Prevalence Of Joint Space Narrowing Research Articles

Age-stratified analysis of temporomandibular joint osteoarthritis using cone-beam computed tomography.

This study aimed to evaluate age-stratified radiographic features in temporomandibular joint osteoarthritis using cone-beam computed tomography. In total, 210 joints from 183 patients (144 females, 39 males, ranging from 12 to 88 years old with a mean age of 44.75±19.97 years) diagnosed with temporomandibular joint osteoarthritis were stratified by age. Mandibular condyle position and bony changes (flattening, erosion, osteophytes, subchondral sclerosis, and subchondral pseudocysts in both the condyle and articular eminence, thickening of the glenoid fossa, joint space narrowing, and joint loose bodies) were evaluated through cone-beam computed tomography. After adjusting for sex, the association between age groups and radiographic findings was analyzed using both a multiple regression model and a multinomial logistic regression model (α=0.05). The prevalence of joint space narrowing and protruded condyle position in the glenoid fossa significantly increased with age (P<0.05). The risks of bony changes, including osteophytes and subchondral pseudocysts in the condyle; flattening, erosion, osteophyte, and subchondral sclerosis in the articular eminence; joint loose bodies; and thickening of the glenoid fossa, also significantly rose with increasing age (P<0.05). The number of radiographic findings increased with age; in particular, the increase was more pronounced in the temporal bone than in the mandibular condyle (P<0.05). Increasing age was associated with a higher frequency and greater diversity of bony changes in the temporal bone, as well as a protruded condyle position in the glenoid fossa, resulting in noticeable joint space narrowing in temporomandibular joint osteoarthritis.

Hands and feet radiologic involvements in systemic sclerosis

AimSystemic sclerosis (SSc) is a rare autoimmune disorder characterized by vascular and fibrosing involvement of the skin and internal organs. In this study, we determined the prevalence and characteristics of radiological hands and feet involvements in Iranian SSc patients to identify the associations between clinical features and radiologic findings.Methods43 SSc patients (41 women and 2 men), with a median age of 44.8 years (ranges 26–70 years) and a mean disease duration of 11.8 years (ranges 2–28 years) were studied in this cross-sectional study.Results42 patients had radiological changes both in their hands and feet. Only one patient had alteration just in hand. The most frequent changes that we found in hand were Juxta-articular Osteoporosis (93%), Acro-osteolysis (58.2%), and Joint Space Narrowing (55.8%). The prevalence of joint space narrowing or acro-osteolysis was higher in subjects with active skin involvement [modified Rodnan skin score (mRSS) > 14] [16/21 vs. 4/16 for patients with inactive skin involvement (mRSS < 14); p = 0.002]. The most frequent changes that we found in the foot were Juxta-articular Osteoporosis (93%), Acro-osteolysis (46.5%), Joint Space Narrowing (58.1%), and subluxation (44.2%). The presence of anti-ccp antibody was detected in 4 (9.3%), while positive rheumatoid factor was found in 13 (30.2%) of SSc patients.ConclusionThis study corroborates that arthropathy is common in SSc patients. The introduction of the specific radiological involvements of SSc needs to be confirmed by further studies, in order to define the appropriate prognosis and treatment of patients.

Patterns of Involvement of the Hand Joints in Classical Rheumatoid Arthritis.

Symmetrical involvement of the hand joints is described as characteristic of rheumatoid arthritis (RA). Quantitative data on specific patterns of involvement are lacking. The Brigham Rheumatoid Arthritis Sequential Study was created for observational studies of patients with RA and afforded a unique opportunity to answer these questions. Of 1598 subjects in the Brigham Rheumatoid Arthritis Sequential Study cohort, 535 met the following criteria: (1) disease duration of 7 years or greater, (2) seropositive, and (3) hand radiographs available. Patterns in specific hand joints based on physical examination and radiographic findings obtained at entry were identified. The level of symmetry of involvement of the metacarpophalangeal (MCP) and wrist joints was determined, as was the correlation between findings on physical examination and radiographic changes in the hand joints. The prevalence of joint space narrowing and/or erosions in each proximal interphalangeal (PIP) joints ranged between 11% and 18%. Joint space narrowing and/or erosions in the MCPs increased radially from the fifth to the second finger. Swelling and tenderness on physical examination of both the PIPs and MCPs also increased radially although the positive predictive value of physical examination as an indicator of joint damage decreased radially. The wrist was the most common joint involved both by physical examination (67%) and radiographically (70%). The right side was more involved radiographically. Analysis of radiographic changes in individual patients revealed that symmetrical findings in the wrists and MCPs occurred in only 67% of patients. The study describes the pattern of involvement of the hand joints in patients with long standing RA. Findings of interest include symmetrical involvement in only 67% of patients and a discordancy between physical findings and radiographic changes most marked in the more radial PIP joints.

Relation between phalangeal bone mineral density and radiographic knee osteoarthritis: a cross-sectional study.

BackgroundMajor reports have suggested that bone mineral density (BMD) is higher in patients with osteoarthritis (OA), while other studies do not agree. Our aim was to examine the cross-sectional association between phalangeal BMD and radiographic knee OA.MethodsA total of 2855 participants were included in this study. Radiographic knee OA was defined as Kellgren-Lawrence (K-L) Grade ≥ 2 in at least one leg. BMD scans of the middle phalanges of the second, third and fourth digits of the nondominant hand were performed with a compact radiographic absorptiometry system (Alara MetriScan®). A multivariable logistic analysis model was applied to test the relation between phalangeal BMD with radiographic knee OA, the presence of knee osteophytes (OSTs), and knee joint space narrowing (JSN) after adjusting for a number of potential confounding factors.ResultsThe multivariable-adjusted odds ratios with 95 % confidence intervals [ORs (95 % CI)] of radiographic knee OA across phalangeal BMDs were 1.08 (95 % CI 0.89–1.32) and 0.62 (95 % CI 0.45–0.86), respectively. The P for trend was 0.09. For the female population, the multivariable-adjusted ORs (95 % CI) of radiographic knee OA across phalangeal BMD were 1.01 (95 % CI 0.73–1.37) and 0.58 (95 % CI 0.38 − 0.87), respectively. The P for trend was 0.02. This positive finding, however, did not exist in the male subgroup. There was a significantly lower prevalence of OST in the osteoporosis (OP) group than in the normal group (OR = 0.59, 95 % CI 0.40–0.88; P for trend was 0.01). In contrast, the prevalence of JSN was significantly higher in the osteopenia group (OR = 1.22, 95 % CI 1.00–1.48) and the OP group (OR = 1.35, 95 % CI 1.00–1.84) than in the normal group. The P for trend was 0.02.ConclusionsThis study observed lower odds for the presence of radiographic knee OA and OST in OP patients than in normal subjects. The prevalence of JSN was higher in the osteopenia and OP groups than in normal subjects.Electronic supplementary materialThe online version of this article (doi:10.1186/s12891-016-0918-x) contains supplementary material, which is available to authorized users.

Prevalence of radiographic hip osteoarthritis is increased in high bone mass

SummaryObjectiveEpidemiological studies have shown an association between increased bone mineral density (BMD) and osteoarthritis (OA), but whether this represents cause or effect remains unclear. In this study, we used a novel approach to investigate this question, determining whether individuals with High Bone Mass (HBM) have a higher prevalence of radiographic hip OA compared with controls.DesignHBM cases came from the UK-based HBM study: HBM was defined by BMD Z-score. Unaffected relatives of index cases were recruited as family controls. Age-stratified random sampling was used to select further population controls from the Chingford and Hertfordshire cohort studies. Pelvic radiographs were pooled and assessed by a single observer blinded to case-control status. Analyses used logistic regression, adjusted for age, gender and body mass index (BMI).Results530 HBM hips in 272 cases (mean age 62.9 years, 74% female) and 1702 control hips in 863 controls (mean age 64.8 years, 84% female) were analysed. The prevalence of radiographic OA, defined as Croft score ≥3, was higher in cases compared with controls (20.0% vs 13.6%), with adjusted odds ratio (OR) [95% CI] 1.52 [1.09, 2.11], P = 0.013. Osteophytes (OR 2.12 [1.61, 2.79], P < 0.001) and subchondral sclerosis (OR 2.78 [1.49, 5.18], P = 0.001) were more prevalent in cases. However, no difference in the prevalence of joint space narrowing (JSN) was seen (OR 0.97 [0.72, 1.33], P = 0.869).ConclusionsAn increased prevalence of radiographic hip OA and osteophytosis was observed in HBM cases compared with controls, in keeping with a positive association between HBM and OA and suggesting that OA in HBM has a hypertrophic phenotype.

FRI0486 Analysis of Wrist Joints in Patients with Systemic Sclerosis Using Magnetic Resonance Imaging

BackgroundSystemic sclerosis (SSc) is a systemic inflammatory autoimmune disease characterized by fibrosis and involvement in the small vessels, skin, joints, and multiple internal organs. Although joint involvement is common in...

The prevalence of radiographic hip osteoarthritis is increased in high bone mass; a case-control study

s / Osteoarthritis and Cartilage 22 (2014) S57–S489 S343 601 THE PREVALENCE OF RADIOGRAPHIC HIP OSTEOARTHRITIS IS INCREASED IN HIGH BONE MASS; A CASE-CONTROL STUDY S.A. Hardcastle y, P. Dieppe yz, C.L. Gregson y, D. Hunter x, G. Thomas x, N.K. Arden kx, T.D. Spector{, D.J. Hart{, M.J. Laugharne#, G.A. Clague yy, M.H. Edwards k, E. Dennison k, C. Cooper kx, M. Williams zz, G. Davey Smith xx, J.H. Tobias y. yMusculoskeletal Res. Unit, Univ. of Bristol, Bristol, UNITED KINGDOM; zUniv. of Exeter Med. Sch., Exeter, UNITED KINGDOM; xNIHR Musculoskeletal BioMed. Res. Unit, Univ. of Oxford, Oxford, United Kingdom; kMRC Lifecourse Epidemiology Unit, Univ. of Southampton, Southampton, United Kingdom; {Dept. of Twin Res. and Genetic Epidemiology, King’s Coll. London, London, United Kingdom; Dept. of Radiology, Royal United Hosp., Bath, United Kingdom; yyDept. of Radiology, Royal Glamorgan Hosp., Llantrisant, United Kingdom; zzDept. of Radiology, North Bristol NHS Trust, Bristol, United Kingdom; xxMRC Integrative Epidemiology Unit, Univ. of Bristol, Bristol, United Kingdom Purpose: Numerous epidemiological studies have reported an association between increased bone mineral density (BMD) and osteoarthritis (OA), but whether this represents cause or effect remains unclear. To establish whether higher BMD predisposes to OA, we aimed to determine whether individuals with High Bone Mass (HBM) have a higher prevalence of radiographic hip OA compared with controls. Methods: HBM cases were recruited from 15 UK centres by systematically screening DXA databases. HBM was defined in index cases as a total hip Z-score þ3.2 and L1 Z-score þ1.2, or vice-versa, and in firstdegree relatives of index cases as total hip Z-score plus L1 Z-score þ3.2; unaffected relatives were recruited as controls. AP pelvic X-rays were performed in participants aged 40 years. Age-stratified random sampling was used to select further population controls from the Chingford 1000-women and Hertfordshire cohort studies. All radiographs were assessed for features of OA (Croft score, osteophytes, joint space narrowing (JSN), cysts, sclerosis) by a single observer blinded to case-control status using an atlas. Minimum joint space width (JSW) was measured using a computer-aided method. Intra-observer repeatability for most features was good. Analyses used logistic regression, with generalised estimating equations to account for within-person clustering (right/left), adjusted a priori for age, gender and body mass index (BMI). Results: Analyses included 530 HBM hips in 272 cases (mean age 62.9 years, 74% female) and 1702 control hips in 863 controls (mean age 64.8 years, 84% female), after excluding poor quality films and hip replacements (n1⁄4109). The prevalence of radiographic hip OA, defined as Croft score 3, was increased in cases compared with controls (20.0% vs. 13.6%). Results of logistic regression analyses for the binary radiographic OA variables in HBM cases vs. controls are shown in the table below, adjusted for age, gender and BMI. Cases had an increased odds of hip OA compared with controls after adjustment (OR 1.52 [1.09, 2.11], p1⁄40.013). In analyses of individual radiographic features, osteophytes (both any osteophyte, and moderate ( grade 2) osteophytes) and subchondral sclerosis were also more prevalent in cases compared with controls. However, the prevalence of JSN was not increased in HBM cases, and measured JSW did not differ between the groups (mean difference 0.04mm [-0.05, 0.13], p1⁄40.39). Analyses were repeated in the different control groups separately, and stratified by gender, with broadly similar findings. Logistic regression analysis of radiographic hip OA variables in HBM cases vs. all

The natural history of the knee following arthroscopic medial meniscectomy

We examined the natural history of arthroscopic medial meniscectomy in knees with an isolated meniscal injury by reviewing 317 of 894 cases following medial meniscectomy. At the time of the initial surgery none of the knees had been operated on, and there was no evidence of ligament injury. The patients were reviewed clinically and radiologically after a mean of 11.5 years (range 10-15). The knee was considered "normal" or "nearly normal" by 91% of patients. In 218 patients the contralateral knee was asymptomatic without history of operation or significant injury and could be used as control for comparison. Radiology showed 22.4% greater excess prevalence of joint space narrowing in the operated compared to the control knee. The factors predisposing to a poor radiological result were age above 35 years, the presence of medial compartment cartilage degeneration at the time of the first arthroscopy, resection of the posterior one-third of the meniscus, and meniscal rim resection. Preoperative participation in sport was a predictor of a better outcome.