Progressive Joint Disease Research Articles

Association between medial and anterior meniscal extrusion and knee pain in primary stage of knee osteoarthritis

Purpose: Osteoarthritis of the knee (knee OA) is a slowly progressive joint disease and a leading cause of impaired mobility in the elderly. Functional meniscus disorder and osteophyte formation has been a secondary phenomenon of the pathogenesis of knee OA, and medial meniscus extrusion (MME) is one of the important roles in the process of OA pathogenesis, but its pathogenic mechanism remains unclear. Histologically, osteophytes are composed of the cartilage and bone parts. Because of the limitation in detectability of the cartilage part of osteophytes by radiography or conventional magnetic resonance imaging (MRI), we have reported that the cartilage part of osteophytes can be detected by using T2 mapping MRI.

Facile Synthesis of Hollow MnO2 Nanoparticles for Reactive Oxygen Species Scavenging in Osteoarthritis.

Osteoarthritis (OA) is a progressive degenerative joint disease whose molecular mechanism has not been revealed clearly, and there is still no effective approach to cure OA completely. Recently, reactive oxygen species (ROS) are exposed as an important mediator of OA's inflammatory response, and it has been regarded as a therapeutic target for OA treatment. MnO2 nanoparticles possess good biocompatibility and can act as an artificial nanoenzyme to scavenge ROS in various diseases effectively. In this study, the modified Stöber method was applied to synthesize hollow MnO2 (H-MnO2) and H-MnO2 was modified with NH2-PEG-NH2, which possesses excellent biological stability and biocompatibility. It induced a change in the articular cartilage structure changes in vivo, with the knee tissue staining and micro-CT scanning of the whole knee suggesting that H-MnO2 nanoparticles could effectively remove ROS and significantly relieve the inflammatory response of OA without obvious side effects. This study reveals the therapeutic effects of MnO2-based nanomedicine toward OA, which provides potential alternative therapeutic options for patients with inflammation tissue.

Trends in Articular Cartilage Tissue Engineering: 3D Mesenchymal Stem Cell Sheets as Candidates for Engineered Hyaline-Like Cartilage.

Articular cartilage defects represent an inciting factor for future osteoarthritis (OA) and degenerative joint disease progression. Despite multiple clinically available therapies that succeed in providing short term pain reduction and restoration of limited mobility, current treatments do not reliably regenerate native hyaline cartilage or halt cartilage degeneration at these defect sites. Novel therapeutics aimed at addressing limitations of current clinical cartilage regeneration therapies increasingly focus on allogeneic cells, specifically mesenchymal stem cells (MSCs), as potent, banked, and available cell sources that express chondrogenic lineage commitment capabilities. Innovative tissue engineering approaches employing allogeneic MSCs aim to develop three-dimensional (3D), chondrogenically differentiated constructs for direct and immediate replacement of hyaline cartilage, improve local site tissue integration, and optimize treatment outcomes. Among emerging tissue engineering technologies, advancements in cell sheet tissue engineering offer promising capabilities for achieving both in vitro hyaline-like differentiation and effective transplantation, based on controlled 3D cellular interactions and retained cellular adhesion molecules. This review focuses on 3D MSC-based tissue engineering approaches for fabricating “ready-to-use” hyaline-like cartilage constructs for future rapid in vivo regenerative cartilage therapies. We highlight current approaches and future directions regarding development of MSC-derived cartilage therapies, emphasizing cell sheet tissue engineering, with specific focus on regulating 3D cellular interactions for controlled chondrogenic differentiation and post-differentiation transplantation capabilities.

Nail Psoriasis: Diagnosis, Assessment, Treatment Options, and Unmet Clinical Needs.

An estimated 40-50% of patients with psoriasis (PsO) have psoriatic nail disease, which is associated with and directly contributes to a greater clinical burden and worse quality of life in these patients. In this review, we examine how recent advances in the use of new diagnostic techniques have led to improved understanding of the link between nail and musculoskeletal manifestations of psoriatic disease (PsD; e.g., enthesitis, arthritis) and we review targeted therapies for nail PsO (NP). We performed a literature search to identify which systemic therapies approved for the treatment of PsO and/or psoriatic arthritis (PsA) have been evaluated for the treatment of NP, either as a primary or secondary outcome. A total of 1546 articles were identified on February18, 2019, and evaluated for relevance. We included findings from 66 articles on systemic therapies for the treatment of NP in PsD. With several scoring systems available for the evaluation of psoriatic nail disease, including varied subtypes and application of the Nail Psoriasis Area Severity Index, there was a high level of methodological heterogeneity across studies. NP is an important predictor of enthesitis, which is associated with the early stages of PsA; therefore, it is important for rheumatologists and dermatologists to accurately diagnose and treat NP to prevent nail damage and potentially delay the onset and progression of joint disease. Further research is needed to address the lack of both standardized NP scoring systems and well-defined treatment guidelines to improve management of PsD.

Asiaticoside Regulates Toll-Like Receptor 4/Nuclear Factor-Kappa B Signaling Pathway to Relieve Lipopolysccharide-Induced Inflammation and Apoptosis in ATDC5 Cells

Osteoarthritis is a progressive joint disease characterized by degeneration and destruction of articular cartilage. The incidence of osteoarthritis has increased steadily over the years leading to more than 50% in people over the age of 65. Due to associated side effects of prevailing therapeutics, better drugs are needed for osteoarthritis management. Asiaticoside is a bioactive component isolated from the medicinal plant Centella asiatica. It has been reported to possess neuroprotective, antiulcer, wound healing, anti-inflammatory, antioxidative, and other pharmacological properties. However, the potential of asiaticoside in the management of osteoarthritis remains to be explored. To this end, we examined the effect of asiaticoside on lipopolysaccharides induced inflammatory injury and apoptosis of chondrocytes. The results show that asiaticoside promotes viability and decrease in apoptosis of ATDC5 cells through decreased production of proinflammatory cytokines and the regulation of toll-like receptor 4/nuclear factor-kappa b signaling pathway. In summary, our results provide the evidence that asiaticoside could serve as a promising therapeutic drug for osteoarthritis treatment.

Force Platform Assessment of Postural Balance in Knee Osteoarthritis - A Systematic Review

Osteoarthritis (OA) is the most common form of progressive joint disease. It presents with pain, stiffness and swelling which leads to muscle weakness and reduced physical function. The involvement of lower limb joints leads to deterioration of proprioception and predisposes to postural instability. Postural sway assessment is an integral component in the institution of goal-oriented treatment for OA. Postural sway assessment consists of various parameters such as Antero-Posterior amplitude, Medio-Lateral amplitude, total sway area, and Center of Pressure velocity. The study aims to systematically appraise the current evidence of different postural sway parameters from force plates and their association with knee OA. A literature search was conducted through PubMed, Scopus, and Web of Science databases. 115 articles were identified for screening, of which 10 studies met the inclusion criteria. The methodological quality of the study was assessed by two independent reviewers using Newcastle-Ottawa Quality Assessment Scale (NOS). 5 out of 9 studies showed significant Anterior-Posterior deviation, 5 out of 6 studies showed significant Center of pressure deviation and 3 out of 9 studies showed significant Medio- Lateral deviation. This review indicates that patients with knee OA sway more in Anterior-Posterior direction as compared to Medio-Lateral direction and can be considered as a key finding while assessing knee pain.

Hind limb ossification centre hypoplasia and deformities induced by quadriceps contracture: Radiographic and Computed Tomographic study in 13 Doberman Pinscher littermates

Quadriceps contracture (QC) is reported in dogs mainly as a complication of trauma or parasitic infection. QC causes progressive hind limb deviation, muscular hypotrophy and degenerative joint disease and, in puppies, bone hypoplasia. The aim of this clinical case series is to describe the radiographic and computed tomographic (CT) changes in hind limb ossification centres in thirteen 55 to 57-days-old Doberman Pinscher related littermates induced by QC after repeated intramuscular injections. The presence, size, and shape of ossification centres of affected and unaffected hind limbs were compared. Affected limbs were hyperextended and externally rotated, with genu recurvatum and proximo-medial patellar luxation. QC had no influence on the time of appearance of ossification centres however, it was associated with femoral head flattening, hip subluxation, flattening of the femoral distal epiphysis. The tibial plateau was tilted caudoproximally-craniodistally and wedged into the growth plate. Thirty-two out of fifty-five ossification centres (including diaphyseal and epiphyseal centres, such as femoral head and tibial plateau) were significantly smaller in affected limbs (p < 0.05). Lack of weight-bearing could account for the smaller size of ossification centres in affected tarsi and metatarsi. Progressive limb hyperextension and external rotation might have induced gradual loading withdrawal on the medial aspect of the foot justifying the reduced size observed only for the medial ossification centres of the digits of affected limbs. To the best of our knowledge, this is the first study describing CT findings of hind limb ossification centre changes in puppies with QC contracture.

CD11b Signaling Prevents Chondrocyte Mineralization and Attenuates the Severity of Osteoarthritis.

Osteoarthritis (OA) is a progressive joint disease that is strongly associated with calcium-containing crystal formation (mineralization) by chondrocytes leading ultimately to cartilage calcification. However, this calcification process is poorly understood and treatments targeting the underlying disease mechanisms are lacking. The CD11b/CD18 integrin (Mac-1 or αMβ2), a member of the beta 2 integrin family of adhesion receptors, is critically involved in the development of several inflammatory diseases, including rheumatoid arthritis and systemic lupus erythematosus. We found that in a collagen-induced arthritis, CD11b-deficient mice exhibited increased cartilage degradation compared to WT control animals. However, the functional significance of CD11b integrin signaling in the pathophysiology of chondrocytes remains unknown. CD11b expression was found in the extracellular matrix and in chondrocytes in both healthy and damaged human and murine articular cartilage. Primary murine CD11b KO chondrocytes showed increased mineralization when induced in vitro by secondary calciprotein particles (CPP) and quantified by Alizarin Red staining. This increased propensity to mineralize was associated with an increased alkaline phosphatase (Alp) expression (measured by qRT-PCR and activity assay) and an enhanced secretion of the pro-mineralizing IL-6 cytokine compared to control wild-type cells (measured by ELISA). Accordingly, addition of an anti-IL-6 receptor antibody to CD11b KO chondrocytes reduced significantly the calcification and identified IL-6 as a pro-mineralizing factor in these cells. In the same conditions, the ratio of qRT-PCR expression of collagen X over collagen II, and that of Runx2 over Sox9 (both ratio being indexes of chondrocyte hypertrophy) were increased in CD11b-deficient cells. Conversely, the CD11b activator LA1 reduced chondrocyte mineralization, Alp expression, IL-6 production and collagen X expression. In the meniscectomy (MNX) model of murine knee osteoarthritis, deficiency of CD11b led to more severe OA (OARSI scoring of medial cartilage damage in CD11b: 5.6 ± 1.8, in WT: 1.2 ± 0.5, p < 0.05, inflammation in CD11b: 2.8 ± 0.2, in WT: 1.4 ± 0.5). In conclusion, these data demonstrate that CD11b signaling prevents chondrocyte hypertrophy and chondrocyte mineralization in vitro and has a protective role in models of OA in vivo.

Incorporating joint pain screening into the pediatric dermatologic examination.

Joint manifestations are a feature of many pediatric skin disorders, among them psoriasis, autoimmune and autoinflammatory diseases, hypermobility disorders, and as an adverse effect of certain medications. Identifying joint disease early is important for intervention and prevention of chronic damage. However, pediatric musculoskeletal complaints are common and determining whether symptoms warrant a rheumatology referral for arthritis can be challenging. Pediatric dermatologists were surveyed for their comfort in screening for joint disease. Through literature review and interviews with three pediatric rheumatologists, key joints involved in disorders with skin manifestations and arthritis were identified and the essential evaluations were determined. Of 100 surveyed practicing board-certified pediatric dermatologists, 79% did not feel confident in their ability to perform a joint-focused physical examination, a key step in screening for joint disease. A rapid joint examination technique (R-JET) was developed, along with an accompanying three-question survey and body diagram for patient self-report of symptoms. A video demonstration of the R-JET was created as a teaching tool. Teaching and incorporation of a rapid screening examination for arthritis by pediatric dermatologists has the potential to identify pediatric arthritis earlier, facilitate referral, and reduce the risk of progressive joint disease. These instruments can easily be incorporated into a pediatric dermatology office visit.

Inhibition of PI3K/Akt/NF-κB signaling by Aloin for ameliorating the progression of osteoarthritis: In vitro and in vivo studies

Osteoarthritis (OA) is a progressive and degenerative joint disease. Aloin is a bitter and yellow-brown-coloured compound from the Aloe plant and is allowed for use in foods as a “natural flavour”. In our study, we examined the protective effects of Aloin on the inhibition of OA development as well as its underlying mechanism in both in vitro and vivo experiments. In in-vitro experiments, the protective effect of aloin on the anabolism and catabolism of the extracellular matrix (ECM) induced by IL-1 β in chondrocytes by inhibiting the expression of pro-inflammatory factors, including TNF-α (p = 0.016), IL-6 (p = 0.006), iNOS (p = 0.001) and COX-2 (p = 0.006). Mechanistically, Aloin suppressed the IL-1β-induced activation of the PI3K/Akt/NF-κB signalling pathway cascades. Moreover, molecular docking studies demonstrated that Aloin bound strongly to PI3K. In vivo, Aloin ameliorated the OA process in the destabilization of the medial meniscus (DMM) model.In summary, our findings demonstrate that Aloin ameliorates the progression of OA via the PI3K/Akt/NF-κB signalling pathways, which supports Aloin as a promising therapeutic agent for the treatment of OA.

Modifiable lifestyle and environmental factors associated with onset of psoriatic arthritis in patients with psoriasis: A systematic review and meta-analysis of observational studies

Psoriatic arthritis (PsA) is a progressive joint disease associated with psoriasis. To investigate the association of modifiable lifestyle and environmental factors with PsA risk among people with psoriasis. We conducted a systematic search of PubMed, Embase, and Cochrane Library through May 2, 2020, for observational studies reporting lifestyle or environmental factors for PsA onset in patients with psoriasis. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were combined using a random-effects model. We included 16 studies comprising 322,967 individuals. Obesity and being overweight were associated with an increased PsA risk in patients with psoriasis (OR, 1.75 [95% CI, 1.42-2.16] and OR, 1.50 [95% CI, 1.08-2.09], respectively), with an increase of approximately 6% for each kg/m2 rise in body mass index (OR, 1.06; 95% CI, 1.03-1.10). The presence of PsA was associated with a history of physical trauma (OR, 1.33; 95% CI, 1.16-1.54) or fracture (OR, 1.46; 95% CI, 1.22-1.74). No significant associations were observed regarding alcohol consumption (OR, 0.99; 95% CI, 0.88-1.13), smoking (OR, 0.89; 95% CI, 0.75-1.06), female hormonal exposure (OR, 1.45; 95% CI, 0.95-2.20), and psychologically traumatic events. Inherent limitations in the included observational studies. Several lifestyle and environmental factors are associated with PsA onset among patients with psoriasis. These findings indicate that such risk may be modified with lifestyle changes or avoidance of physical trauma in people with psoriasis.

Apoptosis and secondary necrosis of neutrophils and monocytes in the immunopathogenesis of rheumatoid arthritis: a cohort study.

Rheumatoid arthritis (RA) is a progressive chronic inflammatory and autoimmune joint disease. Neutrophils and monocytes are the main target cells of innate immune defense that modulate the course of inflammatory rheumatic diseases. Dysfunctional phagocytosis is a common feature in RA. The aim of this study was to evaluate the diagnostic value of apoptotic changes in neutrophils and monocytes and their relationship with rheumatoid activity measured by the DAS28 score. We used the APOLECT flow cytometric assay for evaluating primary necrotic, apoptotic, and secondary necrotic neutrophils and monocytes determination in RA patients compared with healthy controls. The apoptotic granulocytes were greater in RA patients compared to healthy controls (0.76 ± 0.15% vs. 0.58 ± 0.17%, P < 0.05). The percentage of primary necrotic granulocytes was significantly elevated in RA patients compared to healthy controls (3.84 ± 0.5% vs. 1.96 ± 0.33%). No significant difference was noted for primary necrotic monocytes. The number of secondary necrotic granulocytes and monocytes was high in RA patients (0.94 ± 0.15% vs. 0.4 ± 0.06% and 4.83 ± 1.06% vs. 1.8 ± 0.33%, respectively). The obtained results suggest that neutrophils and monocytes undergo apoptotic modifications which are accompanied by secondary necrotic cells formation in RA. These shifts may lead to autoantigen accumulation that results in the progressive course RA.

The Role of Cashew (Anacardium occidentale L.) Nuts on an Experimental Model of Painful Degenerative Joint Disease.

Osteoarthritis is a progressive joint disease characterized by the activation of different molecular mediators, including proinflammatory cytokines, reactive oxygen species, metalloproteinases and nociceptive mediators. Anacardium occidentale L. is a medicinal plant with anti-oxidative and anti-inflammatory properties. In this study we evaluate the effects of cashew nuts (from Anacardium occidentale L.) oral administration on an experimental model of painful degenerative joint disease. Monosodium iodoacetate (MIA) was intraarticularly injected, and cashew nuts were orally administered three times per week for 21 days, starting the third day after MIA injection. Nociception was evaluated by a Von Frey filament test, and motor function by walking track analysis at 3, 7, 14 and 21 days after osteoarthritis. Histological and biochemical alteration were examined at the end of the experiment. Cashew nuts administration reduced pain-like behavior and showed antioxidant activities, restoring biochemical serum parameters: glutathione (GSH), catalase (CAT) levels, glutathione peroxidase (GPx) activity and lipid peroxidation. Moreover, cashew nuts ameliorated radiographic and histological alteration, resulting in decreased cartilage degradation, pro-inflammatory cytokines and metalloproteinases levels and mast cells recruitment. Our results demonstrated that the oral assumption of cashew nuts counteracts the inflammatory and oxidative process involved in osteoarthritis.

Interdisciplinary Approach to the Temporomandibular Joint Osteoarthritis-Review of the Literature.

Background and objectives: There is an increasing number of patients applying for dental treatment who suffer from temporomandibular joint osteoarthritis (TMJOA). Osteoarthritis may be the cause of the pain in the area of temporomandibular joints, but its course may also be absolutely asymptomatic. The aim of this study was to present an interdisciplinary approach to TMJOA, including current diagnostics and treatment modalities on the basis of the available literature. Materials and Methods: PubMed and Scopus databases were analyzed using the keywords: ((temporomandibular joint AND osteoarthritis) AND imaging) and ((temporomandibular joint AND osteoarthritis) AND treatment). The bibliography was supplemented with books related to the temporomandibular joint. After screening 2450 results, the work was based in total on 98 publications. Results and Conclusions: Osteoarthritis is an inflammatory, age-related, chronic and progressive degenerative joint disease. Magnetic resonance imaging (MRI) and cone-beam computed tomography (CBCT), together with clinical symptoms, play significant roles in TMJOA diagnosis. Current MRI techniques seem to be clinically useful for assessment of bony changes in temporomandibular joint (TMJ) disorders. Treatment of TMJOA requires a complex, interdisciplinary approach. TMJOA treatment includes the cooperation of physiotherapists, rheumatologists, gnathologists, orthodontists and quite often also maxillofacial surgeons and prosthodontists. Sometimes additional pharmacotherapy is indicated. Thorough examination of TMJ function and morphology is necessary at the beginning of any orthodontic or dental treatment. Undiagnosed TMJ dysfunction may cause further problems with the entire masticatory system, including joints, muscles and teeth.

Noggin Inhibits IL-1β and BMP-2 Expression, and Attenuates Cartilage Degeneration and Subchondral Bone Destruction in Experimental Osteoarthritis.

Osteoarthritis (OA) is a chronic inflammatory and progressive joint disease that results in cartilage degradation and subchondral bone remodeling. The proinflammatory cytokine interleukin 1 beta (IL-1β) is abundantly expressed in OA and plays a crucial role in cartilage remodeling, although its role in the activity of chondrocytes in cartilage and subchondral remodeling remains unclear. In this study, stimulating chondrogenic ATDC5 cells with IL-1β increased the levels of bone morphogenetic protein 2 (BMP-2), promoted articular cartilage degradation, and enhanced structural remodeling. Immunohistochemistry staining and microcomputed tomography imaging of the subchondral trabecular bone region in the experimental OA rat model revealed that the OA disease promotes levels of IL-1β, BMP-2, and matrix metalloproteinase 13 (MMP-13) expression in the articular cartilage and enhances subchondral bone remodeling. The intra-articular injection of Noggin protein (a BMP-2 inhibitor) attenuated subchondral bone remodeling and disease progression in OA rats. We also found that IL-1β increased BMP-2 expression by activating the mitogen-activated protein kinase (MEK), extracellular signal-regulated kinase (ERK), and specificity protein 1 (Sp1) signaling pathways. We conclude that IL-1β promotes BMP-2 expression in chondrocytes via the MEK/ERK/Sp1 signaling pathways. The administration of Noggin protein reduces the expression of IL-1β and BMP-2, which prevents cartilage degeneration and OA development.

Chondrocalcinosis of the Knee and the Risk of Osteoarthritis Progression: Data From the Knee and Hip Osteoarthritis Long-term Assessment Cohort.

To assess the impact of knee chondrocalcinosis (CC) on the 5-year risk of joint replacement and disease progression in patients with knee osteoarthritis (OA). Patients with symptomatic knee OA without previous total joint (knee or hip) replacement (TJR) were recruited from the Knee and Hip Osteoarthritis Long-term Assessment cohort. Cox proportional hazards regression and generalized estimating equation models were used to compare the time from inclusion or OA diagnosis to total knee replacement (TKR) or TJR between patients with and those without knee CC at inclusion. In patients without incident TKR, logistic regression was performed to examine the association between CC and radiographic progression (Kellgren/Lawrence [K/L] grade) or worsening of Western Ontario and McMaster Universities Arthritis Index (WOMAC) subscores for OA pain or function between years 0 and 5. Hazard ratios (HRs) and 95% confidence intervals (95% CIs) were estimated. Analyses were adjusted for age, sex, body mass index, WOMAC subscores, and K/L grade. Among the 656 patients included, 93 (14.2%) had knee CC, and 91 (13.9%) underwent TKR during the follow-up. Risk of TKR was not affected by the presence of knee CC (HR 1.26 [95% CI 0.74-2.17]). Similar results were obtained for the risk of incident TJR. For patients without incident TKR, knee CC did not affect the risk of worsening of K/L grade (odds ratio [OR] 0.9 [95% CI 0.4-1.7]), WOMAC pain subscore (OR 1.1 [95% CI 0.7-1.4]), or WOMAC function subscore (OR 0.9 [95% CI 0.4-2.0]). In patients with symptomatic knee OA, the presence of knee CC did not affect the risk of arthroplasty or disease progression at 5 years.

CD11B activation prevents chondrocyte mineralization and osteoarthritis progression

Purpose: Osteoarthritis (OA) is a progressive joint disease that is strongly associated with calcium-containing crystal formation (mineralization) by chondrocytes leading ultimately to joint calcification. However, this calcification process is poorly understood and treatments targeting underlying disease mechanisms lacking. CD11b integrin (CD11b/CD18, Mac-1, or αMβ2) is a member of the beta 2 integrin family of adhesion receptors, critically involved in the development of several inflammatory diseases, including collagen-induced arthritis, where CD11b-deficient mice exhibited increased cartilage degradation as compared with those of WT control animals.

G-protein receptor kinase 2 inhibition attenuates osteoarthritis progression and promotes parathyroid hormone chondroprotection

Purpose: This study aimed to evaluate the role of GRK2 inhibition in PTH1R resensitization and PTH-mediated chondroprotection in OA. Osteoarthritis (OA) is a progressive degenerative joint disease, highlighted by chondrocyte hypertrophy, cartilage degeneration, subchondral bone remodeling, and synovial inflammation. Current treatments are limited to palliative pain management therapies with little potential to prevent further disease progression. Parathyroid hormone (PTH) has demonstrated chondroprotective and chondroregenerative effects in OA mice.

Vitamin D levels are inversely associated with osteophyte formation in elderly women, but not men - a population-based cohort study “The Bunkyo Health Study”

Purpose: Osteoarthritis of the knee (knee OA) is a slowly progressive joint disease and a leading cause of impaired mobility in elderlies. Vitamin D insufficiency and deficiency are common in elderly women. As vitamin D plays an important role for formation and mineralization of both bone and cartilage in growth plate, vitamin D insufficiency and/or deficiency has been speculated to affect not only osteoporosis but also knee OA. However, it is still controversial whether or how vitamin D insufficiency and deficiency is involved in the pathophysiology of knee OA.

Association between medial meniscus extrusion in knee osteoarthritis and locomotive syndrome in the elderly population

Purpose: Osteoarthritis of the knee (knee OA) is a slowly progressive joint disease and a leading cause of impaired mobility in the elderly. Functional meniscus disorder has been considered to be a secondary phenomenon of the pathogenesis of knee OA, and medial meniscus extrusion (MME) is one of the important role in the process of OA pathogenesis. Histologically, osteophytes are composed of the cartilage and bone parts. Because of the limitation in detectability of the cartilage part of osteophytes by radiography or conventional magnetic resonance imaging (MRI), we have reported that the cartilage part of osteophytes can be detected by using T2 mapping MRI.