Presence Of Osteophytes Research Articles

Effects of strontium ranelate on spinal osteoarthritis progression

Objective:The aim of this study was to determine whether a 3-year treatment with strontium ranelate could delay the progression of spinal osteoarthritis (OA).Methods:This study was a post-hoc analysis of pooled...

Korrelieren die klinischen, radiologischen und intraoperativen Befunde der Gonarthrose? Eine prospektive Studie an 103 Patienten

The aim of this study was to compare the different diagnostic features (symptoms, physical examination, radiographic features and intraoperative findings) of osteoarthritis of the knee before total joint replacement and consequently relate them with each other. Patients with primary osteoarthritis of the knee, who where accepted for total joint replacement in our clinic, were integrated in our study. The medical conditions were recorded by using the Womac score, the knee subscore (KS) of the Knee Society Clinical Rating System and a visual analogue scale (VAS). A physical examination was also performed. The radiological evaluation was performed by using standardised radiographs. Joint space narrowing, subchondral sclerosis, osteophytes, knee alignment and the Kellgren score were recorded. During surgery an orthopaedic specialist documented the progression of cartilage lesions using the classification of chondromalacia described by Outerbridge. The analysis of correlation was performed by using the Spearman correlation (SpK) coefficient. 103 patients were integrated in the study (mean age: 68 years, 70 women). No significant correlation could be found between the Womac score or VAS and the results of the radiological examination (SpK [Womac - Kellgren score]: - 0.04; SpK [VAS - Kellgren score]: 0.08). There was a significant correlation between the KS and the results of the radiological examination as well as the progression of the cartilage lesions, caused by the results of the physical examination documented in the KS (SpK [KS - Kellgren score]: - 0.39). The radiographic features, with the exception of subchondral sclerosis, showed a significant correlation with the degree of chondromalacia (SpK [Kellgren score - chondromalacia]: 0.43). The amount of osteophytes correlated the most with the cartilage lesions: SpK: 0.43. The knee subscore appears to be an efficient method for staging the clinical progression of osteoarthritis of the knee for clinical practice as well as for clinical trials. The Womac score especially serves to record the level of pain. We were able to confirm that the presence of osteophytes is the most significant radiographic feature of osteoarthritis of the knee. The Kellgren score turned out to be a reliable method for monitoring the radiographic progression of osteoarthritis of the knee.

Radiological evaluation of acromial characteristic using supraspinatus outlet view in shoulder impingement syndrome

Purpose of this study was to find the association between shoulder impingement syndrome (SIS) and morphological characteristics of acromion  (acromial  tilt  angle,  typeof  acromion,  subacromial osteophyte).Supraspinatus  outlet  view  was  performed  using  fluoroscopy. There  were  40  SIS  patients  and  40  individuals  with  no  shoulder  pain  examined  and  measured  for  their  acromial  tilt  angle,  typeof acromion  (according  to  Bigliani’s  classification  and  Park’s  criteria)  and  forthe  presence  of  subacromial  osteophyte.  Average acromial tilt angle was 34.1° (SD 7.6) for SIS group and 32.1° (SD 7.7) for control group. Type II acromion was found more frequent in both groups (85% and 95%). The association between SIS and acromial tiltangle or between SIS and type of acromion were statisticallyinsignificant (p=0.241 and p=0.221). Subacromial osteophyte was found in 52.5% of SIS group compare to 12.5% among the control group,  and  the  association  with  SIS  was  statistically  significant  (p=0.0003).Subacromial  osteophyte  was  found  to  have  significant association with SIS. Such association was not found in acromial tilt angle and type of acromion. (Med J Indones 2007; 16:176-80)

Association of a single nucleotide polymorphism in the WISP1 gene with spinal osteoarthritis in postmenopausal Japanese women

The Wnt-beta-catenin signaling pathway that regulates bone density is also involved in cartilage development and homeostasis in vivo. Here, we assumed that genetic variation in Wnt-beta-catenin signaling genes can affect the pathogenesis of cartilage related diseases, such as osteoarthritis. Wnt-1-induced secreted protein 1 (WISP1) is a target of the Wnt pathway and directly regulated by beta-catenin. In the present study, we analyzed the association of a single nucleotide polymorphism (SNP) in the WISP1 3'-UTR region with the development of radiographically observable osteoarthritis of the spine. For this purpose, we evaluated the presence of osteophytes, endplate sclerosis, and narrowing of disc spaces in 304 postmenopausal Japanese women. We compared those who carried the G allele (GG or GA, n = 184) with those who did not (AA, n = 120). We found that the subjects without the G allele (AA) were significantly over-represented in the subjects having higher endplate sclerosis score (P = 0.0069; odds ratio, 2.91; 95% confidence interval, 1.34-6.30 by logistic regression analysis). On the other hand, the occurrence of disc narrowing and osteophyte formation did not significantly differ between those with and without at least one G allele. Thus, we suggest that a genetic variation in the WISP1 gene locus is associated with spinal osteoarthritis, in line with the involvement of the Wnt-beta-catenin-regulated gene in bone and cartilage metabolism.

Predictors of symptomatic response to glucosamine in knee osteoarthritis: an exploratory study

Objective: To evaluate whether patient characteristics and/or radiographic disease patterns predict symptomatic response to treatment with glucosamine in osteoarthritis (OA) of the knee. Design: Exploratory prospective correlational study. Setting: Institutional....

Estimating the probability of radiographic osteoarthritis in the older patient with knee pain

To determine whether clinical information can practically rule in or rule out the presence of radiographic osteoarthritis in older adults with knee pain. We conducted a cross-sectional diagnostic study involving 695 adults ages >/=50 years reporting knee pain within the last year identified by postal survey and attending a research clinic. Potential indicators of radiographic osteoarthritis were gathered by self-complete questionnaires, clinical interview, and physical examination. Participants underwent plain radiography (posteroanterior, skyline, and lateral views). Radiographic osteoarthritis was defined as the presence of definite osteophytes in at least 1 joint compartment of the index knee. Independent predictors of radiographic osteoarthritis were age, sex, body mass index, absence of whole leg pain, traumatic onset, difficulty descending stairs, palpable effusion, fixed-flexion deformity, restricted-flexion range of motion, and crepitus. Using this model, 245 participants had a predicted probability >/=80% (practical rule in), of whom 231 (94%) actually had radiographic osteoarthritis (specificity 93%). Twenty-one participants had a predicted probability <20% (practical rule out), of whom only 2 (10%) had radiographic osteoarthritis (sensitivity 99.6%). The predicted probability of radiographic osteoarthritis for the remaining 429 participants fell into an intermediate category (20-79%). Simple clinical information can be used to estimate the probability of radiographic osteoarthritis in individual patients. However, for the majority of community-dwelling older adults with knee pain this method enables the presence of radiographic osteoarthritis to be neither confidently ruled in nor ruled out. Prospective validation and updating of these findings in an independent sample is required.

Are bone losers distinguishable from bone formers in a skeletal series? Implications for adult age at death assessment methods

Clinical studies indicate that genetic factors play a crucial role in primary osteoarthritis and osteoporosis. In addition, it has been suggested that these two diseases are inversely related. Within a population, one can find two sub-groups: the “bone formers” and the “bone losers”. The changes to the joint surfaces used to assess adult age at death are related to the loss of bone substance and to bone formation (osteophytes). The modification of these indicators with age differs between bone formers and bone losers. Therefore, age-at-death assessment methods should make use of two standards, one for each sub-group. A preliminary study examining the possibility of distinguishing those who lose cortical bone from those who show signs of bony formation was conducted on a series of skeletons from Portugal, dating to the end of 19th century and the beginning of the 20th. Bone loss was evaluated using the cortical index (CI) of the second metacarpal on X-rays. The presence of osteophytes on dry bones was assessed macroscopically. Our study indicates that females’ CI decreases with age, whereas the presence of osteophytes is strongly related to age in both sexes. But we have failed to find the inverse relationship between osteophytes and bone loss. Our study, however, shows that within a population, some individuals are not likely to develop osteophytes.

Q89R Polymorphism in the LDL Receptor-Related Protein 5 Gene Is Associated With Spinal Osteoarthritis in Postmenopausal Japanese Women

An association study investigating the genetic etiology for spinal osteoarthritis. To determine the association of single-nucleotide polymorphism (SNP) causing an amino-acid change (Q89R) in the low-density lipoprotein receptor-related protein 5 (LRP5) coding region with spinal osteoarthritis. Wnt/beta-catenin signaling pathway regulates bone density through a Wnt coreceptor LRP5. This pathway is also involved in cartilage development and homeostasis, suggesting that genetic variation in LRP5 gene may affect the pathogenesis of cartilage-related diseases, such as osteoarthritis. We evaluated the presence of osteophytes, endplate sclerosis, and narrowing of disc spaces in 357 Japanese postmenopausal women. Missense coding SNP for Q89R of LRP5 gene was determined using TaqMan polymerase chain reaction (PCR) method. We found that subjects without the R allele (QQ; n = 321) had a significantly lower osteophyte formation score than did subjects bearing at least one R allele (QR + RR; n = 36) (7.80 vs. 10.89, P = 0.0019 by analysis of covariance). We suggest that a genetic variation at the LRP5 gene locus is associated with spinal osteoarthritis, in line with the involvement of the LRP5 gene in the bone and cartilage metabolism.

Effects of chronic growth hormone and insulin‐like growth factor 1 deficiency on osteoarthritis severity in rat knee joints

To determine the effects of chronic deficiency of growth hormone (GH) and insulin-like growth factor 1 (IGF-1) on osteoarthritis (OA) severity. Thirty-five rats were divided into 4 treatment groups at 4 weeks of age: 1 control group (normal GH/IGF-1 levels [heterozygous]) and 3 groups of dwarves with a genetic mutation that results in GH deficiency. The first dwarf group received GH for 64 weeks (GH replete) and the second received GH until 14 weeks of age, followed by saline for 50 weeks (adult-onset GH/IGF-1 deficiency [AO-GHD]). The third dwarf group received saline injections only (lifetime GH deficient [GHD]). Sections of the medial knee joint compartment were graded and measured histologically; data were summarized using factor analysis, and treatment effects were assessed using analysis of variance and adjusting for body weight. Terminal IGF-1 levels and body weights were significantly affected by treatment (P = 0.002 and P < 0.001, respectively). Factor analysis yielded a total of 5 factors, the first 3 of which were not significantly affected by treatment. Factor 4 (weighted by medial tibial plateau articular cartilage width and area) was significantly affected by treatment (P < 0.012), with larger values in the AO-GHD group than in the GHD group (P < 0.05). Factor 5 (weighted primarily by articular cartilage structure and loss of toluidine blue staining scores) also was significantly affected by treatment (P < 0.001), and was significantly lower (less severe lesions) in the GH replete group than in all other treatment groups (P < 0.05). Despite the presence of cartilage lesions, osteophytes and subchondral sclerosis were not observed in GH/IGF-1-deficient animals. These results indicate that chronic GH/IGF-1 deficiency causes an increased severity of articular cartilage lesions of OA without the bony lesions normally seen in this disease.

Is the degree of osteophyte formation associated with the symptoms and functions in the patellofemoral joint in patients undergoing total knee arthroplasty?

Osteophyte formation and loss of articular cartilage are the main pathologic features of osteoarthritis in the patellofemoral joint. The goal of this study was to determine whether the degree of osteophyte formation was associated with the degree of cartilage loss and the patellofemoral symptoms and functions in osteoarthritic patients undergoing total knee arthroplasty (TKA). We evaluated 71 knees in 54 consecutive patients who underwent TKA under the diagnosis of osteoarthritis. The degree of patellofemoral osteophyte formation was assessed by proportional diameter and proportional rim involvement. The cartilage status was assessed by depth and size of the cartilage lesion. The patellofemoral symptoms and functions included anterior knee pain, abilities of chair-rising and stair-climbing and quadriceps muscle power. No significant association was found between the degrees of patellar or trochlear osteophyte formation with anterior knee pain or any of the patellofemoral functional parameters (P>0.05). The degree of osteophyte formation in the patella and the trochlea had a significant but weak correlation with the status of patellar cartilage and the status of the trochlear cartilage, respectively (correlation coefficient = 0.22-0.41 and P<0.05). This study indicates that physicians need to be cautious not to easily reach the conclusion that the patellofemoral symptoms and functional disabilities can be attributed to the presence of osteophyte in the patellofemoral joint in consulting patients with the patellofemoral radiographs or deciding on patellar resurfacing in TKA.

Correlation between radiographic findings of osteoarthritis and arthroscopic findings of articular cartilage degeneration within the patellofemoral joint

To correlate radiographic findings of osteoarthritis on axial knee radiographs with arthroscopic findings of articular cartilage degeneration within the patellofemoral joint in patients with chronic knee pain. The study group consisted of 104 patients with osteoarthritis of the patellofemoral joint and 30 patients of similar age with no osteoarthritis of the patellofemoral joint. All patients in the study group had an axial radiograph of the knee performed prior to arthroscopic knee surgery. At the time of arthroscopy, each articular surface of the patellofemoral joint was graded using the Noyes classification system. Two radiologists retrospectively reviewed the knee radiographs to determine the presence of marginal osteophytes, joint-space narrowing, subchondral sclerosis, and subchondral cysts. The sensitivity and specificity of the various radiographic features of osteoarthritis for the detection of articular cartilage degeneration within the patellofemoral joint were determined. The sensitivity of marginal osteophytes, joint-space narrowing, subchondral sclerosis, and subchondral cysts for the detection of articular cartilage degeneration within the patellofemoral joint was 73%, 37%, 4%, and 0% respectively. The specificity of marginal osteophytes, joint-space narrowing, subchondral sclerosis, and subchondral cysts for the detection of articular cartilage degeneration within the patellofemoral joint was 67%, 90%, 100%, and 100% respectively. Marginal osteophytes were the most sensitive radiographic feature for the detection of articular cartilage degeneration within the patellofemoral joint. Joint-space narrowing, subchondral sclerosis, and subchondral cysts were insensitive radiographic features of osteoarthritis, and rarely occurred in the absence of associated osteophyte formation.

Clinical Predictors of the Response to Glucosamine in Chronic Knee Pain

PURPOSE: To identify clinical features that predict response to treatment with glucosamine sulphate in individuals with chronic knee pain. The specific hypothesis is that age, body mass index, absence or presence of osteoarthritis and severity of osteoarhritis, predict response to glucosamine sulphate. METHODS: A prospective correlation study of pre- and post intervention was perfomed. A cohort of 45 patients with chronic knee pain were recruited and treated with 12 weeks of oral glucosamine sulphate 1.5g daily. Subjects underwent assessment at baseline and after completion of treatment. Baseline knee radiographs were used to assess presence and severity of osteo arthritis (OA). Primary outcome measures used to determine clinical response to glucosamine were the Visual Analogue Scale (VAS) for pain and function and the Knee Osteo arthritis Outcome Scale (KOOS). Secondary outcome measures were the Patient global change score and Patient Specific Functional Score. Statistical analysis was performed to confirm response and logistic regression analysis was used to identify predictor variables. RESULTS: Sixteen (35.6%) male and 29 (64.4%) female patients with a mean duration of symptoms of 9.5yrs (range 0.5–45) were included in the study. The mean age was 52.7yr (range 31–82) and BMI was 27.8kg/m2 (range 19.1–38.4). Thirty-eight (63.6%) had American College of Rheumatology denned OA. Severity of OA was determined by Kellgren and Lawrence grading: Gade I-9%, Grade II-9%, Grade 3–14%, Grade 4–16%. There were significant improvements in all primary and secondary outcome measures including VAS for pain on movement (p=0.002), VAS for pain at rest (p= 0.009), VAS for restriction in daily activites (p<0.001) and VAS for pain on worst activity (p<0.001). Four predictor variables; presence and absence of osteophytes, severity of OA, age and BMI were analysed by logistic regression with response to primary outcome measures. Presence of osteophytes (p=0.04) and more mild osteoarthritis (p=0.048) predicted improvement in restriction in activities of daily living as measured by VAS. However none of these clinical variables predicted response to any other outcome measure. CONCLUSIONS: Glucosamine sulphate 1.5g daily resulted in a significant improvement in all outcome measures in a population of patients with chronic knee pain. The presence of OA and milder OA are predictors of improvement in restriction in activities of daily living. However, response to all other outcome measures including, pain, other symptoms, sport and recreation and quality of live, are equal in patients with chronic knee pain regardless of age, BMI, presence or absence of OA and severity of OA.

Radiographic Findings of Osteoarthritis versus Arthroscopic Findings of Articular Cartilage Degeneration in the Tibiofemoral Joint

To retrospectively correlate radiographic findings of osteoarthritis of the tibiofemoral joint with arthroscopic findings of articular cartilage degeneration within the tibiofemoral joint in patients with chronic knee pain. The study was performed in compliance with HIPAA regulations. Approval from an institutional review board and a waiver of informed consent were obtained. The study group consisted of 125 patients with osteoarthritis of the tibiofemoral joint (66 men, 59 women; age range, 35-77 years; average age, 52 years) and 25 patients of similar age (14 men, 11 women; age range, 36-69 years; average age, 50 years) with no osteoarthritis of the tibiofemoral joint. All patients underwent standing anteroposterior radiography of the knee prior to arthroscopic knee surgery. Each articular surface of the tibiofemoral joint was graded at arthroscopy. Two radiologists retrospectively reviewed the knee radiographs to determine the presence of marginal osteophytes, joint space narrowing, subchondral sclerosis, and subchondral cysts. The sensitivity and specificity of the radiographic features of osteoarthritis for the detection of articular cartilage degeneration within the medial and lateral compartments of the tibiofemoral joint were determined. The sensitivity of marginal osteophytes, joint space narrowing, subchondral sclerosis, and subchondral cysts for the detection of articular cartilage degeneration was 67%, 46%, 16%, and 10%, respectively, for the medial compartment and 49%, 7%, 6%, and 3%, respectively, for the lateral compartment. The specificity of marginal osteophytes, joint space narrowing, subchondral sclerosis, and subchondral cysts for the detection of articular cartilage degeneration was 73%, 95%, 100%, and 100%, respectively, for the medial compartment and 81%, 100%, 100%, and 100%, respectively, for the lateral compartment. Marginal osteophytes were the most sensitive radiographic feature for the detection of osteoarthritis of the tibiofemoral joint. Joint space narrowing, subchondral sclerosis, and subchondral cysts were less sensitive radiographic features of osteoarthritis and rarely occurred in the absence of associated osteophyte formation.

Association of tumor necrosis factor α polymorphism, but not the shared epitope, with increased radiographic progression in a seropositive rheumatoid arthritis inception cohort

To determine whether the tumor necrosis factor alpha (TNFA) -308 guanine-to-adenosine polymorphism and/or the shared epitope (SE) is associated with radiographic damage in patients with early rheumatoid arthritis (RA). The cohort consisted of 189 patients with early seropositive RA (median 5.6 months since symptom onset) who had active disease, no previous disease-modifying antirheumatic drug treatment, and >or=2 sets of scored radiographs of the hands/wrists and forefeet. TNFA -308 polymorphism was analyzed by polymerase chain reaction pyrosequencing. The SE was defined as presence of any 1 of the following HLA-DRB1 alleles: *0101, *0102, *0401, *0404, *0405, *0408, *0410, *1001, *1402, or *1406. Radiographic progression was assessed by the total Sharp score. Using a weighted least-squares regression analysis, patients with the -308 TNFA AA plus AG genotypes (n=49) had significantly higher rates of progression in erosion scores (median 0.84 versus 0.48 units/year), joint space narrowing (JSN) scores (0.42 versus 0.04), and total Sharp scores (1.70 versus 0.61) compared with patients with the TNFA GG genotype (n=140). Presence of the SE (n=137) was associated with significantly lower progression rates (per year) for total Sharp scores (median 0.9 versus 1.25 units/year) and JSN scores (0.04 versus 0.41), but not for erosion scores (0.50 versus 0.61) compared with patients without the SE (n=52). In a least-squares multiple linear regression model, the presence of the AA plus AG genotypes was associated with a significantly higher progression rate after adjusting for the presence of the SE, interaction between the SE and the AA plus AG genotypes, baseline log C-reactive protein level, Health Assessment Questionnaire Disability Index, total Sharp score, swollen joint count, and presence of osteophytes (osteoarthritis). There was a strong linkage disequilibrium between DRB1*0301 and TNFA polymorphism (D'=0.84, r2=0.45, P<0.001). This study showed an association between the TNFA -308 polymorphism and progression of radiographic damage in patients with early seropositive RA. This association appeared to be independent of the SE, but might be dependent on other genetic variants in linkage disequilibrium with the -308 TNFA A allele and DRB1*0301. Further studies should be conducted to validate these results in both longitudinal observational cohorts and randomized clinical trials.

Osteoarthritis is for the birds

The purpose of this study was to assess birds as a potential model for osteoarthritis. Compromised by confounding factors, it has not been possible to clearly delineate causation in humans. Nonhuman mammals manifest osteoarthritis in the natural state too rarely for comparative study. Artificial environments (of captive animals) are associated with higher frequencies, but are still inadequate for comparative study, and surgical and chemical models provide only limited insight. As frequency of pathology (except trauma-related) in birds has not been systematically examined across species lines, several families were selected for examination. Skeletal collections of major museums were examined for presence of osteophytes in hawks and pigeons. Three percent of 2,243 free-ranging hawks and 9.8% of 2,718 pigeons had osteoarthritis, all localized to the ankle. The bird ankle morphologically resembles the human knee. Frequency in pigeons was significantly greater than in hawks (chi (2)=86.48, p<0.00001), but was no difference in frequency between wild caught and captive birds (chi (2)=1.06). While misconceptions have plagued past perspectives, it turns out that the most common form of arthritis in humans (osteoarthritis) is actually for, or at least, is common in the class Aves (birds). The frequency of osteoarthritis and cacophony of bird morphologies and behaviors provides an opportunity to start to understand such causation.

Management of Elbow Osteoarthritis

Primary osteoarthritis of the elbow is characterized by painful stiffness, mechanical symptoms, and the presence of hypertrophic osteophytes. Preservation of the joint space is common and may account for the good results that are usually achieved with nonoperative treatment and nonprosthetic arthroplasty. Elbow osteoarthritis typically affects middle-aged men who engage in strenuous manual activity. Open or arthroscopic capsular release and removal of impinging osteophytes are the primary surgical treatment options. The relative sparing of joint cartilage makes elbow osteoarthritis unique in this regard and amenable to this treatment. Arthroplasty is rarely indicated for primary osteoarthritis of the elbow and should be reserved for elderly individuals with low demands for whom other treatment options have failed.

High signal in knee osteophytes is not associated with knee pain

Our understanding of the local source of pain in osteoarthritis (OA) remains unclear. We undertook this study to determine if the presence of high-signal osteophytes on magnetic resonance imaging (MRI) was associated with pain presence, location or severity. Subjects were chosen from the Boston Osteoarthritis of the Knee Study, a natural history study of symptomatic knee OA. Assessments included knee MRI, pain assessments and information on weight and height. Osteophyte signal was defined as areas of increased signal intensity in the osteophyte on fat-suppressed T2 weighted images, and graded in the joint margins where osteophyte size is graded. All patients were evaluated with the frequent knee symptoms question for pain presence, the Western Ontario McMasters Osteoarthritis Index (WOMAC) for pain severity, and location of self-reported pain was recorded as present or absent based on locations identified on a standardized diagram. The osteophyte signal measures anywhere within one given knee were summed, creating an osteophyte signal aggregate. Logistic regression was conducted with quartile of osteophyte signal aggregate as the independent predictor and frequent knee symptom question as the dependent outcome. Association between quartile of osteophyte signal aggregate and pain severity on WOMAC was assessed using a linear regression. Logistic regression was used to evaluate the association between compartment-specific high-signal osteophytes aggregates (independent variable) and compartment-specific knee pain (dependent variable). Analyses were adjusted for gender, body mass index (BMI), and age. Two hundred and seventeen subjects were included in this analysis. They were predominantly male and 75% of subjects had radiographic tibio-femoral (TF) OA, and the remainder had patello-femoral (PF) radiographic OA. We did not find any association of high-signal osteophytes with presence of pain, pain severity or self-reported pain location. High-signal osteophytes detected on MRI are not associated with the presence of pain, pain severity or the self-reported location of pain.

P325 SUSTAINED PATIENT ACCEPTABLE SYMPTOM STATE (PASS), A CLINICALLYMEANINGFUL RESPONSE, WITH LUMIRACOXIB: A POOLED ANALYSIS OF TWO RANDOMIZED STUDIES IN PATIENTS WITH OSTEOARTHRITIS

gm/cm3 sd: 42.5, p = 0.01), but not with cortical density at the 14% site (1080.6 gm/cm3 sd: 52.3 vs 1069.8 gm/cm3 sd: 52.4, p = 0.08) and 38% site (1150.3 gm/cm3 sd: 30.6 vs 1148.2 gm/cm3 sd: 33.8, p = 0.60). Tibia polar strength strain index was also increased significantly at the 14% site (1739.05 sd: 445.1 vs 1607.41 sd: 410.47, p=0.007) and 38% site (1872.57 sd: 4790.34 vs 1716.34 sd: 428.934, p=0.002). Tibio-femoral osteophytosis was associated with a significant increase in total and trabecular BMD at the 4% site but not in cortical BMD at 14% and 38% sites (see table). Joint space narrowing displayed a weaker association with trabecular bone density and and no significant association with cortical bone density. Multivariate analyses of PQCT values adjusted to BMI, gender and age were performed and did not significantly alter the results Conclusions: Radiographic osteoarthritis is associated with an increase in volumetric BMD assessed by PQCT. However, this increase is confined predominantly to trabecular bone rather than cortical bone. This association is driven predominently by the presence of osteophytes rather than joint space narrowing.

Radiographic Progression of Lumbar Spine Disc Degeneration Is Influenced by Variation at Inflammatory Genes

A candidate gene association study in a longitudinal cohort. To investigate the association between polymorphisms at 25 candidate genes and progression of individual radiographic features of lumbar disc degeneration (LDD). LDD is characterized radiographically by the presence of osteophytes and disc space narrowing and is known to have a genetic component. Because of the high prevalence of radiographic features, progression may be a more useful phenotype clinically to study than prevalence itself. We tested the effect on radiographic progression of LDD of polymorphisms in 25 genes, 24 of which had been previously tested with regards to knee osteoarthritis. The progression traits used were the change in radiographic grade over 9 years in osteophytes, disc space narrowing, and summary Kellgren-Lawrence grade. Lumbar spine radiographs (L1-L5) at baseline and at follow-up were read for 720 women genotyped at the 25 genes participating in the Chingford study. Polymorphisms in MMP3, TIMP1, and COX2, which encode molecules involved in inflammatory pathways, were associated with radiographic progression of LDD. The strongest associations observed (statistically significant after correcting for multiple comparisons) were between COX2 and change in osteophyte grade (P < 0.001) and Kellgren-Lawrence grade (P < 2 x 10(-5)), and between the genes for vitamin D receptor (P < 0.002) and a thrombospondin (THSD2) (P < 0.002) and change in osteophyte grade. Our results suggest a role for genes regulating inflammatory pathways in the radiographic progression of spine degeneration. This could prove a fruitful area for future therapeutics for the spine and other joints.

Hip abduction moment and protection against medial tibiofemoral osteoarthritis progression

To test the hypothesis that a greater peak internal hip abduction moment is associated with a reduced likelihood of ipsilateral medial tibiofemoral osteoarthritis (OA) progression. Fifty-seven persons with knee OA (by definite osteophyte presence and symptoms) were evaluated. Baseline assessments included kinematic and kinetic gait parameters, obtained with an optoelectronic camera system and force platform, with inverse dynamics used to calculate 3-dimensional moments at the joints; pain, using a separate visual analog scale for each knee; and alignment, using full-limb radiographs. Radiographs of the knee in a semiflexed position, with fluoroscopic confirmation of tibial rim alignment, were obtained at baseline and 18 months later. Disease progression was defined as worsening of the grade of medial joint space narrowing. Logistic regression obtained with generalized estimating equations was used to estimate odds ratios (ORs) for progression per unit of hip abduction moment, after excluding knees with the worst joint space grade at baseline (which could not progress). The 57 participants (63% women) with mild to moderate OA had a mean age of 67 years and a mean body mass index of 29. A greater internal hip abduction moment during gait was associated with a reduced likelihood of medial tibiofemoral OA progression, with OR/unit hip abduction moment of 0.52 and a 95% confidence interval (95% CI) of 0.32-0.85. This protective effect persisted after adjustment for age, sex, walking speed, knee pain severity, physical activity, varus malalignment severity, hip OA presence, and hip OA symptom presence, with an adjusted OR of 0.43 a 95% CI of 0.22-0.81. A greater hip abduction moment during gait at baseline protected against ipsilateral medial OA progression from baseline to 18 months. The likelihood of medial tibiofemoral OA progression was reduced 50% per 1 unit of hip abduction moment.