bone and joint space width at the knee from weight bearing computed tomography. Osteoarthr Imaging 2022; 2:100069. [PMID: 36249485 PMCID: PMC9559750 DOI: 10.1016/j.ostima.2022.100069] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
OBJECTIVE Computed tomography (CT) can deliver multiple parameters relevant to osteoarthritis. In this study we demonstrate that a 3-D multiparametric approach at the weight bearing knee with cone beam CT is feasible, can include multiple parameters from across the joint space, and can reveal stronger relationships with disease status in combination. DESIGN 33 participants with knee weight bearing CT (WBCT) were analysed with joint space mapping and cortical bone mapping to deliver joint space width (JSW), subchondral bone plate thickness, endocortical thickness, and trabecular attenuation at both sides of the joint. All data were co-localised to the same canonical surface. Statistical parametric mapping (SPM) was applied in uni- and multivariate models to demonstrate significant dependence of parameters on Kellgren & Lawrence grade (KLG). Correlation between JSW and bony parameters and 2-week test-retest repeatability were also calculated. RESULTS SPM revealed that the central-to-posterior medial tibiofemoral joint space was significantly narrowed by up to 0.5 mm with significantly higher tibial trabecular attenuation up to 50 units for each increment in KLG as single features, and in a wider distribution when combined (p<0.05). These were also more strongly correlated with worsening KLG grade category. Test-retest repeatability was subvoxel (0.37 mm) for nearly all thickness parameters. CONCLUSIONS 3-D JSW and tibial trabecular attenuation are repeatable and significantly dependent on radiographic disease severity at the weight bearing knee joint not just alone, but more strongly in combination. A quantitative multiparametric approach with WBCT may have potential for more sensitive investigation of disease progression in osteoarthritis.
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Affiliation(s)
- Tom D Turmezei
- Norfolk and Norwich University Hospital NHS Foundation Trust, Colney Lane, Norwich, UK
- University of East Anglia, Norwich Research Park, Norwich, UK
| | - Samantha B Low
- University of East Anglia, Norwich Research Park, Norwich, UK
| | - Simon Rupret
- University Hospitals Bristol and Weston NHS Foundation Trust, Marlborough Street, Bristol, UK
| | - Graham M Treece
- Cambridge University Engineering Department, Trumpington Street, Cambridge, UK
| | - Andrew H Gee
- Cambridge University Engineering Department, Trumpington Street, Cambridge, UK
| | - James W MacKay
- Norfolk and Norwich University Hospital NHS Foundation Trust, Colney Lane, Norwich, UK
- University of East Anglia, Norwich Research Park, Norwich, UK
| | - John A Lynch
- University of California San Francisco, 550 16th Street, San Francisco, USA
| | - Kenneth ES Poole
- University of Cambridge Department of Medicine, Hills Road, Cambridge, UK
| | - Neil A Segal
- University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, USA
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Lynch JA. Revising the Bioethics Story: Memory and Story in Precarious Times. Perspect Biol Med 2022; 65:521-528. [PMID: 36468379 DOI: 10.1353/pbm.2022.0042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
The foundation story of bioethics is, as Susan Reverby (2009) argues, one of a trinity of horror stories culminating in what we commonly call the "Tuskegee Syphilis Study." The foundation story emphasizes that medical researchers violated participant autonomy by deceiving them about their medical conditions, the goals of the study, and the treatments they would receive, and by failing to consider the health and best interests of the research participant. While this story reflects some key elements of the Tuskegee study, it is only a selection of all the possible facts that, as a consequence, deflects attention from equally salient and problematic elements of the Public Health Service's unethical study and its context. Those elements not included in the bioethics foundation story represent the types of racial and social inequities that COVID-19 and other contemporary events have thrown into stark relief. If bioethics plans to emphasize translational work around public policy and public engagement understood broadly, then it will need to revise and expand the story it tells about itself and its founding.
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Crema MD, Roemer FW, Nevitt MC, Felson DT, Marra MD, Lynch JA, Tolstykh I, Lewis CE, Torner J, Guermazi A. Cross-sectional and longitudinal reliability of semiquantitative osteoarthritis assessment at 1.0T extremity MRI: Multi-reader data from the MOST study. Osteoarthr Cartil Open 2021; 3:100214. [PMID: 36474762 PMCID: PMC9718190 DOI: 10.1016/j.ocarto.2021.100214] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 09/07/2021] [Indexed: 10/20/2022] Open
Abstract
Objective To determine reliability among four experienced and calibrated readers in cross-sectional and longitudinal semi-quantitative MRI assessments of knee osteoarthritis (OA) in the Multicenter Osteoarthritis (MOST) study. Design From all MOST participants with at least one knee with readable 60-month and 84-month paired knee MRIs (1.0 T extremity systems), we selected 10 subjects having a spectrum of baseline disease severity of cartilage, bone marrow lesions, and meniscal damage and a spectrum of longitudinal changes in severity at 24 months follow-up. MRIs were independently assessed using the WORMS grading system by four musculoskeletal radiologists with the chronological sequence known to the readers. Kappa statistics were used to determine agreement between each pair of readers and Kendall's coefficient of concordance to determine average agreement across readers. Results For most features, cross-sectional reliability was substantial to almost perfect. Regarding longitudinal reliability (detection of longitudinal change), inter-reader reliability as weighted kappa values ranged from 0.62 to 0.78 for cartilage damage, 0.75-0.88 for bone marrow lesions, 0.75-0.92 for meniscal tears, 0.67-0.95 for meniscal extrusion, 0.51-0.77 for bone attrition, 0.43-0.76 for osteophytes, 0.31-0.70 for Hoffa-synovitis, and 0.47-0.85 for effusion-synovitis. Kendall's coefficient ranged from 0.65 to 0.98. Conclusion High levels of cross-sectional reliability and moderate to high longitudinal reliability was achieved using four experienced readers in semiquantitative MRI-assessment of most knee OA features.
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Affiliation(s)
- Michel D. Crema
- Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine, Boston, MA, USA
- Institute of Sports Imaging; Department of Sports Medicine, French National Institute of Sports (INSEP), Paris, France
| | - Frank W. Roemer
- Institute of Sports Imaging; Department of Sports Medicine, French National Institute of Sports (INSEP), Paris, France
- Department of Radiology, Friedrich-Alexander University Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Michael C. Nevitt
- Department of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, CA, USA
| | - David T. Felson
- Section of Rheumatology, Boston University School of Medicine, Boston, MA, USA
| | - Monica D. Marra
- Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine, Boston, MA, USA
- Department of Radiology, Rothschild Hospital, Sorbonne University, Paris, France
| | - John A. Lynch
- Department of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, CA, USA
| | - Irina Tolstykh
- Department of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, CA, USA
| | - Cora E. Lewis
- Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - James Torner
- Department of Epidemiology, University of Iowa, Iowa City, IA, USA
| | - Ali Guermazi
- Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine, Boston, MA, USA
- Department of Radiology, VA Boston Healthcare System, Boston, MA, USA
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Segal NA, Murphy MT, Everist BM, Brown KD, He J, Lynch JA, Nevitt MC. Clinical value of weight-bearing CT and radiographs for detecting patellofemoral cartilage visualized by MRI in the MOST study. Osteoarthritis Cartilage 2021; 29:1540-1548. [PMID: 34332048 PMCID: PMC8542599 DOI: 10.1016/j.joca.2021.07.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 02/05/2021] [Revised: 06/28/2021] [Accepted: 07/13/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The patellofemoral joint is frequently affected by osteoarthritis (PFOA) and is incompletely imaged on radiographs (XR). Weight-Bearing CT (WBCT) could offer advantages for visualization. This study determined the sensitivity, specificity, and accuracy of axial WBCT and lateral XR for detection of PFOA features in comparison with cartilage damage on MRI. DESIGN A convenience sample of 60 right knees from the MOST cohort were analyzed. WBCT and XR were read for OARSI JSN score and MRI for MOAKS cartilage score by two experienced musculoskeletal radiologists blinded to participant. Using MOAKS scoring on MRI (referent standard), the sensitivity, specificity and accuracy of patellofemoral OARSI JSN scores based on WBCT and XR were compared. RESULTS The mean ± SD age and BMI for the participants included (66.7% women) were 67.6 ± 9.8 years and 30.0 ± 5.3 kg/m2 respectively. WBCT demonstrated significantly greater sensitivity (0.85-0.97 on WBCT vs 0.47-0.57 on XR) and accuracy (0.85-0.92 on WBCT vs 0.48-0.57 on XR) for all parameters except lateral full-thickness cartilage loss (McNemar's test p-values all <0.001). There was moderate-to-strong and low-to-moderate agreement between PFOA findings on WBCT and XR, respectively, and semi-quantitative scores of PF cartilage on MRI. Inter-rater reliability for XR JSN [weighted kappa = 0.83 (0.64, 1.0)], WBCT JSN [kappa = 0.60 (0.48, 0.72)] and MRI MOAKS-CM [kappa = 0.70 (0.61, 0.79)] readings were good. CONCLUSION WBCT demonstrates significantly greater sensitivity and accuracy than radiographs for identification of PFOA. Given the same Relative Radiation Level as XR and improved visualization, WBCT holds promise to improve understanding of the weight-bearing patellofemoral joint.
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Affiliation(s)
- Neil A. Segal
- Department of Rehabilitation Medicine, University of Kansas Medical Center, 3901 Rainbow Boulevard, Mailstop 1046, Kansas City, KS, 66160
| | - Michael T. Murphy
- Department of Rehabilitation Medicine, University of Kansas Medical Center, Kansas City, KS, USA
| | - Brian M. Everist
- Department of Radiology, University of Kansas Medical Center, Kansas City, KS, USA
| | - Kevin D. Brown
- Department of Radiology, University of Kansas Medical Center, Kansas City, KS, USA
| | - Jianghua He
- Department of Biostatistics and Data Science, University of Kansas Medical Center, Kansas City, KS, USA
| | - John A. Lynch
- Department of Epidemiology and Biostatistics, University of California-San Francisco, San Francisco, CA, USA
| | - Michael C. Nevitt
- Department of Epidemiology and Biostatistics, University of California-San Francisco, San Francisco, CA, USA
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Bodden J, Joseph GB, Schirò S, Lynch JA, Lane NE, McCulloch CE, Nevitt MC, Link TM. Opioid users show worse baseline knee osteoarthritis and faster progression of degenerative changes: a retrospective case-control study based on data from the Osteoarthritis Initiative (OAI). Arthritis Res Ther 2021; 23:146. [PMID: 34022942 PMCID: PMC8140460 DOI: 10.1186/s13075-021-02524-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 05/05/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Opioids are frequently prescribed for pain control in knee osteoarthritis patients, despite recommendations by current guidelines. Previous studies have investigated the chondrotoxicity of different opioid subtypes. However, the impact opioids may have on progression of osteoarthritis in vivo remains unknown. The aim of this study was thus to describe the associations between opioid use and knee structural changes and clinical outcomes, over 4 years. METHODS Participants with baseline opioid use (n=181) and who continued use for ≥1 year between baseline and 4-year follow-up (n=79) were included from the Osteoarthritis Initiative cohort and frequency matched with non-users (controls) (1:2). Whole-Organ Magnetic Resonance Imaging Scores (WORMS) were obtained, including a total summation score (WORMS total, range 0-96) and subscores for cartilage (0-36), menisci (0-24), and bone marrow abnormalities and subchondral cyst-like lesions (0-18, respectively). Knee Injury Osteoarthritis Outcomes score (KOOS) symptoms, quality of life (QOL), and pain were also obtained at baseline and follow-up (range 0-100; lower scores indicate worse outcomes). Using linear regression models, associations between baseline and longitudinal findings were investigated. As pain may modify observations, a sensitivity analysis was performed for longitudinal findings. All analyses were adjusted for sex, BMI, age, race, and Kellgren-Lawrence grade. RESULTS Opioid users had greater structural degeneration at baseline (WORMS total: Coef. [95% CI], P; 7.1 [5.5, 8.8], <0.001) and a greater increase over 4 years (4.7 [2.9, 6.5], <0.001), compared to controls. Cartilage and meniscus scores increased greater in opioid users, compared to controls (P≤0.001), and findings withstood the adjustment for baseline pain (P≤0.002). All baseline KOOS scores were lower in opioid users compared to controls (P<0.001). QOL loss was greater, when adjusted for baseline KOOS pain (QOL -6.9 [-11.6, -2.1], 0.005). CONCLUSIONS Opioid users had worse baseline knee structural degeneration and faster progression. Opioid use was also associated with worse symptoms, pain, and QOL. Furthermore, QOL loss was greater in opioid users compared to controls, when adjusted for baseline KOOS pain, indicating that opioids may not be suited to prevent subjective disease progression in KOA patients.
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Affiliation(s)
- Jannis Bodden
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, 185 Berry Street, Lobby 6, Suite 350, San Francisco, CA, 94107, USA.
- Department of Radiology, Klinikum Rechts der Isar, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany.
| | - Gabby B Joseph
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, 185 Berry Street, Lobby 6, Suite 350, San Francisco, CA, 94107, USA
| | - Silvia Schirò
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, 185 Berry Street, Lobby 6, Suite 350, San Francisco, CA, 94107, USA
| | - John A Lynch
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - Nancy E Lane
- Center for Musculoskeletal Health and Department of Medicine, University of California, Davis, Davis, CA, USA
| | - Charles E McCulloch
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - Michael C Nevitt
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - Thomas M Link
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, 185 Berry Street, Lobby 6, Suite 350, San Francisco, CA, 94107, USA
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19
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Turmezei TD, B Low S, Rupret S, Treece GM, Gee AH, MacKay JW, Lynch JA, Poole KES, Segal NA. Quantitative Three-dimensional Assessment of Knee Joint Space Width from Weight-bearing CT. Radiology 2021; 299:649-659. [PMID: 33847516 DOI: 10.1148/radiol.2021203928] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background Imaging of structural disease in osteoarthritis has traditionally relied on MRI and radiography. Joint space mapping (JSM) can be used to quantitatively map joint space width (JSW) in three dimensions from CT images. Purpose To demonstrate the reproducibility, repeatability, and feasibility of JSM of the knee using weight-bearing CT images. Materials and Methods Two convenience samples of weight-bearing CT images of left and right knees with radiographic Kellgren-Lawrence grades (KLGs) less than or equal to 2 were acquired from 2014 to 2018 and were analyzed retrospectively with JSM to deliver three-dimensional JSW maps. For reproducibility, images of three sets of knees were used for novice training, and then the JSM output was compared against an expert's assessment. JSM was also performed on 2-week follow-up images in the second cohort, yielding three-dimensional JSW difference maps for repeatability. Statistical parametric mapping was performed on all knee imaging data (KLG, 0-4) to show the feasibility of a surface-based analysis in three dimensions. Results Reproducibility (in 20 individuals; mean age, 58 years ± 7 [standard deviation]; mean body mass index, 28 kg/m2 ± 6; 14 women) and repeatability (in nine individuals; mean age, 53 years ± 6; mean body mass index, 26 kg/m2 ± 4; seven women) reached their lowest performance at a smallest detectable difference less than ±0.1 mm in the central medial tibiofemoral joint space for individuals without radiographically demonstrated disease. The average root mean square coefficient of variation was less than 5% across all groups. Statistical parametric mapping (33 individuals; mean age, 57 years ± 7; mean body mass index, 27 kg/m2 ± 6; 23 women) showed that the central-to-posterior medial joint space was significantly narrower by 0.5 mm for each incremental increase in the KLG (threshold P < .05). One knee (KLG, 2) demonstrated a baseline versus 24-month change in its three-dimensional JSW distribution that was beyond the smallest detectable difference across the lateral joint space. Conclusion Joint space mapping of the knee using weight-bearing CT images is feasible, demonstrating a relationship between the three-dimensional joint space width distribution and structural joint disease. It is reliably learned by novice users, can be personalized for disease phenotypes, and can be used to achieve a smallest detectable difference that is at least 50% smaller than that reported to be achieved at the highest performance level in radiography. © RSNA, 2021 Online supplemental material is available for this article. See also the editorial by Roemer in this issue.
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Affiliation(s)
- Tom D Turmezei
- From the Department of Radiology, Norfolk and Norwich University Hospitals NHS Foundation Trust, Colney Lane, Norwich NR4 7UY, England (T.D.T., J.W.M.); Norwich Medical School, University of East Anglia, Norwich, England (T.D.T., J.W.M.); Royal Liverpool University Hospital, Liverpool, England (S.B.L.); Department of Radiology, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, England (S.R.); Departments of Engineering (G.M.T., A.H.G.) and Medicine (K.E.S.P.), University of Cambridge, Cambridge, England; Department of Epidemiology and Biostatistics, University of California-San Francisco, San Francisco, Calif (J.A.L.); and Department of Physical Medicine and Rehabilitation, Kansas University Medical Center, Kansas City, Kan (N.A.S.)
| | - Samantha B Low
- From the Department of Radiology, Norfolk and Norwich University Hospitals NHS Foundation Trust, Colney Lane, Norwich NR4 7UY, England (T.D.T., J.W.M.); Norwich Medical School, University of East Anglia, Norwich, England (T.D.T., J.W.M.); Royal Liverpool University Hospital, Liverpool, England (S.B.L.); Department of Radiology, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, England (S.R.); Departments of Engineering (G.M.T., A.H.G.) and Medicine (K.E.S.P.), University of Cambridge, Cambridge, England; Department of Epidemiology and Biostatistics, University of California-San Francisco, San Francisco, Calif (J.A.L.); and Department of Physical Medicine and Rehabilitation, Kansas University Medical Center, Kansas City, Kan (N.A.S.)
| | - Simon Rupret
- From the Department of Radiology, Norfolk and Norwich University Hospitals NHS Foundation Trust, Colney Lane, Norwich NR4 7UY, England (T.D.T., J.W.M.); Norwich Medical School, University of East Anglia, Norwich, England (T.D.T., J.W.M.); Royal Liverpool University Hospital, Liverpool, England (S.B.L.); Department of Radiology, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, England (S.R.); Departments of Engineering (G.M.T., A.H.G.) and Medicine (K.E.S.P.), University of Cambridge, Cambridge, England; Department of Epidemiology and Biostatistics, University of California-San Francisco, San Francisco, Calif (J.A.L.); and Department of Physical Medicine and Rehabilitation, Kansas University Medical Center, Kansas City, Kan (N.A.S.)
| | - Graham M Treece
- From the Department of Radiology, Norfolk and Norwich University Hospitals NHS Foundation Trust, Colney Lane, Norwich NR4 7UY, England (T.D.T., J.W.M.); Norwich Medical School, University of East Anglia, Norwich, England (T.D.T., J.W.M.); Royal Liverpool University Hospital, Liverpool, England (S.B.L.); Department of Radiology, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, England (S.R.); Departments of Engineering (G.M.T., A.H.G.) and Medicine (K.E.S.P.), University of Cambridge, Cambridge, England; Department of Epidemiology and Biostatistics, University of California-San Francisco, San Francisco, Calif (J.A.L.); and Department of Physical Medicine and Rehabilitation, Kansas University Medical Center, Kansas City, Kan (N.A.S.)
| | - Andrew H Gee
- From the Department of Radiology, Norfolk and Norwich University Hospitals NHS Foundation Trust, Colney Lane, Norwich NR4 7UY, England (T.D.T., J.W.M.); Norwich Medical School, University of East Anglia, Norwich, England (T.D.T., J.W.M.); Royal Liverpool University Hospital, Liverpool, England (S.B.L.); Department of Radiology, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, England (S.R.); Departments of Engineering (G.M.T., A.H.G.) and Medicine (K.E.S.P.), University of Cambridge, Cambridge, England; Department of Epidemiology and Biostatistics, University of California-San Francisco, San Francisco, Calif (J.A.L.); and Department of Physical Medicine and Rehabilitation, Kansas University Medical Center, Kansas City, Kan (N.A.S.)
| | - James W MacKay
- From the Department of Radiology, Norfolk and Norwich University Hospitals NHS Foundation Trust, Colney Lane, Norwich NR4 7UY, England (T.D.T., J.W.M.); Norwich Medical School, University of East Anglia, Norwich, England (T.D.T., J.W.M.); Royal Liverpool University Hospital, Liverpool, England (S.B.L.); Department of Radiology, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, England (S.R.); Departments of Engineering (G.M.T., A.H.G.) and Medicine (K.E.S.P.), University of Cambridge, Cambridge, England; Department of Epidemiology and Biostatistics, University of California-San Francisco, San Francisco, Calif (J.A.L.); and Department of Physical Medicine and Rehabilitation, Kansas University Medical Center, Kansas City, Kan (N.A.S.)
| | - John A Lynch
- From the Department of Radiology, Norfolk and Norwich University Hospitals NHS Foundation Trust, Colney Lane, Norwich NR4 7UY, England (T.D.T., J.W.M.); Norwich Medical School, University of East Anglia, Norwich, England (T.D.T., J.W.M.); Royal Liverpool University Hospital, Liverpool, England (S.B.L.); Department of Radiology, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, England (S.R.); Departments of Engineering (G.M.T., A.H.G.) and Medicine (K.E.S.P.), University of Cambridge, Cambridge, England; Department of Epidemiology and Biostatistics, University of California-San Francisco, San Francisco, Calif (J.A.L.); and Department of Physical Medicine and Rehabilitation, Kansas University Medical Center, Kansas City, Kan (N.A.S.)
| | - Kenneth E S Poole
- From the Department of Radiology, Norfolk and Norwich University Hospitals NHS Foundation Trust, Colney Lane, Norwich NR4 7UY, England (T.D.T., J.W.M.); Norwich Medical School, University of East Anglia, Norwich, England (T.D.T., J.W.M.); Royal Liverpool University Hospital, Liverpool, England (S.B.L.); Department of Radiology, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, England (S.R.); Departments of Engineering (G.M.T., A.H.G.) and Medicine (K.E.S.P.), University of Cambridge, Cambridge, England; Department of Epidemiology and Biostatistics, University of California-San Francisco, San Francisco, Calif (J.A.L.); and Department of Physical Medicine and Rehabilitation, Kansas University Medical Center, Kansas City, Kan (N.A.S.)
| | - Neil A Segal
- From the Department of Radiology, Norfolk and Norwich University Hospitals NHS Foundation Trust, Colney Lane, Norwich NR4 7UY, England (T.D.T., J.W.M.); Norwich Medical School, University of East Anglia, Norwich, England (T.D.T., J.W.M.); Royal Liverpool University Hospital, Liverpool, England (S.B.L.); Department of Radiology, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, England (S.R.); Departments of Engineering (G.M.T., A.H.G.) and Medicine (K.E.S.P.), University of Cambridge, Cambridge, England; Department of Epidemiology and Biostatistics, University of California-San Francisco, San Francisco, Calif (J.A.L.); and Department of Physical Medicine and Rehabilitation, Kansas University Medical Center, Kansas City, Kan (N.A.S.)
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Blumling AA, Childers-Buschle KE, Lynch JA, Myers MF, McGowan ML. The Underdeveloped "Gift": Ethics in Implementing Precision Medicine Research. Am J Bioeth 2021; 21:67-69. [PMID: 33825648 PMCID: PMC8170672 DOI: 10.1080/15265161.2021.1891352] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Affiliation(s)
| | | | | | - Melanie F. Myers
- Cincinnati Children’s Hospital Medical Center
- University of Cincinnati
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21
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Smith ME, Stastny AL, Lynch JA, Yu Z, Zhang P, Heineman WR. Correction to Indicator Dyes and Catalytic Nanoparticles for Irreversible Visual Hydrogen Sensing. Anal Chem 2021; 93:1852. [PMID: 33331767 DOI: 10.1021/acs.analchem.0c05121] [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: 11/30/2022]
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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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Hunter DJ, Deveza LA, Collins JE, Losina E, Nevitt MC, Roemer FW, Guermazi A, Bowes MA, Dam EB, Eckstein F, Lynch JA, Katz JN, Kwoh CK, Hoffmann S, Kraus VB. Multivariable modeling of biomarker data from the phase 1 Foundation for the NIH Osteoarthritis Biomarkers Consortium. Arthritis Care Res (Hoboken) 2021; 74:1142-1153. [PMID: 33421361 DOI: 10.1002/acr.24557] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 12/18/2020] [Accepted: 01/05/2021] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To determine the optimal combination of imaging and biochemical biomarkers to predict knee osteoarthritis (OA) progression. METHODS Nested case-control study from the FNIH OA Biomarkers Consortium of participants with Kellgren-Lawrence grade 1-3 and complete biomarker data (n=539 to 550). Cases were knees with radiographic and pain progression between 24-48 months from baseline. Radiographic progression only was assessed in secondary analyses. Biomarkers (baseline and 24-month changes) with p<0.10 in univariate analysis were selected, including MRI (quantitative (Q) cartilage thickness and volume; semi-quantitative (SQ) MRI markers; bone shape and area; Q meniscal volume), radiographic (trabecular bone texture (TBT)), and serum and/or urine biochemical markers. Multivariable logistic regression models were built using three different step-wise selection methods (complex vs. parsimonious models). RESULTS Among baseline biomarkers, the number of locations affected by osteophytes (SQ), Q central medial femoral and central lateral femoral cartilage thickness, patellar bone shape, and SQ Hoffa-synovitis predicted progression in most models (C-statistics 0.641-0.671). 24-month changes in SQ MRI markers (effusion-synovitis, meniscal morphology, and cartilage damage), Q central medial femoral cartilage thickness, Q medial tibial cartilage volume, Q lateral patellofemoral bone area, horizontal TBT (intercept term), and urine NTX-I predicted progression in most models (C-statistics 0.680-0.724). A different combination of imaging and biochemical biomarkers (baseline and 24-month change) predicted radiographic progression only, with higher C-statistics (0.716-0.832). CONCLUSION This study highlights the combination of biomarkers with potential prognostic utility in OA disease-modifying trials. Properly qualified, these biomarkers could be used to enrich future trials with participants likely to progress.
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Affiliation(s)
- David J Hunter
- Department of Rheumatology, Royal North Shore Hospital and Institute of Bone and Joint Research, Kolling Institute, University of Sydney, Sydney, Australia
| | - Leticia A Deveza
- Department of Rheumatology, Royal North Shore Hospital and Institute of Bone and Joint Research, Kolling Institute, University of Sydney, Sydney, Australia
| | - Jamie E Collins
- Orthopaedic and Arthritis Center for Outcomes Research, Department of Orthopedic Surgery, Brigham and Women's Hospital Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Elena Losina
- Orthopaedic and Arthritis Center for Outcomes Research, Department of Orthopedic Surgery, Brigham and Women's Hospital Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Michael C Nevitt
- University of California-San Francisco, San Francisco, CA, United States
| | - Frank 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
| | - Ali Guermazi
- Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine, Boston, MA, USA
| | - Michael A Bowes
- Imorphics Ltd, a wholly-owned subsidiary of Stryker Corp, Manchester, UK
| | - Erik B Dam
- Department of Computer Science, University of Copenhagen, Denmark.,Biomediq, Copenhagen, Denmark
| | - Felix Eckstein
- Department of Imaging & Functional Musculoskeletal Research, Institute of Anatomy and Cell Biology, Paracelsus Medical University, Salzburg & Nuremberg, Salzburg, Austria.,Ludwig Boltzmann Institute for Arthritis and Rehabilitation, Paracelsus Medical University, Salzburg, Austria.,Chondrometrics GmbH, Ainring, Germany
| | - John A Lynch
- Department of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, CA, USA
| | - Jeffrey N Katz
- Orthopaedic and Arthritis Center for Outcomes Research, Department of Orthopedic Surgery, Brigham and Women's Hospital Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - C Kent Kwoh
- University of Arizona, Arthritis Center & Division of Rheumatology, University of Arizona College of Medicine, Tucson, AZ, USA
| | - Steve Hoffmann
- Foundation for the National Institutes of Health, North Bethesda, MD, USA
| | - Virginia B Kraus
- Duke Molecular Physiology Institute and Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, NC, 27701, USA
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Lynch JA, Goldenberg AJ, Garrison NA, Brothers KB. Analogies in Genomics Policymaking: Debates and Drawbacks. Am J Hum Genet 2020; 107:797-801. [PMID: 33157006 DOI: 10.1016/j.ajhg.2020.08.024] [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: 06/23/2020] [Accepted: 08/21/2020] [Indexed: 11/29/2022] Open
Abstract
The analogy between genomics and imaging has been an important touchstone in the debate on how secondary findings should be handled in both clinical and research genomics contexts. However, a critical eye is needed to understand whether an analogy like this one provides an adequate basis for policymaking in genomics. Genomics and imaging are undoubtedly similar in certain ways, but whether that similarity is adequate to justify adopting identical policies is a task that requires further analysis. This is highlighted by the fact that secondary findings are produced in other domains of medicine and public health, such as newborn screening programs, routine laboratory panels, and antibiotic sensitivity testing, and that the practices for handling secondary findings in each of these areas are different. These examples demonstrate that medicine has no single comprehensive policy or set of practices for managing secondary findings. Analogies to imaging, newborn screening, routine testing panels, and antibiotic sensitivity testing all lead to different policy options for genomics. In this piece we argue that analogies are a powerful way of driving policy discussions by rendering two different areas of medical practice similar, but an overdependence on a single analogy risks limiting policy discussions in potentially deleterious ways.
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Affiliation(s)
- John A Lynch
- Department of Communication, University of Cincinnati, Cincinnati, OH 45221, USA.
| | - Aaron J Goldenberg
- Department of Bioethics & Medical Humanities, Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA
| | - Nanibaa' A Garrison
- Institute for Society and Genetics, University of California, Los Angeles, CA 90095, USA; Institute for Precision Health, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA; General Internal Medicine and Health Services Research, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA
| | - Kyle B Brothers
- Department of Pediatrics, University of Louisville School of Medicine, Louisville, KY 40202, USA; Institute for Bioethics, Health Policy and Law, University of Louisville, Louisville, KY 40202, USA.
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Posadzy M, Joseph GB, McCulloch CE, Nevitt MC, Lynch JA, Lane NE, Link TM. Natural history of new horizontal meniscal tears in individuals at risk for and with mild to moderate osteoarthritis: data from osteoarthritis initiative. Eur Radiol 2020; 30:5971-5980. [PMID: 32572566 DOI: 10.1007/s00330-020-06960-0] [Citation(s) in RCA: 2] [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] [Received: 11/26/2019] [Revised: 04/05/2020] [Accepted: 05/15/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVES To study the natural history of new horizontal meniscal tears and their association with progression of cartilage degeneration in individuals at risk for or with mild to moderate knee osteoarthritis over 4 years. METHODS Individuals who developed a new meniscal tear in the right knee over 2 years were selected from the Osteoarthritis Initiative 3T MRI studies. Knee structural changes were analyzed at the time of tear appearance (baseline), and after 4 years using a modified Whole-Organ Magnetic Resonance Imaging Score (WORMS). Meniscal tears were classified as either horizontal tears or non-horizontal tears. Individuals without a meniscal tear were 1:3 frequency matched according to BMI, gender, race, and age and served as the control group. Linear regression analysis was used to compare cross-sectional and longitudinal changes in cartilage WORMS scores. RESULTS Forty-one subjects developed horizontal tears, including one indiviudal who developed a tear in both menisci, and 34 developed non-horizonal tears. We found that (29/41 (70.7%)) of horizontal and (20/34 (58.8%)) of non-horizonatal tears were stable during follow-up (p = 0.281). Although knees with an incident tear had higher than controls WORMS MAX total knee scores at baseline (coef. = 0.47, p = 0.044, 95% CI = 0.01 to 0.93), there were no significant differences between the horizontal subgroup and knees without tears in overall cartilage scores at baseline and in progression over 4 years of follow-up. CONCLUSIONS New horizontal meniscal tears tended to be stable over 4 years and presented no significant differences in progression of cartilage degeneration when compared with knees without tears. KEY POINTS • Most of horizonal meniscal tears were stable over 4 years. • There were no statistically significant differences in overall progression of cartilage degenerative changes between knees with horizonal meniscal tears and control knees without tears • Horizontal tears most often occurred at the posterior horn of the medial meniscus and at the body of the lateral meniscus.
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Affiliation(s)
- Magdalena Posadzy
- Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry Street, Lobby 6, Suite 350, San Francisco, CA, 94107, USA.
| | - Gabby B Joseph
- Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry Street, Lobby 6, Suite 350, San Francisco, CA, 94107, USA
| | - Charles E McCulloch
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
| | - Michael C Nevitt
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
| | - John A Lynch
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
| | - Nancy E Lane
- Department of Rheumatology, University of California, Davis, CA, USA
| | - Thomas M Link
- Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry Street, Lobby 6, Suite 350, San Francisco, CA, 94107, USA
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Joseph GB, McCulloch CE, Nevitt MC, Neumann J, Lynch JA, Lane NE, Link TM. Associations Between Vitamins C and D Intake and Cartilage Composition and Knee Joint Morphology Over 4 Years: Data From the Osteoarthritis Initiative. Arthritis Care Res (Hoboken) 2020; 72:1239-1247. [PMID: 31282125 DOI: 10.1002/acr.24021] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Accepted: 07/02/2019] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To determine the cross-sectional and longitudinal associations of vitamin C and D intake with magnetic resonance imaging (MRI) measures of cartilage composition (T2) and joint structure (cartilage, meniscus, and bone marrow) using data from the Osteoarthritis Initiative (OAI) cohort. METHODS A total of 1,785 subjects with radiographic Kellgren/Lawrence knee grades 0-3 in the right knee were selected from the OAI database. Vitamins C and vitamin D intake (diet, supplements, and total) were assessed using the Block Brief 2000 Food Frequency Questionnaire at baseline. The MRI analysis protocol included 3T cartilage T2 quantification and semiquantitative joint morphology gradings (Whole-Organ Magnetic Resonance Imaging Score [WORMS]) at baseline and 4 years. Linear regression was used to assess the association between standardized baseline vitamin intake and both baseline WORMS scores and standardized cartilage T2 values. RESULTS Higher vitamin C intake was associated with lower average cartilage T2 values, medial tibia T2 values, and medial tibia WORMS scores (standardized coefficient range -0.07 to -0.05, P < 0.05). Higher vitamin D intake was associated with a lower cartilage WORMS sum score and medial femur WORMS score (standardized coefficient range -0.24 to -0.09, P < 0.05). Consistent use of vitamin D supplements of 400 IU at least once a week over 4 years was associated with significantly less worsening of cartilage, meniscus, and bone marrow abnormalities (odds ratio range 0.40-0.56, P < 0.05). CONCLUSION Supplementation with vitamin D over 4 years was associated with significantly less progression of knee joint abnormalities. Given the observational nature of this study, future longitudinal randomized controlled trials of vitamin D supplementation are warranted.
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Smith ME, Stastny AL, Lynch JA, Yu Z, Zhang P, Heineman WR. Indicator Dyes and Catalytic Nanoparticles for Irreversible Visual Hydrogen Sensing. Anal Chem 2020; 92:10651-10658. [DOI: 10.1021/acs.analchem.0c01769] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Michael E. Smith
- Department of Chemistry, University of Cincinnati, Cincinnati, Ohio 45221-0172, United States
| | - Angela L. Stastny
- Department of Chemistry, University of Cincinnati, Cincinnati, Ohio 45221-0172, United States
| | - John A. Lynch
- Department of Chemistry, University of Cincinnati, Cincinnati, Ohio 45221-0172, United States
| | - Zhao Yu
- Department of Chemistry, University of Cincinnati, Cincinnati, Ohio 45221-0172, United States
| | - Peng Zhang
- Department of Chemistry, University of Cincinnati, Cincinnati, Ohio 45221-0172, United States
| | - William R. Heineman
- Department of Chemistry, University of Cincinnati, Cincinnati, Ohio 45221-0172, United States
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Wise BL, Niu J, Zhang Y, Liu F, Pang J, Lynch JA, Lane NE. Patterns of Change Over Time in Knee Bone Shape Are Associated with Sex. Clin Orthop Relat Res 2020; 478:1491-1502. [PMID: 32187098 PMCID: PMC7310328 DOI: 10.1097/corr.0000000000001219] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 02/24/2020] [Indexed: 01/31/2023]
Abstract
BACKGROUND Knee osteoarthritis (OA) is more common in females than in males; however, the biological mechanisms for the difference in sex in patients with knee OA are not well understood. Knee shape is associated with OA and with sex, but the patterns of change in the bone's shape over time and their relation to sex and OA are unknown and may help inform how sex is associated with shape and OA and whether the effect is exerted early or later in life.Questions/purposes (1) Does knee shape segregate stably into different groups of trajectories of change (groups of knees that share similar patterns of changes in bone shape over time)? (2) Do females and males have different trajectories of bone shape changes? (3) Is radiographic OA at baseline associated with trajectories of bone shape changes? METHODS We used data collected from the NIH-funded Osteoarthritis Initiative (OAI) to evaluate a cohort of people aged 45 to 79 years at baseline who had either symptomatic knee OA or were at high risk of having it. The OAI cohort included 4796 participants (58% females; n = 2804) at baseline who either had symptomatic knee OA (defined as having radiographic tibiofemoral knee OA and answering positively to the question "have you had pain, aching or stiffness around the knee on most days for at least one month during the past 12 months") or were at high risk of symptomatic knee OA (defined as having knee symptoms during the prior 12 months along with any of the following: overweight; knee injury; knee surgery other than replacement; family history of total knee replacement for OA; presence of Heberden's nodes; daily knee bending activity) or were part of a small nonexposed subcohort. From these participants, we limited the eligible group to those with radiographs available and read at baseline, 2 years, and 4 years, and randomly selected participants from each OAI subcohort in a manner to enrich representation in the study of the progression and nonexposed subcohorts, which were smaller in number than the OA incidence subcohort. From these patients, we randomly sampled 473 knees with radiographs available at baseline, 2 years, and 4 years. We outlined the shape of the distal femur and proximal tibia on radiographs at all three timepoints using statistical shape modelling. Five modes (each mode represents a particular type of knee bone shape variation) were derived for the proximal tibia and distal femur's shape, accounting for 78% of the total variance in shape. Group-based trajectory modelling (a statistical approach to identify the clusters of participants following a similar progression of change of bone shape over time, that is, trajectory group) was used to identify distinctive patterns of change in the bone shape for each mode. We examined the association of sex and radiographic OA at baseline with the trajectories of each bone shape mode using a multivariable polytomous regression model while adjusting for age, BMI, and race. RESULTS Knee bone shape change trajectories segregated stably into different groups. In all modes, three distinct trajectory groups were derived, with the mean posterior probabilities (a measure of an individual's probability of being in a particular group and often used to characterize how well the trajectory model is working to describe the population) ranging from 84% to 99%, indicating excellent model fitting. For most of the modes of both the femur and tibia, the intercepts for the three trajectory groups were different; however, the rates of change were generally similar in each mode. Females and males had different trajectories of bone shape change. For Mode 1 in the femur, females were more likely to be in trajectory Groups 3 (odds ratio 30.2 [95% CI 12.2 to 75.0]; p < 0.001) and 2 than males (OR 4.1 [95% CI 2.3 to 7.1]; p < 0.001); thus, females had increased depth of the intercondylar fossa and broader shaft width relative to epicondylar width compared with males. For Mode 1 in the tibia, females were less likely to be in trajectory Group 2 (OR 0.5 [95% CI 0.3 to 0.9]; p = 0.01) than males (that is, knees of females were less likely to display superior elevation of tibial plateau or decreased shaft width relative to head width). Radiographic OA at baseline was associated with specific shape-change trajectory groups. For Mode 1 in the femur, knees with OA were less likely to be in trajectory Groups 3 (OR 0.4 [95% CI 0.2 to 0.8]; p = 0.008) and 2 (OR 0.6 [95% CI 0.3 to 1.0]; p = 0.03) than knees without OA; thus, knees with OA had decreased depth of the intercondylar fossa and narrower shaft width relative to epicondylar width compared with knees without OA. For Mode 1 in the tibia, knees with OA were not associated with trajectory. CONCLUSIONS The shapes of the distal femur and proximal tibia did not change much over time. Sex and baseline knee radiographic OA status are associated with the trajectory of change in the bone's shape, suggesting that both may contribute earlier in life to the associations among trajectories observed in older individuals. Future studies might explore sex-related bone shape change earlier in life to help determine when the sex-specific shapes arise and also the degree to which these sex-related shapes are alterable by injury or other events. LEVEL OF EVIDENCE Level III, prognostic study.
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Affiliation(s)
- Barton L Wise
- B. L. Wise, Department of Orthopaedic Surgery, University of California, Davis School of Medicine, Sacramento, CA, USA
- B. L. Wise, N. E. Lane, Department of Internal Medicine, University of California, Davis School of Medicine, Sacramento, CA, USA
| | - Jingbo Niu
- J. Niu, Boston University School of Medicine, Boston, MA, USA
| | - Yuqing Zhang
- Y. Zhang, Harvard Medical School, Boston, MA, USA
| | - Felix Liu
- F. Liu, J. A. Lynch, Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - Joyce Pang
- J. Pang, Department of General Surgery, University of New Mexico School of Medicine, Albuquerque, NM, USA
| | - John A Lynch
- F. Liu, J. A. Lynch, Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - Nancy E Lane
- B. L. Wise, N. E. Lane, Department of Internal Medicine, University of California, Davis School of Medicine, Sacramento, CA, USA
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Guermazi A, Jarraya M, Lynch JA, Felson DT, Clancy M, Nevitt M, Lewis CE, Torner J, Neogi T. Reliability of a new scoring system for intraarticular mineralization of the knee: Boston University Calcium Knee Score (BUCKS). Osteoarthritis Cartilage 2020; 28:802-810. [PMID: 32173626 PMCID: PMC8188576 DOI: 10.1016/j.joca.2020.03.003] [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] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Revised: 02/19/2020] [Accepted: 03/02/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND The role of intra-articular mineralization in osteoarthritis (OA) is unclear. Its understanding may potentially advance our knowledge of knee OA pathogenesis. We describe and assess the reliability of a novel computed tomography (CT) scoring system, the Boston University Calcium Knee Score (BUCKS) for evaluating intra-articular mineralization. METHODS We included subjects from the most recent study visit of the Multicenter Osteoarthritis Study (MOST) Study, a NIH-funded longitudinal cohort of community-dwelling older adults with or at risk of knee OA. All subjects underwent CT of bilateral knees. Each knee was scored at 28 scored locations (14 for cartilage, 6 for menisci, 6 for ligaments, 1 for joint capsule, and 1 popliteal-tibial vessels). A single musculoskeletal radiologist scored cartilage and meniscus subregions, as well as vascular calcifications assigning to each a score ranging from 0 to 3. The joint capsule, medial and lateral posterior meniscal roots, anterior cruciate ligament (ACL)/posterior cruciate ligament (PCL) and 2 collateral ligaments [medial collateral ligament (MCL)/lateral collateral ligament (LCL)] were each scored 0 or 1 for absence or presence of mineralization. To assess reliability, 31 subject CTs were reread 12 weeks later by the same reader and by a second reader and agreement was evaluated using a weighted kappa. RESULTS The intra-reader reliability ranged from 0.92 for ligaments to 1.0 for joint capsule. The inter-reader reliability ranged from 0.94 for cartilage and ligaments, to 1.0 for joint capsule. CONCLUSION BUCKS demonstrated excellent reliability and is a potentially useful CT-based tool for studying the role of calcium crystals in knee OA.
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Affiliation(s)
- Ali Guermazi
- Department of Radiology, Boston University School of Medicine, Boston University, Boston MA
| | - Mohamed Jarraya
- Department of Radiology, Boston University School of Medicine, Boston University, Boston MA,Department of Radiology, Mercy Catholic Medical Center, Darby, PA
| | - John A Lynch
- Department of Epidemiology, University of California San Francisco, CA
| | - David T Felson
- Department of Medicine, Boston University School of Medicine, Boston University, Boston MA
| | - Margaret Clancy
- Department of Medicine, Boston University School of Medicine, Boston University, Boston MA
| | - Michael Nevitt
- Department of Epidemiology, University of California San Francisco, CA
| | - Cora E. Lewis
- Department of Epidemiology, University of Alabama at Birmingham, AL
| | - James Torner
- Department of Epidemiology, College of Public Health, University of Iowa, IA
| | - Tuhina Neogi
- Department of Medicine, Boston University School of Medicine, Boston University, Boston MA
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Lynch JA, Sharp RR, Aufox SA, Bland ST, Blout C, Bowen DJ, Buchanan AH, Halverson C, Harr M, Hebbring SJ, Henrikson N, Hoell C, Holm IA, Jarvik G, Kullo IJ, Kochan DC, Larson EB, Lazzeri A, Leppig KA, Madden J, Marasa M, Myers MF, Peterson J, Prows CA, Kulchak Rahm A, Ralston J, Milo Rasouly H, Scrol A, Smith ME, Sturm A, Stuttgen K, Wiesner G, Williams MS, Wynn J, Williams JL. Understanding the Return of Genomic Sequencing Results Process: Content Review of Participant Summary Letters in the eMERGE Research Network. J Pers Med 2020; 10:jpm10020038. [PMID: 32413979 PMCID: PMC7354464 DOI: 10.3390/jpm10020038] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 05/06/2020] [Accepted: 05/09/2020] [Indexed: 01/26/2023] Open
Abstract
A challenge in returning genomic test results to research participants is how best to communicate complex and clinically nuanced findings to participants in a manner that is scalable to the large numbers of participants enrolled. The purpose of this study was to examine the features of genetic results letters produced at each Electronic Medical Records and Genomics (eMERGE3) Network site to assess their readability and content. Letters were collected from each site, and a qualitative analysis of letter content and a quantitative analysis of readability statistics were performed. Because letters were produced independently at each eMERGE site, significant heterogeneity in readability and content was found. The content of letters varied widely from a baseline of notifying participants that results existed to more detailed information about positive or negative results, as well as materials for sharing with family members. Most letters were significantly above the Centers for Disease Control-suggested reading level for health communication. While continued effort should be applied to make letters easier to understand, the ongoing challenge of explaining complex genomic information, the implications of negative test results, and the uncertainty that comes with some types of test and result makes simplifying letter text challenging.
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Affiliation(s)
- John A. Lynch
- Department of Communication, University of Cincinnati, Cincinnati, OH 45220, USA
- Correspondence:
| | | | - Sharon A. Aufox
- Center for Genomic Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA; (S.A.A.); (C.H.)
| | - Sarah T. Bland
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN 37232, USA; (S.T.B.); (J.P.)
| | - Carrie Blout
- Harvard Pilgrim Health Care Institute, Boston, MA 02115, USA;
| | - Deborah J. Bowen
- Department of Bioethics and Humanities, School of Medicine, University of Washington, Seattle, WA 98195, USA;
| | - Adam H. Buchanan
- Genomic Medicine Institute, Geisinger, Danville, PA 17822, USA; (A.H.B.); (A.L.); (A.K.R.); (A.S.); (M.S.W.); (J.L.W.)
| | - Colin Halverson
- School of Medicine, Indiana University-Purdue University, Indianapolis, IN 46202, USA;
| | - Margaret Harr
- Center for Applied Genomics, Children’s Hospital of Pennsylvania, Philadelphia, PA 19104, USA;
| | | | - Nora Henrikson
- Kaiser Permanente Washington Health Research Institute, Kaiser Permanente of Washington, Seattle, WA 98101, USA; (N.H.); (E.B.L.); (J.R.); (A.S.)
- Department of Health Services, School of Public Health, University of Washington, Seattle, WA 98195, USA
| | - Christin Hoell
- Center for Genomic Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA; (S.A.A.); (C.H.)
| | - Ingrid A. Holm
- Department of Pediatrics, Harvard Medical School, Boston, MA 02115, USA;
- Division of Genetics and Genomics, Boston Children’s Hospital, Boston, MA 02115, USA;
| | - Gail Jarvik
- Departments of Medicine (Medical Genetics) and Genome Sciences, University of Washington, Seattle, WA 98195, USA;
| | - Iftikhar J. Kullo
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN 55902, USA; (I.J.K.); (D.C.K.); (K.S.)
| | - David C. Kochan
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN 55902, USA; (I.J.K.); (D.C.K.); (K.S.)
| | - Eric B. Larson
- Kaiser Permanente Washington Health Research Institute, Kaiser Permanente of Washington, Seattle, WA 98101, USA; (N.H.); (E.B.L.); (J.R.); (A.S.)
- Division of General Internal Medicine, University of Washington, Seattle, WA 98195, USA
| | - Amanda Lazzeri
- Genomic Medicine Institute, Geisinger, Danville, PA 17822, USA; (A.H.B.); (A.L.); (A.K.R.); (A.S.); (M.S.W.); (J.L.W.)
| | - Kathleen A. Leppig
- Genetic Services, Kaiser Permanente of Washington, Seattle, WA 98101, USA;
- University of Washington Biomedical and Health Informatics, Seattle, WA 98195, USA
| | - Jill Madden
- Division of Genetics and Genomics, Boston Children’s Hospital, Boston, MA 02115, USA;
| | - Maddalena Marasa
- Department of Medicine, Division of Nephrology, Columbia University Irving Medical Center, New York, NY 10032, USA; (M.M.); (H.M.R.)
| | - Melanie F. Myers
- College of Medicine, University of Cincinnati, Cincinnati, OH 45220, USA;
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, University of Cincinnati, Cincinnati, OH 45229, USA;
| | - Josh Peterson
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN 37232, USA; (S.T.B.); (J.P.)
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN 37232, USA;
| | - Cynthia A. Prows
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, University of Cincinnati, Cincinnati, OH 45229, USA;
| | - Alanna Kulchak Rahm
- Genomic Medicine Institute, Geisinger, Danville, PA 17822, USA; (A.H.B.); (A.L.); (A.K.R.); (A.S.); (M.S.W.); (J.L.W.)
| | - James Ralston
- Kaiser Permanente Washington Health Research Institute, Kaiser Permanente of Washington, Seattle, WA 98101, USA; (N.H.); (E.B.L.); (J.R.); (A.S.)
- University of Washington Biomedical and Health Informatics, Seattle, WA 98195, USA
| | - Hila Milo Rasouly
- Department of Medicine, Division of Nephrology, Columbia University Irving Medical Center, New York, NY 10032, USA; (M.M.); (H.M.R.)
| | - Aaron Scrol
- Kaiser Permanente Washington Health Research Institute, Kaiser Permanente of Washington, Seattle, WA 98101, USA; (N.H.); (E.B.L.); (J.R.); (A.S.)
| | - Maureen E. Smith
- Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA;
| | - Amy Sturm
- Genomic Medicine Institute, Geisinger, Danville, PA 17822, USA; (A.H.B.); (A.L.); (A.K.R.); (A.S.); (M.S.W.); (J.L.W.)
| | - Kelsey Stuttgen
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN 55902, USA; (I.J.K.); (D.C.K.); (K.S.)
| | - Georgia Wiesner
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN 37232, USA;
- Vanderbilt Clinical and Translational Hereditary Cancer Program, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Marc S. Williams
- Genomic Medicine Institute, Geisinger, Danville, PA 17822, USA; (A.H.B.); (A.L.); (A.K.R.); (A.S.); (M.S.W.); (J.L.W.)
| | - Julia Wynn
- Department of Pediatrics, Columbia University Irving Medical Center, New York, NY 10027, USA;
| | - Janet L. Williams
- Genomic Medicine Institute, Geisinger, Danville, PA 17822, USA; (A.H.B.); (A.L.); (A.K.R.); (A.S.); (M.S.W.); (J.L.W.)
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Chang J, Zhu Z, Han W, Zhao Y, Kwoh CK, Lynch JA, Hunter DJ, Ding C. The morphology of proximal tibiofibular joint (PTFJ) predicts incident radiographic osteoarthritis: data from Osteoarthritis Initiative. Osteoarthritis Cartilage 2020; 28:208-214. [PMID: 31733306 DOI: 10.1016/j.joca.2019.11.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [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: 06/03/2019] [Revised: 09/30/2019] [Accepted: 11/06/2019] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To determine whether the morphology of proximal tibiofibular joint (PTFJ) is associated with increased risk of incident radiographic osteoarthritis (iROA) over 4 years in the OA Initiative (OAI) study. METHODS A nested matched case-control study design was used to select participants from OAI study. Case knees were defined as those with iROA. Control knees were matched one-to-one by sex, age and radiographic status with case knees. T2-weighted MR images were assessed at P0 (the visit when incident ROA was found on radiograph), P1 (1 year prior to P0) and at OAI baseline. The contacting area of PTFJ (S) and its projection areas onto the horizontal (load-bearing area, Sτ), sagittal (lateral stress-bolstering area, Sφ) and coronal plane (posterior stress-bolstering area, Sυ) were assessed, respectively. RESULTS 354 case knees and 354 matched control knees were included, with a mean age of 60 and a mean body mass index (BMI) of 28 kg/m2. Baseline PTFJ morphological parameters (S, Sτ and Sυ) were significantly associated with iROA over 4 years, and these associations remained unchanged after adjustment for BMI, number of knee bending activities, self-reported knee injury and surgery. S, Sτ and Sυ were also significantly associated with iROA at P1 and P0. In subgroup analysed, S, Sτ and Sυ were associated with risks of incident joint space narrowing in the medial, but not the lateral tibiofemoral compartment. CONCLUSION Greater contacting area, load-bearing area and posterior stress-bolstering area of PTFJ were associated with increased risks of iROA, largely in the medial tibiofemoral compartment.
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Affiliation(s)
- J Chang
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China; Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia; Department of Orthopaedics, 4th Affiliated Hospital, Anhui Medical University, Hefei, Anhui, China
| | - Z Zhu
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China; Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - W Han
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China; Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Y Zhao
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia; Department of Rheumatology and Immunology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - C K Kwoh
- University of Arizona Arthritis Center& Division of Rheumatology, University of Arizona College of Medicine, Tucson, AZ, USA
| | - J A Lynch
- Department of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, CA, USA
| | - D J Hunter
- Department of Rheumatology, Royal North Shore Hospital and Institute of Bone and Joint Research, Kolling Institute, University of Sydney, Australia
| | - C Ding
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China; Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.
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Roemer FW, Collins J, Kwoh CK, Hannon MJ, Neogi T, Felson DT, Hunter DJ, Lynch JA, Guermazi A. MRI-based screening for structural definition of eligibility in clinical DMOAD trials: Rapid OsteoArthritis MRI Eligibility Score (ROAMES). Osteoarthritis Cartilage 2020; 28:71-81. [PMID: 31513920 PMCID: PMC7235947 DOI: 10.1016/j.joca.2019.08.005] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [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: 04/10/2019] [Revised: 08/06/2019] [Accepted: 08/28/2019] [Indexed: 02/02/2023]
Abstract
PURPOSE Our aim was to introduce a simplified MRI instrument, Rapid OsteoArthritis MRI Eligibility Score (ROAMES), for defining structural eligibility of patients for inclusion in disease-modifying osteoarthritis drug trials using a tri-compartmental anatomic approach that enables stratification of knees into different structural phenotypes and includes diagnoses of exclusion. We also aimed to define overlap between phenotypes and determine reliability. METHODS 50 knees from the Foundation for National Institutes of Health Osteoarthritis Biomarkers study, a nested case-control study within the Osteoarthritis Initiative, were selected within pre-defined definitions of phenotypes as either inflammatory, subchondral bone, meniscus/cartilage, atrophic or hypertrophic. A focused scoring instrument was developed covering cartilage, meniscal damage, inflammation and osteophytes. Diagnoses of exclusion were meniscal root tears, osteonecrosis, subchondral insufficiency fracture, tumors, malignant marrow infiltration and acute traumatic changes. Reliability was determined using weighted kappa statistics. Descriptive statistics were used for determining concordance between the a priori phenotypic definition and ROAMES and overlap between phenotypes. RESULTS ROAMES identified 43 of 50 (86%) pre-defined phenotypes correctly. Of the 50 participants, 27 (54%) had no additional phenotypes other than the pre-defined phenotype. 18 (36%) had one and 5 (10%) had two additional phenotypes. None had three or four additional phenotypes. All features of ROAMES showed almost perfect agreement. One case with osteonecrosis and one with a tumor were detected. CONCLUSIONS ROAMES is able to screen and stratify potentially eligible knees into different structural phenotypes and record relevant diagnoses of exclusion. Reliability of the instrument showed almost perfect agreement.
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Affiliation(s)
- Frank W. Roemer
- Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine, FGH Building, 4th floor, 820 Harrison Avenue, Boston, MA 02118, USA,Department of Radiology, Friedrich-Alexander University Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany, Maximiliansplatz 3, 91054 Erlangen, Germany
| | - Jamie Collins
- Orthopaedics and Arthritis Center of Outcomes Research, Brigham and Women’s Hospital, Harvard Medical, School, 75 Francis Street, BTM Suite 5016 Boston, MA 02115 Boston, Massachusetts
| | - C. Kent Kwoh
- University of Arizona Arthritis Center & University of Arizona College of Medicine, 1501 N Campbell Ave, Tucson, AZ 85724, USA
| | - Michael J. Hannon
- Pinney Associates, 201 N Craig St # 320, Pittsburgh, PA 15213, USA & Division of Rheumatology and Clinical Immunology, University of Pittsburgh School of Medicine, S700 Biomedical Science Tower, 3500 Terrace Street, Pittsburgh, PA 15261, USA (former affiliation at time of study)
| | - Tuhina Neogi
- Boston University School of Medicine, Section of Rheumatology, 650 Albany Street, Suite X-20, Boston, MA, 02118, USA
| | - David T. Felson
- Boston University School of Medicine, Section of Rheumatology, 650 Albany Street, Suite X-20, Boston, MA, 02118, USA
| | - David J. Hunter
- Department of Rheumatology, Royal North Shore Hospital and Institute of Bone and Joint Research, Kolling Institute, University of Sydney, Pacific Hwy, St Leonards, NSW 2065, Australia
| | - John A. Lynch
- Department of Epidemiology and Biostatistics, University of California San Francisco, 550 16th St, San Francisco, CA 94158, USA
| | - Ali Guermazi
- Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine, FGH Building, 4th floor, 820 Harrison Avenue, Boston, MA 02118, USA
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Kothari MD, Rabe KG, Anderson DD, Nevitt MC, Lynch JA, Segal NA, Franz H. The Relationship of Three-Dimensional Joint Space Width on Weight Bearing CT With Pain and Physical Function. J Orthop Res 2019; 38:10.1002/jor.24566. [PMID: 31840831 PMCID: PMC8016550 DOI: 10.1002/jor.24566] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Accepted: 12/04/2019] [Indexed: 02/04/2023]
Abstract
Limitations of plain radiographs may contribute to poor sensitivity in the detection of knee osteoarthritis and poor correlation with pain and physical function. 3D joint space width, measured from weight bearing CT images, may yield a more accurate correlation with patients' symptoms. We assessed the cross-sectional association between 3D joint space width and self-reported pain and physical function. 528 knees (57% women) were analyzed from Multicenter Osteoarthritis Study participants. An upright weight bearing CT scanner was used to acquire bilateral, weight-bearing fixed-flexion images of the knees. A 3D dataset was reconstructed from cone beam projections and joint space width was calculated across the joint surface. The percentages of the apposed medial tibiofemoral joint surface with joint space width <2.0mm and <2.5mm respectively were calculated. Pain and physical function were measured using Western Ontario and McMaster Universities Osteoarthritis Index. Participants who reported greater pain severity tended to have a greater joint area with joint space width <2.0mm (p=.07 for the highest vs. the lowest tertile). Participants who reported greater functional limitations had a greater joint area with joint space width <2.0mm (p=.02 for the highest vs. the lowest tertile). There appears to be an association between the medial tibiofemoral area with joint space width <2.0mm and pain and physical function. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Mayank Dineshkumar Kothari
- The University of Kansas, Kansas City, 3901 Rainbow Boulevard, Mailstop 1046; KUMC Department of Rehabilitation Medicine, Kansas City, KS, 66160
| | - Kaitlin G Rabe
- The University of Texas at Dallas, 800 West Campbell Rd, BSB 11 Richardson, Richardson, TX, 75080
| | | | - Michael C Nevitt
- The University of California, San Francisco, San Francisco, 550 16th St, 2nd Floor, UCSF Dept of Epidemiology & Biostatistics, Mission Hall: Global Health & Clinical Sciences Building, San Francisco, CA, 94143
| | - John A Lynch
- The University of California, San Francisco, San Francisco, 550 16th St, 2nd Floor, UCSF Dept of Epidemiology & Biostatistics, Mission Hall: Global Health & Clinical Sciences Building, San Francisco, CA, 94143
| | - Neil A Segal
- The University of Kansas, Kansas City, 3901 Rainbow Boulevard, Mailstop 1046; KUMC Department of Rehabilitation Medicine, Kansas City, KS, 66160
| | - Hayden Franz
- The University of Kansas, Kansas City, 3901 Rainbow Boulevard, Mailstop 1046; KUMC Department of Rehabilitation Medicine, Kansas City, KS, 66160
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M Dunn C, Nevitt MC, Lynch JA, Jeffries MA. A pilot study of peripheral blood DNA methylation models as predictors of knee osteoarthritis radiographic progression: data from the Osteoarthritis Initiative (OAI). Sci Rep 2019; 9:16880. [PMID: 31727952 PMCID: PMC6856188 DOI: 10.1038/s41598-019-53298-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 10/30/2019] [Indexed: 12/20/2022] Open
Abstract
Knee osteoarthritis (OA) is a leading cause of chronic disability worldwide, but no diagnostic or prognostic biomarkers are available. Increasing evidence supports epigenetic dysregulation as a contributor to OA pathogenesis. In this pilot study, we investigated epigenetic patterns in peripheral blood mononuclear cells (PBMCs) as models to predict future radiographic progression in OA patients enrolled in the longitudinal Osteoarthritis Initiative (OAI) study. PBMC DNA was analyzed from baseline OAI visits in 58 future radiographic progressors (joint space narrowing at 24 months, sustained at 48 months) compared to 58 non-progressors. DNA methylation was quantified via Illumina microarrays and beta- and M-values were used to generate linear classification models. Data were randomly split into a 60% development and 40% validation subsets, models developed and tested, and cross-validated in a total of 40 cycles. M-value based models outperformed beta-value based models (ROC-AUC 0.81 ± 0.01 vs. 0.73 ± 0.02, mean ± SEM, comparison p = 0.002), with a mean classification accuracy of 73 ± 1% (mean ± SEM) for M- and 69 ± 1% for beta-based models. Adjusting for covariates did not significantly alter model performance. Our findings suggest that PBMC DNA methylation-based models may be useful as biomarkers of OA progression and warrant additional evaluation in larger patient cohorts.
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Affiliation(s)
- Christopher M Dunn
- University of Oklahoma Health Sciences Center, Department of Internal Medicine, Division of Rheumatology, Immunology, and Allergy, Oklahoma City, OK, USA.,Oklahoma Medical Research Foundation, Arthritis and Clinical Immunology Program, Oklahoma City, OK, USA
| | | | - John A Lynch
- University of California San Francisco, San Francisco, CA, USA
| | - Matlock A Jeffries
- University of Oklahoma Health Sciences Center, Department of Internal Medicine, Division of Rheumatology, Immunology, and Allergy, Oklahoma City, OK, USA. .,Oklahoma Medical Research Foundation, Arthritis and Clinical Immunology Program, Oklahoma City, OK, USA.
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Lynch JA, Birch QT, Ridgway TH, Birch ME. Quantification of Carbon Nanotubes by Raman Analysis. Ann Work Expo Health 2019; 62:604-612. [PMID: 29718067 DOI: 10.1093/annweh/wxy016] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Accepted: 04/19/2018] [Indexed: 11/12/2022] Open
Abstract
The increasing prevalence of carbon nanotubes (CNTs) in manufacturing and research environments, together with the potential exposure risks, necessitates development of reliable and accurate monitoring methods for these materials. We examined quantification of CNTs by two distinct methods based on Raman spectroscopy. First, as measured by the Raman peak intensity of aqueous CNT suspensions, and second, by Raman mapping of air filter surfaces onto which CNTs were collected as aerosols or applied as small-area (0.05 cm2) deposits. Correlation (R2 = 0.97) between CNT concentration and Raman scattering intensity for suspensions in cuvettes was found over a concentration range from about 2 to 10 µg/ml, but measurement variance precludes practical determination of a calibration curve. Raman mapping of aerosol sample filter surfaces shows correlation with CNT mass when the surface density is relatively high (R2 = 0.83 and 0.95 above about 5 µg total mass on filter), while heterogeneity of CNT deposition makes obtaining representative maps of lower density samples difficult. This difficulty can be mitigated by increasing the area mapped relative to the total sample area, improving both precision and the limit of detection (LOD). For small-area deposits, detection of low masses relevant to occupational monitoring can be achieved, with an estimated LOD of about 50 ng.
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Affiliation(s)
- John A Lynch
- Division of Applied Research and Technology, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Cincinnati, OH, USA.,Department of Chemistry, University of Cincinnati, Cincinnati, OH, USA
| | - Quinn T Birch
- Division of Applied Research and Technology, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Cincinnati, OH, USA
| | - Thomas H Ridgway
- Department of Chemistry, University of Cincinnati, Cincinnati, OH, USA
| | - M Eileen Birch
- Division of Applied Research and Technology, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Cincinnati, OH, USA
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Abstract
As genomic science has evolved, so have policy and practice debates about how to describe and evaluate the ways in which genomic information is treated for individuals, institutions, and society. The term genetic exceptionalism, describing the concept that genetic information is special or unique, and specifically different from other kinds of medical information, has been utilized widely, but often counterproductively in these debates. We offer genomic contextualism as a new term to frame the characteristics of genomic science in the debates. Using stasis theory to draw out the important connection between definitional issues and resulting policies, we argue that the framework of genomic contextualism is better suited to evaluating genomics and its policy-relevant features to arrive at more productive discussion and resolve policy debates.
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Joseph GB, Nevitt MC, McCulloch CE, Neumann J, Lynch JA, Heilmeier U, Lane NE, Link TM. Associations between molecular biomarkers and MR-based cartilage composition and knee joint morphology: data from the Osteoarthritis Initiative. Osteoarthritis Cartilage 2018; 26:1070-1077. [PMID: 29802973 PMCID: PMC6050081 DOI: 10.1016/j.joca.2018.04.019] [Citation(s) in RCA: 21] [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] [Received: 11/15/2017] [Revised: 04/10/2018] [Accepted: 04/13/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The purpose of this study was to assess the associations between serum/urine biomarkers for osteoarthritis and magnetic resonance (MR) imaging measures of cartilage composition and joint structure (cartilage, meniscus, and bone marrow), using MR imaging data from the Osteoarthritis Initiative (OAI). DESIGN 141 subjects with Kellgren Lawrence (KL) grades 0-3 in the right knee and with available serum/urine biomarker assays were selected from the OAI. Cartilage magnetic resonance imaging (MRI) T2 measurements were performed in the medial femur, lateral femur, medial tibia, lateral tibia, and patella compartments. Compartment-specific knee morphologic grading [whole-organ magnetic resonance imaging score (WORMS)] in the cartilage, meniscus, and bone marrow was also performed. We focused on associations of serum hyaluronan (sHA), serum cartilage oligomeric matrix protein (sCOMP), serum matrix metalloproteinase-3 (sMMP3), and Urine Carboxy-Terminal Telepeptides of Type II Collagen (uCtX-II)) with MRI parameters (T2, WORMS), assessed using partial correlations adjusted for age, gender, body mass index (BMI), KL grade in both knees, and diabetes status. RESULTS Higher levels of sHA, sMMP3 and sCOMP were correlated (P < 0.05) with T2 of the lateral femur (r = 0.18 to 0.32) and lateral tibia (r = 0.17 to 0.23), and with average T2 of all knee regions (r = 0.23). uCTXII was correlated with patellar T2 (r = 0.19, P = 0.04). Among the morphologic measures, sHA and sMMP3 was positively correlated (r = 0.17 to 0.21, P < 0.05) with meniscal damage. CONCLUSIONS This study suggests weak, but statistically significant, correlations between serum biomarkers of OA (sHA, sCOMP, and sMMP3) and MRI T2 measures of cartilage extra-cellular matrix degeneration.
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Affiliation(s)
- Gabby B. Joseph
- Department of Radiology and Biomedical Imaging, University of California, San Francisco
| | - Michael C. Nevitt
- Department of Epidemiology and Biostatistics, University of California, San Francisco
| | - Charles E. McCulloch
- Department of Epidemiology and Biostatistics, University of California, San Francisco
| | - Jan Neumann
- Department of Radiology and Biomedical Imaging, University of California, San Francisco
| | - John A Lynch
- Department of Epidemiology and Biostatistics, University of California, San Francisco
| | - Ursula Heilmeier
- Department of Radiology and Biomedical Imaging, University of California, San Francisco
| | - Nancy E. Lane
- Department of Rheumatology, University of California, Davis
| | - Thomas M. Link
- Department of Radiology and Biomedical Imaging, University of California, San Francisco
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Lo GH, Schneider E, Driban JB, Price LL, Hunter DJ, Eaton CB, Hochberg MC, Jackson RD, Kwoh CK, Nevitt MC, Lynch JA, McAlindon TE. Periarticular bone predicts knee osteoarthritis progression: Data from the Osteoarthritis Initiative. Semin Arthritis Rheum 2018; 48:155-161. [PMID: 29449014 DOI: 10.1016/j.semarthrit.2018.01.008] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [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: 02/01/2017] [Revised: 12/22/2017] [Accepted: 01/10/2018] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Osteoarthritis (OA) is a disease with a substantial public health burden. Quantitative assessments of periarticular bone may be a biomarker capable of monitoring early disease progression. The purpose of this study was to evaluate whether measures of periarticular bone associate with longitudinal structural progression. METHODS We conducted a 12-18 months longitudinal study using the Osteoarthritis Initiative (OAI). Participants received knee dual-energy x-ray absorptiometry (DXA), trabecular magnetic resonance (MR) imaging, and x-rays. Knee DXAs generated proximal tibial medial:lateral periarticular bone mineral density (paBMD) measures. Proximal tibial trabecular MR images were assessed for trabecular morphometry: apparent bone volume fraction (BVF), trabecular number, thickness, and spacing. Weight-bearing x-rays were assessed for medial tibiofemoral joint space narrowing (JSN). Chi-squared analyses assessed whether periarticular bone measures were predictive of worsening medial tibiofemoral JSN, adjusted for age, sex, and BMI. RESULTS In all, 444 participants, mean age 64.2 ± 9.2 years, BMI 29.5 ± 4.6kg/m2, and 52% male at baseline. Medial JSN (radiographic progression) occurred in 40 participants (9%). Higher baseline medial:lateral paBMD, apparent BVF, trabecular number and thickness, and lower baseline and decreased trabecular spacing were all associated with more progression of JSN in the medial compartment. From lowest to highest baseline medial:lateral paBMD quartile groups, 2%, 5%, 11%, and 18% had medial JSN progression, respectively, between the 36- and 48-month visits, p-values = 0.001 and 0.002 unadjusted and adjusted. The rate of change in medial:lateral paBMD, apparent BVF, and spacing were associated with more medial JSN. For rate of medial:lateral paBMD change from lowest to highest quartile, the proportion of each group that experienced medial JSN progression were 5%, 5%, 11%, and 18%, with an unadjusted and adjusted p-value of 0.005. CONCLUSION Baseline and most rates of periarticular bone change associate with knee OA structural progression, highlighting the close relationship between subchondral bone and JSN. Future studies should focus on developing these measures as predictive and pathophysiological biomarkers, and evaluating their deployment in clinical trials testing bone-targeted therapeutics.
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Affiliation(s)
- Grace H Lo
- Department of Medicine, Baylor College of Medicine, Houston, TX; Medical Care Line and Research Care Line, Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Medical Center, Houston, TX.
| | - Erika Schneider
- Imaging Institute, Cleveland Clinic Foundation, Cleveland, OH; SciTrials, LCC, Rocky River, OH
| | | | - Lori Lyn Price
- The Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA; Tufts Clinical and Translational Science Institute, Tufts University, Boston, MA
| | - David J Hunter
- Royal North Shore Hospital and Institute of Bone and Joint Research, Kolling Institute, University of Sydney, Australia
| | - Charles B Eaton
- Department of Family Medicine, Warren Alpert Medical School of Brown University, Providence, RI; Department of Epidemiology, School of Public Health of Brown University, Providence, RI
| | | | - Rebecca D Jackson
- Division of Endocrinology, Diabetes and Metabolism, Department of Internal Medicine, The Ohio State University, Columbus, OH
| | - C Kent Kwoh
- University of Pittsburgh School of Medicine, Pittsburgh, PA; University of Arizona Arthritis Center, Tucson, AZ
| | | | - John A Lynch
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA
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Joseph GB, McCulloch CE, Nevitt MC, Neumann J, Gersing AS, Kretzschmar M, Schwaiger BJ, Lynch JA, Heilmeier U, Lane NE, Link TM. Tool for osteoarthritis risk prediction (TOARP) over 8 years using baseline clinical data, X-ray, and MRI: Data from the osteoarthritis initiative. J Magn Reson Imaging 2017; 47:1517-1526. [PMID: 29143404 DOI: 10.1002/jmri.25892] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Accepted: 10/24/2017] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Osteoarthritis (OA), a multifactorial disease causing joint degeneration, often leads to severe disability. The rising rates of disability highlight the need for implementing preventative measures at early stages of the disease, which would especially benefit subjects at high risk for OA development. PURPOSE To develop a risk prediction tool for moderate-severe OA (TOARP) over 8 years based on subject characteristics, knee radiographs, and MRI data at baseline using data from the Osteoarthritis Initiative (OAI). STUDY TYPE Retrospective. SUBJECTS 641 subjects with no/mild radiographic OA (Kellgren-Lawrence [KL] 0-2) and no clinically significant symptoms (Western Ontario and McMaster Universities Arthritis Index [WOMAC] 0-1) were selected from the OAI. FIELD STRENGTH/SEQUENCE MR images were obtained using 3.0T. ASSESSMENT Compartment-specific cartilage and meniscus morphology and cartilage T2 were assessed. Baseline subject demographics, risk factors, KL score, cartilage WORMS score, presence of meniscus tear, and cartilage T2 were used to predict the development of moderate/severe OA (KL = 3-4 or WOMAC pain ≥5 or total knee replacement [TKR]) over 8 years. STATISTICAL TESTS Best subsets variable selection followed by cross-validation were used to assess which combinations of variables best predict moderate/severe OA. RESULTS Model 1 included KL score, previous knee injury in the last 12 months, age, gender, and BMI. Model 2 included all variables in Model 1 plus presence of cartilage defects in the lateral femur and patella, and presence of a meniscal tear. Model 3 included all variables in Models 1 and 2, plus cartilage T2 in the medial tibia and medial femur. Compared to Model 1 (cross-validated AUC = 0.67), Model 3 performed significantly better (AUC = 0.72, P = 0.04), while Model 2 showed a statistical trend (AUC = 0.71, P = 0.08). DATA CONCLUSION We established a risk calculator for the development of moderate/severe knee OA over 8 years that includes radiographic and MRI data. The inclusion of MRI-based morphological abnormalities and cartilage T2 significantly improved model performance. LEVEL OF EVIDENCE 2 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2018;47:1517-1526.
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Affiliation(s)
- Gabby B Joseph
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
| | - Charles E McCulloch
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
| | - Michael C Nevitt
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
| | - Jan Neumann
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
| | - Alexandra S Gersing
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
| | - Martin Kretzschmar
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
| | - Benedikt J Schwaiger
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
| | - John A Lynch
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
| | - Ursula Heilmeier
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
| | - Nancy E Lane
- Department of Rheumatology, University of California, Davis, California, USA
| | - Thomas M Link
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
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Crema MD, Felson DT, Guermazi A, Nevitt MC, Niu J, Lynch JA, Marra MD, Torner J, Lewis CE, Roemer FW. Is the atrophic phenotype of tibiofemoral osteoarthritis associated with faster progression of disease? The MOST study. Osteoarthritis Cartilage 2017; 25:1647-1653. [PMID: 28606556 PMCID: PMC5605441 DOI: 10.1016/j.joca.2017.05.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [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: 10/21/2016] [Revised: 03/31/2017] [Accepted: 05/31/2017] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To assess the associations of atrophic tibiofemoral osteoarthritis (OA) with progression of radiographic joint space narrowing (JSN) and magnetic resonance imaging (MRI)-defined progression of cartilage damage. DESIGN Participants of the Multicenter Osteoarthritis (MOST) Study with available radiographic and MRI assessments at baseline and 30 months were included. The atrophic OA phenotype was defined as Osteoarthritis Research Society International (OARSI) grades 1 or 2 for JSN and grade 0 for osteophytes. Based on MRI, atrophic OA was defined as tibiofemoral (TF) cartilage damage grades ≥3 in at least 2 of 10 subregions with absent or tiny osteophytes in all TF subregions. Progression of JSN and cartilage loss on MRI, was defined as (1) no, (2) slow, and (3) fast progression. Co-variance and logistic regression with generalized estimated equations were performed to assess the association of atrophic knee OA with any progression, compared to non-atrophic OA knees. RESULTS A total of 476 knees from 432 participants were included. There were 50 (10.5%) knees with atrophic OA using the radiographic definition, and 16 (3.4%) knees with atrophic OA using MRI definition. Non-atrophic OA knees more commonly exhibited fast progression of JSN and cartilage damage. Logistic regression showed that the atrophic phenotype of knee OA was associated with a decreased likelihood of progression of JSN and cartilage loss. CONCLUSION In this sample, the atrophic phenotype of knee OA was associated with a decreased likelihood of progression of JSN and cartilage loss compared to the non-atrophic knee OA phenotype.
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Affiliation(s)
- M D Crema
- Department of Radiology, Quantitative Imaging Center, Boston University School of Medicine, Boston, MA, USA; Department of Radiology, Saint-Antoine Hospital, University Paris VI, Paris, France.
| | - D T Felson
- Clinical Epidemiology Research and Training Unit, Boston University, Boston, MA, USA
| | - A Guermazi
- Department of Radiology, Quantitative Imaging Center, Boston University School of Medicine, Boston, MA, USA
| | - M C Nevitt
- Department of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, CA, USA
| | - J Niu
- Clinical Epidemiology Research and Training Unit, Boston University, Boston, MA, USA
| | - J A Lynch
- Department of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, CA, USA
| | - M D Marra
- Department of Radiology, Quantitative Imaging Center, Boston University School of Medicine, Boston, MA, USA; Department of Radiology, Saint-Antoine Hospital, University Paris VI, Paris, France
| | - J Torner
- University of Iowa, Iowa City, IA, USA
| | - C E Lewis
- University of Alabama, Birmingham, AL, USA
| | - F W Roemer
- Department of Radiology, Quantitative Imaging Center, Boston University School of Medicine, Boston, MA, USA; Department of Radiology, University of Erlangen, Erlangen, Germany
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Adelsperger S, Prows CA, Myers MF, Perry CL, Chandler A, Holm IA, Lynch JA. Parental Perception of Self-Empowerment in Pediatric Pharmacogenetic Testing: The Reactions of Parents to the Communication of Actual and Hypothetical CYP2D6 Test Results. Health Commun 2017; 32:1104-1111. [PMID: 27573590 PMCID: PMC5332344 DOI: 10.1080/10410236.2016.1214216] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [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] [Indexed: 05/06/2023]
Abstract
Concerns about the ethical and social implications of genetics persist as more applications of genetic and genomic technology have become available. Pediatric testing for genetic influences on response to opioids like codeine is one area of application. We interviewed parents of children enrolled in a mixed-methods study following the communication of actual or hypothetical results for CYP2D6, which impacts opioid response. Forty-one parents of children naive to opioids and 42 parents of children previously exposed to opioids participated in qualitative interviews. Findings did not differ by the child's opioid exposure or by actual versus hypothetical results. Parents' responses centered on the experience of the parent(s) and the potential impact of that information on the parent, rather than the result's impact on the child. Parents also emphasized that the results did not impact their perceptions of the child, reaffirming that the child was still "normal" regardless of test result. When asked about the impact of receiving secondary results, parents' responses emphasized how the results would impact their ability to advocate for the child or impact their state of mind. While the answers reflect parents' role as surrogate decision maker for their child, they also reinforced concerns that health care decisions might be influenced by secondary parental concerns as much as by the best interests of the child. Emphasis on the child's "normality" challenges concerns about the impact of genetic essentialism, but further research is required to see whether the type of testing done or the way results were communicated shaped this response.
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Affiliation(s)
- Sarah Adelsperger
- a College of Medicine , University of Cincinnati
- b Division of Human Genetics , Cincinnati Children's Hospital Medical Center
| | - Cynthia A Prows
- b Division of Human Genetics , Cincinnati Children's Hospital Medical Center
| | - Melanie F Myers
- a College of Medicine , University of Cincinnati
- b Division of Human Genetics , Cincinnati Children's Hospital Medical Center
| | | | - Ariel Chandler
- c Division of Genetics and Genomics , Boston Children's Hospital
| | - Ingrid A Holm
- c Division of Genetics and Genomics , Boston Children's Hospital
| | - John A Lynch
- d Department of Communication , University of Cincinnati
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Collins JE, Losina E, Nevitt MC, Roemer FW, Guermazi A, Lynch JA, Katz JN, Kent Kwoh C, Kraus VB, Hunter DJ. Semiquantitative Imaging Biomarkers of Knee Osteoarthritis Progression: Data From the Foundation for the National Institutes of Health Osteoarthritis Biomarkers Consortium. Arthritis Rheumatol 2017; 68:2422-31. [PMID: 27111771 DOI: 10.1002/art.39731] [Citation(s) in RCA: 107] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Accepted: 04/19/2016] [Indexed: 01/03/2023]
Abstract
OBJECTIVE To determine the association between changes in semiquantitative magnetic resonance imaging (MRI) biomarkers over 24 months and radiographic and pain progression over 48 months in knees with mild-to-moderate osteoarthritis (OA). METHODS We undertook a nested case-control study as part of the Foundation for the National Institutes of Health Biomarkers Consortium Project. We used multivariable logistic regression models to examine the association between change over 24 months in semiquantitative MRI markers and radiographic and pain progression in knee OA. MRIs were read according to the MRI OA Knee Score system. We focused on changes in cartilage, osteophytes, meniscus, bone marrow lesions, Hoffa-synovitis, and effusion-synovitis. RESULTS The most parsimonious model included changes in cartilage thickness and surface area, effusion-synovitis, Hoffa-synovitis, and meniscal morphology (C statistic 0.740). Compared with no worsening, worsening in cartilage thickness in ≥3 subregions was associated with 2.8-fold (95% confidence interval [95% CI] 1.3-5.9) greater odds of being a case, and worsening in cartilage surface area in ≥3 subregions was associated with 2.4-fold (95% CI 1.3-4.4) greater odds of being a case. Worsening of meniscal morphology in any region was associated with 2.2-fold (95% CI 1.3-3.8) greater odds of being a case. Worsening effusion-synovitis and Hoffa-synovitis were also associated with a greater odds of being a case (odds ratios 2.7 and 2.0, respectively). CONCLUSION Twenty-four-month changes in cartilage thickness, cartilage surface area, effusion-synovitis, Hoffa-synovitis, and meniscal morphology were independently associated with OA progression, suggesting that these factors may serve as efficacy biomarkers in clinical trials of disease-modifying interventions for knee OA.
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Affiliation(s)
- Jamie E Collins
- Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
| | - Elena Losina
- Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | | | - Frank W Roemer
- Boston University School of Medicine and Quantitative Imaging Center, Boston, Massachusetts, and University of Erlangen-Nuremberg, Erlangen, Germany
| | - Ali Guermazi
- Boston University School of Medicine and Quantitative Imaging Center, Boston, Massachusetts
| | | | - Jeffrey N Katz
- Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - C Kent Kwoh
- University of Arizona College of Medicine, Tucson
| | | | - David J Hunter
- Royal North Shore Hospital, Kolling Institute of Medical Research, and University of Sydney, New South Wales, Sydney, Australia
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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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Widjajahakim R, Roux M, Jarraya M, Roemer FW, Neogi T, Lynch JA, Lewis CE, Torner JC, Felson DT, Guermazi A, Stefanik JJ. Relationship of Trochlear Morphology and Patellofemoral Joint Alignment to Superolateral Hoffa Fat Pad Edema on MR Images in Individuals with or at Risk for Osteoarthritis of the Knee: The MOST Study. Radiology 2017; 284:806-814. [PMID: 28418810 DOI: 10.1148/radiol.2017162342] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Purpose To determine the relationship of patellofemoral joint alignment and trochlear morphology to superolateral Hoffa fat pad (SHFP) edema on magnetic resonance (MR) images in older adults with or at risk for osteoarthritis of the knee. Materials and Methods Institutional review board approval and written informed consent were obtained from all subjects. The Multicenter Osteoarthritis Study is a prospective cohort study of older adults with or at risk for osteoarthritis of the knee. Subjects were recruited from Birmingham, Alabama, and Iowa City, Iowa. In this cross-sectional study, patellofemoral joint alignment (bisect offset, patellar tilt angle, and Insall-Salvati ratio), trochlear morphology (sulcus angle, lateral and medial trochlear inclination, and trochlear angle) and SHFP edema were assessed on MR images of the knee. Measures of alignment and morphology were divided into quartiles, and SHFP was determined to be present or absent. Separate logistic regression models were used to determine the relationship of each measure of alignment and morphology to the presence of SHFP edema, with adjustments for age, sex, and body mass index. Results SHFP edema was present in 152 (13.4%) of the 1134 knees that were included. When compared with knees with measurements in the lowest quartile, knees with measurements in the highest quartile for trochlear angle, bisect offset, and Insall-Salvati ratios were 1.6 (95% confidence interval [CI]: 1.0, 2.6), 2.3 (95% CI: 1.3, 4.0), and 8.9 (95% CI: 4.7, 16.9) times more likely to show SHFP edema, respectively. No relationship was found between other measures and SHFP edema. Conclusion A more anterior trochlear facet, a more laterally displaced patella, and knees with patella alta were significantly associated with SHFP edema on MR images in subjects with or at risk for osteoarthritis of the knee. © RSNA, 2017.
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Affiliation(s)
- Rafael Widjajahakim
- From the Department of Physical Therapy, Movement, and Rehabilitation Sciences, Northeastern University, 360 Huntington Ave, 301 Robinson Hall, Boston, MA 02115 (J.J.S.); the Clinical Epidemiology Research and Training Unit (R.W., T.N., D.T.F., J.J.S.) and Quantitative Imaging Center, Department of Radiology (M.R., M.J., F.W.R., A.G.), Boston University School of Medicine, Boston, Mass; Department of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany (F.W.R.); Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, Calif (J.A.L.); Department of Preventive Medicine, University of Alabama at Birmingham, Birmingham, Ala (C.E.L.); and Department of Epidemiology, University of Iowa, Iowa City, Iowa (J.C.T.)
| | - Michael Roux
- From the Department of Physical Therapy, Movement, and Rehabilitation Sciences, Northeastern University, 360 Huntington Ave, 301 Robinson Hall, Boston, MA 02115 (J.J.S.); the Clinical Epidemiology Research and Training Unit (R.W., T.N., D.T.F., J.J.S.) and Quantitative Imaging Center, Department of Radiology (M.R., M.J., F.W.R., A.G.), Boston University School of Medicine, Boston, Mass; Department of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany (F.W.R.); Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, Calif (J.A.L.); Department of Preventive Medicine, University of Alabama at Birmingham, Birmingham, Ala (C.E.L.); and Department of Epidemiology, University of Iowa, Iowa City, Iowa (J.C.T.)
| | - Mohamed Jarraya
- From the Department of Physical Therapy, Movement, and Rehabilitation Sciences, Northeastern University, 360 Huntington Ave, 301 Robinson Hall, Boston, MA 02115 (J.J.S.); the Clinical Epidemiology Research and Training Unit (R.W., T.N., D.T.F., J.J.S.) and Quantitative Imaging Center, Department of Radiology (M.R., M.J., F.W.R., A.G.), Boston University School of Medicine, Boston, Mass; Department of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany (F.W.R.); Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, Calif (J.A.L.); Department of Preventive Medicine, University of Alabama at Birmingham, Birmingham, Ala (C.E.L.); and Department of Epidemiology, University of Iowa, Iowa City, Iowa (J.C.T.)
| | - Frank W Roemer
- From the Department of Physical Therapy, Movement, and Rehabilitation Sciences, Northeastern University, 360 Huntington Ave, 301 Robinson Hall, Boston, MA 02115 (J.J.S.); the Clinical Epidemiology Research and Training Unit (R.W., T.N., D.T.F., J.J.S.) and Quantitative Imaging Center, Department of Radiology (M.R., M.J., F.W.R., A.G.), Boston University School of Medicine, Boston, Mass; Department of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany (F.W.R.); Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, Calif (J.A.L.); Department of Preventive Medicine, University of Alabama at Birmingham, Birmingham, Ala (C.E.L.); and Department of Epidemiology, University of Iowa, Iowa City, Iowa (J.C.T.)
| | - Tuhina Neogi
- From the Department of Physical Therapy, Movement, and Rehabilitation Sciences, Northeastern University, 360 Huntington Ave, 301 Robinson Hall, Boston, MA 02115 (J.J.S.); the Clinical Epidemiology Research and Training Unit (R.W., T.N., D.T.F., J.J.S.) and Quantitative Imaging Center, Department of Radiology (M.R., M.J., F.W.R., A.G.), Boston University School of Medicine, Boston, Mass; Department of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany (F.W.R.); Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, Calif (J.A.L.); Department of Preventive Medicine, University of Alabama at Birmingham, Birmingham, Ala (C.E.L.); and Department of Epidemiology, University of Iowa, Iowa City, Iowa (J.C.T.)
| | - John A Lynch
- From the Department of Physical Therapy, Movement, and Rehabilitation Sciences, Northeastern University, 360 Huntington Ave, 301 Robinson Hall, Boston, MA 02115 (J.J.S.); the Clinical Epidemiology Research and Training Unit (R.W., T.N., D.T.F., J.J.S.) and Quantitative Imaging Center, Department of Radiology (M.R., M.J., F.W.R., A.G.), Boston University School of Medicine, Boston, Mass; Department of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany (F.W.R.); Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, Calif (J.A.L.); Department of Preventive Medicine, University of Alabama at Birmingham, Birmingham, Ala (C.E.L.); and Department of Epidemiology, University of Iowa, Iowa City, Iowa (J.C.T.)
| | - Cora E Lewis
- From the Department of Physical Therapy, Movement, and Rehabilitation Sciences, Northeastern University, 360 Huntington Ave, 301 Robinson Hall, Boston, MA 02115 (J.J.S.); the Clinical Epidemiology Research and Training Unit (R.W., T.N., D.T.F., J.J.S.) and Quantitative Imaging Center, Department of Radiology (M.R., M.J., F.W.R., A.G.), Boston University School of Medicine, Boston, Mass; Department of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany (F.W.R.); Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, Calif (J.A.L.); Department of Preventive Medicine, University of Alabama at Birmingham, Birmingham, Ala (C.E.L.); and Department of Epidemiology, University of Iowa, Iowa City, Iowa (J.C.T.)
| | - James C Torner
- From the Department of Physical Therapy, Movement, and Rehabilitation Sciences, Northeastern University, 360 Huntington Ave, 301 Robinson Hall, Boston, MA 02115 (J.J.S.); the Clinical Epidemiology Research and Training Unit (R.W., T.N., D.T.F., J.J.S.) and Quantitative Imaging Center, Department of Radiology (M.R., M.J., F.W.R., A.G.), Boston University School of Medicine, Boston, Mass; Department of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany (F.W.R.); Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, Calif (J.A.L.); Department of Preventive Medicine, University of Alabama at Birmingham, Birmingham, Ala (C.E.L.); and Department of Epidemiology, University of Iowa, Iowa City, Iowa (J.C.T.)
| | - David T Felson
- From the Department of Physical Therapy, Movement, and Rehabilitation Sciences, Northeastern University, 360 Huntington Ave, 301 Robinson Hall, Boston, MA 02115 (J.J.S.); the Clinical Epidemiology Research and Training Unit (R.W., T.N., D.T.F., J.J.S.) and Quantitative Imaging Center, Department of Radiology (M.R., M.J., F.W.R., A.G.), Boston University School of Medicine, Boston, Mass; Department of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany (F.W.R.); Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, Calif (J.A.L.); Department of Preventive Medicine, University of Alabama at Birmingham, Birmingham, Ala (C.E.L.); and Department of Epidemiology, University of Iowa, Iowa City, Iowa (J.C.T.)
| | - Ali Guermazi
- From the Department of Physical Therapy, Movement, and Rehabilitation Sciences, Northeastern University, 360 Huntington Ave, 301 Robinson Hall, Boston, MA 02115 (J.J.S.); the Clinical Epidemiology Research and Training Unit (R.W., T.N., D.T.F., J.J.S.) and Quantitative Imaging Center, Department of Radiology (M.R., M.J., F.W.R., A.G.), Boston University School of Medicine, Boston, Mass; Department of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany (F.W.R.); Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, Calif (J.A.L.); Department of Preventive Medicine, University of Alabama at Birmingham, Birmingham, Ala (C.E.L.); and Department of Epidemiology, University of Iowa, Iowa City, Iowa (J.C.T.)
| | - Joshua J Stefanik
- From the Department of Physical Therapy, Movement, and Rehabilitation Sciences, Northeastern University, 360 Huntington Ave, 301 Robinson Hall, Boston, MA 02115 (J.J.S.); the Clinical Epidemiology Research and Training Unit (R.W., T.N., D.T.F., J.J.S.) and Quantitative Imaging Center, Department of Radiology (M.R., M.J., F.W.R., A.G.), Boston University School of Medicine, Boston, Mass; Department of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany (F.W.R.); Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, Calif (J.A.L.); Department of Preventive Medicine, University of Alabama at Birmingham, Birmingham, Ala (C.E.L.); and Department of Epidemiology, University of Iowa, Iowa City, Iowa (J.C.T.)
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Wise BL, Niu J, Guermazi A, Liu F, Heilmeier U, Ku E, Lynch JA, Zhang Y, Felson DT, Kwoh CK, Lane NE. Magnetic resonance imaging lesions are more severe and cartilage T2 relaxation time measurements are higher in isolated lateral compartment radiographic knee osteoarthritis than in isolated medial compartment disease - data from the Osteoarthritis Initiative. Osteoarthritis Cartilage 2017; 25:85-93. [PMID: 27539891 PMCID: PMC5182174 DOI: 10.1016/j.joca.2016.08.002] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Revised: 07/02/2016] [Accepted: 08/09/2016] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Isolated lateral compartment tibiofemoral radiographic osteoarthritis (IL-ROA) is an understudied form of knee osteoarthritis (OA). The objective of the present study was to characterize Magnetic Resonance Imaging (MRI) abnormalities and MR-T2 relaxation time measurements associated with IL-ROA and with isolated medial compartment ROA (IM-ROA) compared with knees without OA. METHOD 200 case subjects with IL-ROA (Kellgren/Lawrence (K/L) grade≥2 and joint space narrowing (JSN) > 0 in the lateral compartment but JSN = 0 in the medial compartment) were randomly selected from the Osteoarthritis Initiative baseline visit. 200 cases with IM-ROA and 200 controls were frequency matched to the IL-ROA cases. Cases and controls were analyzed for odds of having a subregion with >10% cartilage area affected, with ≥25% bone marrow lesions (BML), with meniscal tear or maceration, and for association with cartilage T2 values. RESULTS IL-ROA was more strongly associated with ipsilateral MRI knee pathologies than IM-ROA (IL-ROA: OR = 135.2 for size of cartilage lesion, 95% CI 42.7-427.4; OR = 145.4 for large size BML, 95% CI 41.5-509.5; OR = 176 for meniscal tears, 95% CI 59.8-517.7; IM-ROA: OR = 28.4 for size of cartilage lesion, 95% CI 14.7-54.7; OR = 38.1 for size of BML, 95% CI 12.7-114; OR = 37.0 for meniscal tears, 95% CI 12-113.6). Cartilage T2 values were higher in both tibial and medial femoral compartments in IL-ROA, but in IM-ROA were only significantly different from controls in the medial femur. CONCLUSION IL-ROA knees show a greater prevalence and severity of MRI lesions and higher cartilage T2 values than IM-ROA knees compared with controls.
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Affiliation(s)
- Barton L. Wise
- Center for Musculoskeletal Health, University of California, Davis School of
Medicine, 4625 2 Avenue, Suite 2002, Sacramento, CA 95817
| | - Jingbo Niu
- Boston University School of Medicine, Boston, MA
| | - Ali Guermazi
- Boston University School of Medicine, Boston, MA
| | - Felix Liu
- University of California, San Francisco School of Medicine
| | | | - Eric Ku
- University of California, San Francisco School of Medicine
| | - John A. Lynch
- University of California, San Francisco School of Medicine
| | - Yuqing Zhang
- Boston University School of Medicine, Boston, MA
| | | | - C. Kent Kwoh
- University of Arizona College of Medicine, Tuscon, AZ
| | - Nancy E. Lane
- University of California, Davis School of Medicine, Sacramento, CA
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Roemer FW, Guermazi A, Collins JE, Losina E, Nevitt MC, Lynch JA, Katz JN, Kwoh CK, Kraus VB, Hunter DJ. Semi-quantitative MRI biomarkers of knee osteoarthritis progression in the FNIH biomarkers consortium cohort - Methodologic aspects and definition of change. BMC Musculoskelet Disord 2016; 17:466. [PMID: 27832771 PMCID: PMC5105263 DOI: 10.1186/s12891-016-1310-6] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Accepted: 10/26/2016] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND To describe the scoring methodology and MRI assessments used to evaluate the cross-sectional features observed in cases and controls, to define change over time for different MRI features, and to report the extent of changes over a 24-month period in the Foundation for National Institutes of Health Osteoarthritis Biomarkers Consortium study nested within the larger Osteoarthritis Initiative (OAI) Study. METHODS We conducted a nested case-control study. Cases (n = 406) were knees having both radiographic and pain progression. Controls (n = 194) were knee osteoarthritis subjects who did not meet the case definition. Groups were matched for Kellgren-Lawrence grade and body mass index. MRIs were acquired using 3 T MRI systems and assessed using the semi-quantitative MOAKS system. MRIs were read at baseline and 24 months for cartilage damage, bone marrow lesions (BML), osteophytes, meniscal damage and extrusion, and Hoffa- and effusion-synovitis. We provide the definition and distribution of change in these biomarkers over time. RESULTS Seventy-three percent of the cases had subregions with BML worsening (vs. 66 % in controls) (p = 0.102). Little change in osteophytes was seen over 24 months. Twenty-eight percent of cases and 10 % of controls had worsening in meniscal scores in at least one subregion (p < 0.001). Seventy-three percent of cases and 53 % of controls had at least one area with worsening in cartilage surface area (p < 0.001). More cases experienced worsening in Hoffa- and effusion synovitis than controls (17 % vs. 6 % (p < 0.001); 41 % vs. 18 % (p < 0.001), respectively). CONCLUSIONS A wide range of MRI-detected structural pathologies was present in the FNIH cohort. More severe changes, especially for BMLs, cartilage and meniscal damage, were detected primarily among the case group suggesting that early changes in multiple structural domains are associated with radiographic worsening and symptomatic progression.
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Affiliation(s)
- Frank W Roemer
- Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine, FGH Building, 3rd floor, 820 Harrison Avenue, Boston, MA, 02118, USA. .,Department of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany.
| | - Ali Guermazi
- Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine, FGH Building, 3rd floor, 820 Harrison Avenue, Boston, MA, 02118, USA
| | - Jamie E Collins
- Orthopaedic and Arthritis Center for Outcomes Research, Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Elena Losina
- Orthopaedic and Arthritis Center for Outcomes Research, Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Michael C Nevitt
- Department of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, CA, USA
| | - John A Lynch
- Department of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, CA, USA
| | - Jeffrey N Katz
- Orthopaedic and Arthritis Center for Outcomes Research, Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - C Kent Kwoh
- University of Arizona Arthritis Center & Division of Rheumatology, University of Arizona College of Medicine, Tucson, AZ, USA
| | - Virginia B Kraus
- Duke Molecular Physiology Institute and Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | - David J Hunter
- Department of Rheumatology, Royal North Shore Hospital and Institute of Bone and Joint Research, Kolling Institute, University of Sydney, St Leonards, NSW, Australia
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Gersing AS, Schwaiger BJ, Heilmeier U, Joseph GB, Facchetti L, Kretzschmar M, Lynch JA, McCulloch CE, Nevitt MC, Steinbach LS, Link TM. Evaluation of Chondrocalcinosis and Associated Knee Joint Degeneration Using MR Imaging: Data from the Osteoarthritis Initiative. Eur Radiol 2016; 27:2497-2506. [PMID: 27704199 DOI: 10.1007/s00330-016-4608-8] [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] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Revised: 09/07/2016] [Accepted: 09/13/2016] [Indexed: 12/11/2022]
Abstract
OBJECTIVES To evaluate the ability of different MRI sequences to detect chondrocalcinosis within knee cartilage and menisci, and to analyze the association with joint degeneration. METHODS Subjects with radiographic knee chondrocalcinosis (n = 90, age 67.7 ± 7.3 years, 50 women) were selected from the Osteoarthritis Initiative and matched to controls without radiographic chondrocalcinosis (n = 90). Visualization of calcium-containing crystals (CaC) was compared between 3D T1-weighted gradient-echo (T1GE), 3D dual echo steady-state (DESS), 2D intermediate-weighted (IW), and proton density (PD)-weighted fast spin-echo (FSE) sequences obtained with 3T MRI and correlated with a semiquantitative CaC score obtained from radiographs. Structural abnormalities were assessed using Whole-Organ MRI Score (WORMS) and logistic regression models were used to compare cartilage compartments with and without CaC. RESULTS Correlations between CaC counts of MRI sequences and degree of radiographic calcifications were highest for GE (rT1GE = 0.73, P < 0.001; rDESS = 0.68, P < 0.001) compared to other sequences (P > 0.05). Meniscus WORMS was significantly higher in subjects with chondrocalcinosis compared to controls (P = 0.005). Cartilage defects were significantly more frequent in compartments with CaC than without (patella: P = 0.006; lateral tibia: P < 0.001; lateral femur condyle: P = 0.017). CONCLUSIONS Gradient-echo sequences were most useful for the detection of chondrocalcinosis and presence of CaC was associated with higher prevalence of cartilage and meniscal damage. KEY POINTS • Magnetic resonance imaging is useful for assessing burden of calcium-containing crystals (CaC). • Gradient-echo sequences are superior to fast spin echo sequences for CaC imaging. • Presence of CaC is associated with meniscus and cartilage degradation.
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Affiliation(s)
- Alexandra S Gersing
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, 185 Berry St, Suite 350, San Francisco, CA, 94107, USA.
| | - Benedikt J Schwaiger
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, 185 Berry St, Suite 350, San Francisco, CA, 94107, USA
| | - Ursula Heilmeier
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, 185 Berry St, Suite 350, San Francisco, CA, 94107, USA
| | - Gabby B Joseph
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, 185 Berry St, Suite 350, San Francisco, CA, 94107, USA
| | - Luca Facchetti
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, 185 Berry St, Suite 350, San Francisco, CA, 94107, USA
| | - Martin Kretzschmar
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, 185 Berry St, Suite 350, San Francisco, CA, 94107, USA
| | - John A Lynch
- Department of Epidemiology and Biostatistics, University of California, San Francisco, 550 16th Street, 2nd Floor, San Francisco, CA, 94158, USA
| | - Charles E McCulloch
- Department of Epidemiology and Biostatistics, University of California, San Francisco, 550 16th Street, 2nd Floor, San Francisco, CA, 94158, USA
| | - Michael C Nevitt
- Department of Epidemiology and Biostatistics, University of California, San Francisco, 550 16th Street, 2nd Floor, San Francisco, CA, 94158, USA
| | - Lynne S Steinbach
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, 185 Berry St, Suite 350, San Francisco, CA, 94107, USA
| | - Thomas M Link
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, 185 Berry St, Suite 350, San Francisco, CA, 94107, USA
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Podsiadlo P, Nevitt MC, Wolski M, Stachowiak GW, Lynch JA, Tolstykh I, Felson DT, Segal NA, Lewis CE, Englund M. Baseline trabecular bone and its relation to incident radiographic knee osteoarthritis and increase in joint space narrowing score: directional fractal signature analysis in the MOST study. Osteoarthritis Cartilage 2016; 24:1736-1744. [PMID: 27163445 PMCID: PMC5482364 DOI: 10.1016/j.joca.2016.05.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [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: 06/17/2015] [Revised: 04/01/2016] [Accepted: 05/02/2016] [Indexed: 02/02/2023]
Abstract
PURPOSE To explore the association of baseline trabecular bone structure with incident tibiofemoral (TF) osteoarthritis (OA) and with increase in joint space narrowing (JSN) score. METHODS The Multicenter Osteoarthritis Study (MOST) includes subjects with or at risk for knee OA. Knee radiographs were scored for Kellgren-Lawrence (KL) grade and JSN at baseline, 30, 60 and 84 months. Knees (KL ≤ 1) at baseline were assessed for incident OA (KL ≥ 2) and increases in JSN score. For each knee image at baseline, a variance orientation transform method (VOT) was applied to subchondral tibial bone regions of medial and lateral compartments. Seventeen fractal parameters were calculated per region. Associations of each parameter with OA incidence and with medial and lateral JSN increases were explored using logistic regression. Analyses were stratified by digitized film (DF) vs computer radiography (CR) and adjusted for confounders. RESULTS Of 894 knees with CR and 1158 knees with DF, 195 (22%) and 303 (26%) developed incident OA. Higher medial bone roughness was associated with increased odds of OA incidence at 60 and 84 months and also, medial and lateral JSN increases (primarily vertical). Lower medial and lateral anisotropy was associated with increased odds of medial and lateral JSN increase. Compared to DF, CR had more associations and also, similar results at overlapping scales. CONCLUSION Baseline trabecular bone texture was associated with incident radiographic OA and increase of JSN scores independently of risk factors for knee OA. Higher roughness and lower anisotropy were associated with increased odds for radiographic OA change.
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Affiliation(s)
| | - M C Nevitt
- University of California San Francisco, San Francisco, CA, USA
| | - M Wolski
- Curtin University, Bentley, Australia
| | | | - J A Lynch
- University of California San Francisco, San Francisco, CA, USA
| | - I Tolstykh
- University of California San Francisco, San Francisco, CA, USA
| | - D T Felson
- Boston University School of Medicine, Boston, MA, USA
| | - N A Segal
- University of Iowa, Iowa City, IA, USA
| | - C E Lewis
- University of Alabama, Birmingham, AL, USA
| | - M Englund
- Boston University School of Medicine, Boston, MA, USA; Clinical Sciences Lund, Lund University, Lund, Sweden
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Mohr A, Heiss C, Bergmann I, Schrader C, Roemer FW, Lynch JA, Muhle C, Genant HK, Heller M. Value of micro-CT as an investigative tool for osteochondritis dissecans: A preliminary study with comparison to histology. Acta Radiol 2016; 44:532-7. [PMID: 14510761 DOI: 10.1080/j.1600-0455.2003.00113.x] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Purpose: To evaluate micro computed tomography (micro-CT) for the assessment of osteochondritis dissecans in comparison with histology. Material and Methods: Osteochondritis dissecans lesions of 3 patients were evaluated using micro-CT (0.125 mA, 40 keV, 60 μm slice thickness, 60 μm isotropic resolution, entire sample) and light microscopy (toluidine blue, 3–5 μm slice thickness). The methods were compared regarding preparation time, detectability of tissue types and morphologic features of bone and cartilage. Results: Non-destructive micro-CT imaging of the entire sample was faster than histologic preparation of a single slice for light microscopy. Morphologic features of bone and cartilage could be imaged in a comparable way to histology. It was not possible to image cells or different tissue types of bone and cartilage with micro-CT. Conclusion: Micro-CT is a fast, non-destructive tool that may be a supplement or, if detailed histologic information is not necessary, an alternative to light microscopy for the investigation of osteochondritis dissecans.
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Affiliation(s)
- A Mohr
- Department of Diagnostic Radiology, Christian-Albrechts-University, Kiel, Germany.
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Kretzschmar M, Lin W, Nardo L, Joseph GB, Dunlop DD, Heilmeier U, Nevitt MC, Alizai H, McCulloch CE, Lynch JA, Link TM. Association of Physical Activity Measured by Accelerometer, Knee Joint Abnormalities, and Cartilage T2 Measurements Obtained From 3T Magnetic Resonance Imaging: Data From the Osteoarthritis Initiative. Arthritis Care Res (Hoboken) 2016; 67:1272-1280. [PMID: 25777255 DOI: 10.1002/acr.22586] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2014] [Revised: 02/10/2015] [Accepted: 03/10/2015] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To study the cross-sectional association between physical activity measured with an accelerometer, structural knee abnormalities, and cartilage T2 values assessed with 3T magnetic resonance imaging (MRI). METHODS We included 274 subjects from the Osteoarthritis Initiative cohort without definite radiographic osteoarthritis (Kellgren/Lawrence grades 0 and 1) and with at most mild pain, stiffness, and functional limitation in the study knee (Western Ontario and McMaster Universities Osteoarthritis Index scale 0-1), which had not limited their activity due to knee pain. Physical activity was measured over 7 days with an ActiGraph GT1M accelerometer. Subjects were categorized by quartile of physical activity based on the average daily minutes of moderate to vigorous physical activity (mv-PA). MRI images of the right knee (at 48-month visit) were assessed for structural abnormalities using a modified Whole-Organ Magnetic Resonance Imaging Score (WORMS) and for T2 relaxation times derived from segmented cartilage of 4 femorotibial regions and the patella. WORMS grades and T2 measurements were compared between activity quartiles using a linear regression model. Covariates included age, sex, body mass index, knee injury, family history of knee replacement, knee symptoms, hip and ankle pain, and daily wear time of the accelerometer. RESULTS Higher mv-PA was associated with increased severity (P = 0.0087) and number of lesions of the medial meniscus (P = 0.0089) and with severity of bone marrow edema lesions (P = 0.0053). No association between cartilage lesions and mv-PA was found. T2 values of cartilage (loss, damage, and abnormalities) tended to be greater in the higher quartiles of mv-PA, but the differences were nonsignificant. CONCLUSION In knees without radiographic osteoarthritis in subjects with no or mild knee pain, higher physical activity levels were associated with increases in meniscal and bone marrow edema pattern lesions.
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Affiliation(s)
| | - W Lin
- University of California, San Francisco
| | - L Nardo
- University of California, San Francisco
| | | | - D D Dunlop
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | | | | | - H Alizai
- University of California, San Francisco
| | | | - J A Lynch
- University of California, San Francisco
| | - T M Link
- University of California, San Francisco
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