Individual Radiographic Features Research Articles

Investigation of the association of long-term NSAID use with radiographic hip osteoarthritis over four to five years: Data from the OAI and CHECK studies

ObjectiveTo examine the relationship between long-term use of non-steroidal anti-inflammatory drugs (NSAIDs) and the incidence and progression of radiographic hip osteoarthritis (RHOA), as well as the degeneration of individual radiographic features. MethodsWe analyzed data from the Osteoarthritis Initiative (OAI) and the Cohort Hip and Cohort Knee (CHECK) study. Our exposure was the number of years of NSAID use over a 4-to-5-year follow-up period. Our outcomes were the incidence and progression of RHOA over a 4-to-5-year follow-up as assessed using a modified Croft grade in OAI and the Kellgren-Lawrence (K/L) grade in CHECK. The incidence of RHOA was defined as having RHOA (grade ≥2) at follow-up and investigated in “incidence cohorts” of hips without RHOA at baseline (grade <2). The progression of RHOA was defined as an increase of ≥1 grade at follow-up from baseline and investigated in “progression cohorts” of hips with RHOA at baseline (grade ≥2). Additionally, we assessed the degeneration of nine specific radiographic features, such as joint space narrowing and osteophytes, defined by a grade increase of ≥1 ​at follow-up from baseline, in all cohorts. ResultsIn the incidence cohorts, there were 5153 hips in OAI and 1011 in CHECK; in the progression cohorts, there were 285 and 106 hips, respectively. There was no association between NSAID use and the outcomes investigated. ConclusionOver 4-to-5 years, long-term NSAID use showed no association with the incidence or progression of RHOA, or with the degeneration of individual radiographic features.

Poor Accuracy of Manually Derived Head Computed Tomography Parameters in Predicting Intracranial Hypertension After Nontraumatic Intracranial Hemorrhage.

The utility of head computed tomography (CT) in predicting elevated intracranial pressure (ICP) is known to be limited in traumatic brain injury; however, few data exist in patients with spontaneous intracranial hemorrhage. We conducted a retrospective review of prospectively collected data in patients with nontraumatic intracranial hemorrhage (subarachnoid hemorrhage [SAH] or intraparenchymal hemorrhage [IPH]) who underwent external ventricular drain (EVD) placement. Head CT scans performed immediately prior to EVD placement were quantitatively reviewed for features suggestive of elevated ICP, including temporal horn diameter, bicaudate index, basal cistern effacement, midline shift, and global cerebral edema. The modified Fisher score (mFS), intraventricular hemorrhage score, and IPH volume were also measured, as applicable. We calculated the accuracy, positive predictive value (PPV), and negative predictive value (NPV) of these radiographic features for the coprimary outcomes of elevated ICP (> 20mm Hg) at the time of EVD placement and at any time during the hospital stay. Multivariable backward stepwise logistic regression analysis was performed to identify significant radiographic factors associated with elevated ICP. Of 608 patients with intracranial hemorrhages enrolled during the study time frame, 243 (40%) received an EVD and 165 (n = 107 SAH, n = 58 IPH) had a preplacement head CT scan available for rating. Elevated opening pressure and elevated ICP during hospitalization were recorded in 48 of 152 (29%) and 103 of 165 (62%), respectively. The presence of ≥ 1 radiographic feature had only 32% accuracy for identifying elevated opening pressure (PPV 30%, NPV 58%, area under the curve [AUC] 0.537, 95% asymptotic confidence interval [CI] 0.436-0.637, P = 0.466) and 59% accuracy for predicting elevated ICP during hospitalization (PPV 63%, NPV 40%, AUC 0.514, 95% asymptotic CI 0.391-0.638, P = 0.820). There was no significant association between the number of radiographic features and ICP elevation. Head CT scans without any features suggestive of elevated ICP occurred in 25 of 165 (15%) patients. However, 10 of 25 (40%) of these patients had elevated opening pressure, and 15 of 25 (60%) had elevated ICP during their hospital stay. In multivariable models, mFS (adjusted odds ratio [aOR] 1.36, 95% CI 1.10-1.68) and global cerebral edema (aOR 2.93, 95% CI 1.27-6.75) were significantly associated with elevated ICP; however, their accuracies were only 69% and 60%, respectively. All other individual radiographic features had accuracies between 38 and 58% for identifying intracranial hypertension. More than 50% of patients with spontaneous intracranial hemorrhage without radiographic features suggestive of elevated ICP actually had ICP > 20mm Hg during EVD placement or their hospital stay. Morphological head CT findings were only 32% and 59% accurate in identifying elevated opening pressure and ICP elevation during hospitalization, respectively.

Do associations with hand OA vary by knee osteoarthritis phenotype? Cross-sectional data from the Multicenter Osteoarthritis Study

ObjectiveOsteoarthritis (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. DesignWe 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. ResultsWe 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. ConclusionsAge-adjusted associations between hand and knee OA were modest and were largely similar across knee OA phenotypes.

PREDICTION OF OSTEOPHYTE PROGESSION FROM CLINICAL DATA AND MRI-BASED 3D KNEE MORPHOLOGY

Osteophytes (OSTs) are one of the most prominent radiographical features of knee OA progression. They are strongly associated with presence of pain and often with other symptoms. However, clinical picture of OSTs in OA and their pathophysiology are not well understood. Prior research on predicting OA progression, particularly from the imaging data, has considered TKR, change in KLG, or JSN as the surrogate outcomes. Thus, the feasibility of using individual radiographic features, such as OSTs, as a potential surrogate endpoint has not been investigated. 1) To investigate the predictive power of the commonly available demographic and radiographic variables in prediction of osteophyte progression over 4 years. 2) To develop an MRI-based (3D tissue morphology) end-to-end model for the same task and evaluate its performance and added value. We used the data from the baseline of the OAI. Progression criterion was based on radiographic OARSI grade for OSTs [0-3]. Knees with an increase in OARSI grade in any compartment at the 4-year follow-up were set as progressors – the rest – as non-progressors. We excluded the knees with OARSI grade 3 in all regions, the non-progressors that dropped out before the last visit, and the samples with missing data. Final sample had 4600 knees (2476 subjects), with 2218 progressed and 2382 non-progressed knees. The baseline models were based on Logistic Regression and the following variables: age, sex, BMI, KLG, and OARSI OST grades. The latter were available for FL, FM, TL, and TM. For MRI-based model, we used the validated automatic segmentations by Tack et al. 2021 (Zuse Institute, Berlin, Germany) derived from 3D DESS MRI. The data included the masks for femur, tibia, corresponding cartilage tissues, and menisci. The ROIs were cropped from the images and resampled to resolution of 95x192x140 (pixel spacing 1.1x0.73x0.73mm^3). The model was based on 3D ResNet-10 CNN and trained in two experiments – from bone masks only, and from all the listed tissues. Eventually, the MRI models were also fused with the baseline ones. Here, the predicted probabilities of the MRI model were used as an additional variable for the baseline model. To develop the predictive models, we used 5-fold cross-validation. For model evaluation, we used a hold-out set of 920 knees (443 progressors and 477 non-progressors). Performance of the models were assessed using area under the ROC curve (AUC), and average precision (AP). Over 4 years, OARSI OST grade changes of (1, 2, and 3) were observed, for (20.22, 2.85, 0.37) percent of knees in TM, (12.54, 2.13, 0.24) in TL, (12.82, 1.48, 0.30) in FL, and (17.28, 3.56, 0.76) in FM, respectively. The age, sex, BMI model yielded AUC=0.60[0.56-0.63], AP=0.56[0.51-0.61]. Adding KLG resulted in similar performance as with added OARSI OST grade. The baseline model with both grades was the best -AUC=0.68[0.65-0.71] and AP=0.67[0.62-0.71]. The MRI (CNN) models showed AUC=0.55[0.51-0.58], AP=0.53[0.48-0.57] (bones-only) and AUC=0.58[0.54-0.61], AP=0.55[0.50-0.60] (all tissues). Fusion of the best baseline and MRI models did not further improve the performance. The model based on the clinical data including KLG and OARSI OST grade showed the highest performance in predicting OST progression in 4 years. The imaging biomarkers, automatically extracted from 3D bone, cartilage, and menisci morphology, showed only limited predictive power and did not improve the final performance. Interestingly, the imaging model including cartilage- and menisci-based biomarkers showed higher metrics than bone-only, which may suggest contribution of soft tissue morphology to the progression of OSTs. Supported by the Academy of Finland (334771 & 334773), under the frame of ERA PerMed. Alexander Tack and ZIB for providing the data. CORRESPONDENCE ADDRESS: mitra.daneshmand@oulu.fi

Knee osteoarthritis development five years following arthroscopic partial meniscectomy or exercise therapy for degenerative meniscal tears: the odense-oslo meniscectomy versus exercise trial

Purpose: Degenerative meniscal tears per se and partial meniscectomy are strong risk factors for knee osteoarthritis (OA) development. Several randomized controlled trials have found that partial meniscectomy provides no clinically relevant benefit compared to exercise therapy for degenerative meniscal tears. However, long-term follow-up studies of randomized controlled trials are lacking. Hence, the aim of this five-year follow-up of the Odense-Oslo Meniscectomy versus Exercise (OMEX) trial was to compare progression of individual radiographic features of the knee, incident radiographic knee OA and changes in patient-reported outcome measures following partial meniscectomy or exercise therapy for degenerative meniscal tears.

Development of osteoarthritis in patients with degenerative meniscal tears treated with exercise therapy or surgery: a randomized controlled trial

To evaluate progression of individual radiographic features 5years following exercise therapy or arthroscopic partial meniscectomy as treatment for degenerative meniscal tear. Randomized controlled trial including 140 adults, aged 35-60 years, with a magnetic resonance image verified degenerative meniscal tear, and 96% without definite radiographic knee osteoarthritis. Participants were randomized to either 12-weeks of supervised exercise therapy or arthroscopic partial meniscectomy. The primary outcome was between-group difference in progression of tibiofemoral joint space narrowing and marginal osteophytes at 5years, assessed semi-quantitatively by the OARSI atlas. Secondary outcomes included incidence of radiographic knee osteoarthritis and symptomatic knee osteoarthritis, medial tibiofemoral fixed joint space width (quantitatively assessed), and patient-reported outcome measures. Statistical analyses were performed using a full analysis set. Per protocol and as treated analysis were also performed. The risk ratios (95% CI) for progression of semi-quantitatively assessed joint space narrowing and medial and lateral osteophytes for the surgery group were 0.89 (0.55-1.44), 1.15 (0.79-1.68) and 0.77 (0.42-1.42), respectively, compared to the exercise therapy group. In secondary outcomes (full-set analysis) no statistically significant between-group differences were found. The study was inconclusive with respect to potential differences in progression of individual radiographic features after surgical and non-surgical treatment for degenerative meniscal tear. Further, we found no strong evidence in support of differences in development of incident radiographic knee osteoarthritis or patient-reported outcomes between exercise therapy and arthroscopic partial meniscectomy. www.clinicaltrials.gov (NCT01002794).

The relationship between radiographic findings and patient-reported outcomes in adult hip dysplasia patients: A hospital cross-sectional study

IntroductionThis study aimed to clarify the relationship of individual radiographic parameters and features with the patient-reported outcome measurements (PROMs) of patients with developmental dysplasia of the hip (DDH) in a hospital-referred cross-sectional analysis. MethodsThis cross-sectional study included 108 Japanese DDH patients (female, n = 88; male, n = 20; mean age, 43.4 years). We recorded the CE angle, angle of Sharp, ARO, ADR, AHI, crossover sign, pistol grip deformity, and femoral head-neck ratio, which were measured on the AP view, and the α-angle, which was measured on the Lauenstein view. We also recorded cyst formation and osteophytes on either view. We used the Japanese Orthopaedic Association hip disease evaluation questionnaire (JHEQ) to assess the PROMs. The PROMs of patients with and without cysts or osteophytes and those of patients with or without cam or pincer deformity were compared. The relationships between specific PROMs and radiographic features were evaluated with a linear regression analysis and independent associations between PROMs and radiographic features were assessed with a multiple regression analysis using various independent variables. ResultsThe JHEQ movement and mental values in patients with cyst formation were significantly lower in comparison to those in patients without cyst formation. The JHEQ subscale values did not differ according to the presence or absence of osteophytes, cam deformity or pincer deformity. The CE angle was found to be associated with the JHEQ movement score in the linear regression analysis. To identify radiographic features that were independently associated with each of the JHEQ subscale scores, we performed a multiple regression analysis with age, body mass index, sex and the number of affected hip joints (bilateral or unilateral) included as independent variables. The CE angle was found to be independently associated with JHEQ movement. ConclusionThe CE angle was independently associated with the JHEQ movement value.

Associations between the chemokine biomarker CCL2 and knee osteoarthritis outcomes: the Johnston County Osteoarthritis Project

Our study analyzes the association between chemokine-ligand-2 (CCL2) serum concentrations at baseline and knee radiographic osteoarthritis (OA) (knee-rOA), knee-rOA progression, individual radiographic features and knee symptomatic OA at 5-year follow-up. OA outcomes were analyzed in a community-based cohort including a baseline enrollment and a 5-year follow-up. Baseline CCL2 serum concentrations were assessed by multiplex assay and associated with presence or progression of individual radiographic features at 5-year follow-up. Separate multiple logistic regression models were used to examine adjusted associations between baseline CCL2 and each of the knee OA variables at follow-up. CCL2 at baseline was modeled as an explanatory variable, whereas each of the knee OA variables at follow-up served as the response variables. Models were adjusted for age, BMI, race, and sex. Trend tests were conducted to assess any linear effect on outcomes across CCL2 tertiles. Participants (n=168) had a median age of 57-years and median BMI of 29kg/m2. About 63% of all participants were women, and 58% Caucasian (42% African American). In adjusted logistic models, continuous log-CCL2 was significantly associated with knee-rOA. For each unit increase in log CCL2, the odds of having knee-rOA at follow-up was increased by 72%. CCL2 tertiles showed significant linear associations with presence and progression of knee-rOA and medial joint space narrowing (JSN), but not with presence or progression of osteophytes, bone sclerosis, knee symptoms, or symptomatic knee-rOA. Serum CCL2 may help to elucidate some mechanisms of joint destruction and identify individuals with higher odds of structural knee changes.

Depressive symptoms and structural disease progression in knee osteoarthritis: data from the Osteoarthritis Initiative.

Depressive symptoms are associated with increases in pain and functional limitations in knee osteoarthritis (OA). The aim was to determine whether depressive symptoms are also associated with greater structural knee OA progression. Four years of annual radiographic and clinical assessments from the Osteoarthritis Initiative were analyzed. The Center for Epidemiological Studies Depression Scale was used to identify depressive symptoms (threshold=≥16) at the baseline visit. Propensity scores were used to match participants with and without baseline depressive symptoms on multiple potential confounders. Assessment of radiographic knee OA was based on changes in individual radiographic features, which included osteophyte (OST) grade and joint space narrowing (JSN) grade. Mixed effect models were used to examine structural progression between depressed and non-depressed participants with definitive radiographic knee OA. Depressive symptoms were significantly associated with a higher risk of OST progression (odds ratio [OR]=1.74; 95% confidence interval [CI]: 1.01, 3.00) and a non-significant lower risk of JSN progression (OR=0.40; 95% CI: 0.14, 1.15) 1year after baseline. Conversely, there was a non-significant lower risk of OST progression (OR=0.71; 95% CI: 0.28, 1.79) and higher risk of JSN progression (OR=1.89; 95% CI: 0.71, 5.06) from year 3 to year 4 of follow-up. However, the patterns of OST progression and JSN progression were not significantly different between the depressed and non-depressed (P=0.25 and 0.15, respectively). The findings provide no evidence that depressive symptoms have a detectable effect on changes in radiographic disease severity in knee OA.

Reliability and Accuracy of Cross-sectional Radiographic Assessment of Severe Knee Osteoarthritis: Role of Training and Experience.

To dêtermine the reliability of radiographic assessment of knee osteoarthritis (OA) by nonclinician readers compared to an experienced radiologist. The radiologist trained 3 nonclinicians to evaluate radiographic characteristics of knee OA. The radiologist and nonclinicians read preoperative films of 36 patients prior to total knee replacement. Intrareader and interreader reliability were measured using the weighted κ statistic and intraclass correlation coefficient (ICC). Scores κ < 0.20 indicated slight agreement, 0.21-0.40 fair, 0.41-0.60 moderate, 0.61-0.80 substantial, and 0.81-1.0 almost perfect agreement. Intrareader reliability among nonclinicians (κ) ranged from 0.40 to 1.0 for individual radiographic features and 0.72 to 1.0 for Kellgren-Lawrence (KL) grade. ICC ranged from 0.89 to 0.98 for the Osteoarthritis Research Society International (OARSI) summary score. Interreader agreement among nonclinicians ranged from κ of 0.45 to 0.94 for individual features, and 0.66 to 0.97 for KL grade. ICC ranged from 0.87 to 0.96 for the OARSI Summary Score. Interreader reliability between nonclinicians and the radiologist ranged from κ of 0.56 to 0.85 for KL grade. ICC ranged from 0.79 to 0.88 for the OARSI Summary Score. Intrareader and interreader agreement was variable for individual radiograph features but substantial for summary KL grade and OARSI Summary Score. Investigators face tradeoffs between cost and reader experience. These data suggest that in settings where costs are constrained, trained nonclinicians may be suitable readers of radiographic knee OA, particularly if a summary score (KL grade or OARSI Score) is used to determine radiographic severity.

Depressive symptoms and structural disease progression in knee osteoarthritis: Data from the Osteoarthritis Initiative

Depressive symptoms are associated with increases in pain and functional limitations in knee osteoarthritis (OA). The aim was to determine whether depressive symptoms are also associated with greater structural knee OA progression. Four years of annual radiographic and clinical assessments from the Osteoarthritis Initiative were analyzed. The Center for Epidemiological Studies Depression Scale was used to identify depressive symptoms (threshold = ≥16) at the baseline visit. Propensity scores were used to match participants with and without baseline depressive symptoms on multiple potential confounders. Assessment of radiographic knee OA was based on changes in individual radiographic features, which included osteophyte (OST) grade and joint space narrowing (JSN) grade. Mixed effect models were used to examine structural progression between depressed and non-depressed participants with definitive radiographic knee OA. Depressive symptoms were significantly associated with a higher risk of OST progression (odds ratio [OR] = 1.74; 95% confidence interval [CI]: 1.01, 3.00) and a non-significant lower risk of JSN progression (OR = 0.40; 95% CI: 0.14, 1.15) 1 year after baseline. Conversely, there was a non-significant lower risk of OST progression (OR = 0.71; 95% CI: 0.28, 1.79) and higher risk of JSN progression (OR = 1.89; 95% CI: 0.71, 5.06) from year 3 to year 4 of follow-up. However, the patterns of OST progression and JSN progression were not significantly different between the depressed and non-depressed (P = 0.25 and 0.15, respectively). The findings provide no evidence that depressive symptoms have a detectable effect on changes in radiographic disease severity in knee OA.

Does Chondrocalcinosis Associate With a Distinct Radiographic Phenotype of Osteoarthritis in Knees and Hips? A Case–Control Study

To examine if knee chondrocalcinosis (CC), hip CC, or CC at distant joints associates with a distinct radiographic phenotype of osteoarthritis (OA) in knees or hips. We conducted a case-control study using data from the Genetics of Osteoarthritis and Lifestyle (GOAL) study (n = 3,170). All participants of the GOAL study had radiographs of knees, hands, and pelvis, which have been scored for CC and for individual radiographic features of OA. For this study, cases had radiographic OA and CC, and controls had radiographic OA without CC at the index joint. Data for knees and hips were analyzed separately. Binary logistic regression was used to examine the association between each radiographic phenotype and CC in joints with OA. Generalized estimating equation analysis was used to account for correlated data. Knee CC, and CC at any distant joint (without knee CC), associated with attrition in knee OA (adjusted odds ratio 2.32 [95% confidence interval 1.42-3.79] and 2.42 [1.41-4.13], respectively). There was no association between knee CC and osteophytosis or joint space narrowing (JSN) in knees with OA. Hip CC associated negatively with the summated osteophyte score and minimum JSN in hip OA. However, in hips with OA, CC did not associate with cysts or sclerosis. Additionally, distant joint CC did not associate with any structural change in hip OA. This study demonstrates that knee CC and CC at distant joints associate with attrition in knee OA, and hip CC associates with a milder hip OA phenotype. There was no evidence that CC associates with a hypertrophic OA phenotype.

The relationships between bone mineral density and radiographic features of hand or knee osteoarthritis in older adults: data from the Dong-gu Study.

The relationship between OA and osteoporosis has exhibited contradictory features over the past four decades. The aim of this study was to determine using separate analysis of the radiographic features of OA whether various radiographic features of OA were associated differently with BMD in the Korean elderly. Data were derived from the Dong-gu cohort; 2354 subjects were enrolled in the present cross-sectional study. Baseline characteristics, the BMDs of the lumbar spine and femoral neck measured by DXA, and X-rays of knees and hands were collected. A semi-quantitative grading system was used to estimate the severities of individual radiographic features. We adjusted for confounders using multiple linear regression modelling to analyse the relationships. After adjustment for confounders, hand and knee OA total scores were negatively associated with the BMDs of the lumbar spine and femoral neck, except for the total knee OA score and lumbar spine BMD. In detail, hand osteophytes and sclerosis exhibited positive relationships with the BMDs of the lumbar spine and femoral neck, except for hand osteophytes and femoral neck BMD. On the contrary, however, knee joint space narrowing (JSN), hand JSN, and hand subchondral cysts were negatively associated with the BMD of the lumbar spine and femoral neck. Knee JSN and hand subchondral cysts exerted the greatest effects on BMD. Separate analysis of the radiographic features of OA better reveals associations of OA with the BMD of the lumbar spine and femoral neck.

Correlation Between the Severity of Pain and Radiographic Findings in Hip Osteoarthritis

AIM: To analyze the association between the severity of pain and individual radiographic features and global radiographic indexes in hip osteoarthritis (OA). Materials and Methods: Forty-five consecutive patients who attended to our outpatient clinic with hip pain diagnosed as hip OA according to American College of Rheumatology (ACR) criteria were recruited for the study. Anteroposterior pelvic radiographs were obtained in all patients. Radiographs were read blindly and evaluated using Croft index, Lane index, individual radiographic features (IRF) of Lane index and Croft’s measurement of the “minimal joint space” (MJS) and Kellgren-Lawrence grading by a radiologist. After radiographic evaluation Kellgren Lawrence grade 1 patients were excluded from the study and 38 patients with Kelgren Lawrence grade 2-4 hip OA patients were statistically analyzed. Correlation between the severity of pain evaluated by visual analog scale (VAS) and radiographic findings were statistically analyzed with Spearman correlation test. Linear regression analyses (stepwise method) were used to investigate associations between severity of pain and radiographic findings. JSN and osteophyte grading according to Lane index, MJS, MJS 0.05). Applying logistic regression analyses, only reduced minimum joint space (MJS) (cut off value set at 2.5 mm) was found to be significantly associated to the severity of pain (p=0.002.) Conclusion: Quantitative measurement and grading of joint space narrowing showed correlation with severity of pain in hip osteoarthritis patients. It is observed that the radiographic finding that is related to the severity of pain in hip OA was MJS< 2.5 mm. This finding should be confirmed with further studies of larger sample size of patients with different radiographic severity.

Ultrasound-detected inflammation predicts radiographic progression in hand osteoarthritis after 5 years

ObjectiveTo examine whether ultrasound predicts radiographic hand osteoarthritis (OA) progression after 5 years.MethodsWe included 78 participants (71 women, mean (SD) age 67.8 (5.2) years) from the Oslo Hand OA cohort...

Relationship Between Clinical and Radiographic Findings in Osteoarthritis Knee: A Cross-Sectional Study

&#x0D; Several studies have suggested that there is a high discrepancy between clinical and radiographic knee osteoarthritis. The objectives of this study were to examine association between radiographic classification and clinical manifestations of knee osteoarthritis, and to determine if the assessment of individual radiographic features was superior to the general radiographic scale in establishing such a relationship. A total of 125 patients with knee osteoarthritis were enrolled in this study. Radiographic features were assessed with the Kellgren-Lawrence grade scale for general radiographic grading, and a line-drawing atlas for detailed radiographic analysis. The severity of knee pain, stiff ness, and disability were measured using the Western Ontario and McMaster Universities Osteoarthritis Index. Patients' age and pain duration were found to correlate significantly with knee pain, stiff ness, and disability. No association between general radiographic grading scale and clinical manifestations was found. However in detailed radiographic analysis, osteophyte site at the patellofemoral joint was found to correlate with knee stiff ness. In conclusion, radiographic scores were not found to be closely associated with the clinical features of knee osteoarthritis. The results of knee X-rays should not be used in isolation when a management decision is to be taken for patients with knee osteoarthritis.&#x0D; &#x0D;

Correlation Between the Severity of Pain and Radiographic Findings in Hip Osteoarthritis

AIM: To analyze the association between the severity of pain and individual radiographic features and global radiographic indexes in hip osteoarthritis (OA). Materials and Methods: Forty-five consecutive patients who attended to our outpatient clinic with hip pain diagnosed as hip OA according to American College of Rheumatology (ACR) criteria were recruited for the study. Anteroposterior pelvic radiographs were obtained in all patients. Radiographs were read blindly and evaluated using Croft index, Lane index, individual radiographic features (IRF) of Lane index and Croft’s measurement of the “minimal joint space” (MJS) and Kellgren-Lawrence grading by a radiologist. After radiographic evaluation Kellgren Lawrence grade 1 patients were excluded from the study and 38 patients with Kelgren Lawrence grade 2-4 hip OA patients were statistically analyzed. Correlation between the severity of pain evaluated by visual analog scale (VAS) and radiographic findings were statistically analyzed with Spearman correlation test. Linear regression analyses (stepwise method) were used to investigate associations between severity of pain and radiographic findings. JSN and osteophyte grading according to Lane index, MJS, MJS&lt;2.5 mm and global indexes (KL,Croft,Lane) were chosen as independent variables in linear regression analyses. Results: Mean age of patients was 60.76+13 years. 38 patients had Kellgren Lawrence grade 2-4 hip osteoarthritis. Joint space narrowing (JSN) grading according to Lane index (r =0.32 and p=0.05) and minimal joint space measurement &lt;2.5 mm according to Croft index (r = -0.33 and p=0.04) showed correlation with severity of pain. No correlation was observed between osteophyte grading, sclerosis, cyst, deformity and global indexes and severity of pain (p&gt; 0.05). Applying logistic regression analyses, only reduced minimum joint space (MJS) (cut off value set at 2.5 mm) was found to be significantly associated to the severity of pain (p=0.002.) Conclusion: Quantitative measurement and grading of joint space narrowing showed correlation with severity of pain in hip osteoarthritis patients. It is observed that the radiographic finding that is related to the severity of pain in hip OA was MJS&lt; 2.5 mm. This finding should be confirmed with further studies of larger sample size of patients with different radiographic severity.

Diagnostic value of clinical, laboratory, and imaging findings in patients with a clinical suspicion of gout: a systematic literature review.

To analyze the diagnostic utility of clinical, laboratory, and imaging items for gout. A systematic literature search was performed in MEDLINE, EMBASE, and The Cochrane Library; and a manual search of abstracts from the 2010/2011 meetings of the American College of Rheumatology (ACR) and the European League Against Rheumatism, as well as the reference lists of retrieved papers. Studies were included if they evaluated the diagnostic utility of clinical, laboratory, or imaging features or criteria for the diagnosis or classification of gout in adult patients. Two independent reviewers selected papers, extracted the data, and assessed the risk of bias. Nineteen studies were included in the review; 4 used the identification of monosodium urate (MSU) crystals as the reference standard (RS) and the rest used expert opinion or the ACR preliminary criteria. Most features were evaluated in a single study. Evidence for diagnostic utility, using MSU crystals as RS, of over 50 individual clinical, laboratory, and radiographic features was retrieved. Most items showed a positive likelihood ratio (LR+) < 3, except for the following: response of arthritis to colchicine (LR+ 4.3); presence of tophi on physical examination (LR+ 15.6-30.9); identification of the double-contour sign in ultrasound (US) (LR+ 13.6); and detection of urate deposits by dual-energy computed tomography (DECT) (LR+ 9.5). Individual clinical features show low diagnostic utility, with the exception of tophi and response to colchicine. Some US and DECT findings show better performance than most clinical features.

THU0218 Diabetes Effects on Incidence of Radiographic Knee OA and Its Structural Progression: A Longitudinal Analysis of the Osteoarthritis Initiative Data

BackgroundMultiple epidemiological and experimental data indicate that diabetes may be one of osteoarthritis risk factors. In spite of this, there is a lack of data on whether diabetes is an...

Knee cartilage and quadriceps muscle loss after posterior crucial ligament (PCL) injury

Knee cartilage and quadriceps muscle loss after posterior crucial ligament (PCL) injury