Pub Date : 2025-03-01DOI: 10.1016/j.ostima.2024.100255
Arjun Parmar , Anthony A. Gatti , Ryan Fajardo , Matthew S. Harkey
Objective
Traditional assessments of femoral bone shape are not always available and do not adequately describe the full complexity of concave bone shape. We aimed to develop and validate an ultrasound-based statistical shape model (SSM) and a derived bone shape score (B-score) to quantify the femoral trochlear morphology associated with anterior cruciate ligament reconstruction (ACLR).
Design
This was a cross-sectional investigation involving 20 individuals with and 28 individuals without a history of ACLR. Bilateral ultrasound images of the femoral trochlear groove were acquired and analyzed. Both the SSM and B-score were validated using 5-fold cross-validation, assessing reconstruction and classification accuracy, respectively.
Results
In held-out test data, the SSM captured over 99% of the bone shape variance with minimal reconstruction error (RMSE = 0.027 ± 0.004 mm). On test data, the B-score accurately quantified bone shape associated with ACLR, demonstrating high accuracy (92.42%), sensitivity (97.37%), specificity (85.71%), and AUROC (0.95). A B-score threshold of 1.41 standard deviations from the mean healthy bone shape was identified for classifying ACLR history.
Conclusions
The ultrasound-based SSM and derived B-score provide a valid and accessible method for quantifying femoral trochlear bone shape changes post-ACLR. This approach offers potential for early detection of bone shape changes associated with disease and injury, improving long-term outcomes for ACLR patients. Future research should focus on enhancing model generalizability and assessment of bone shape changes longitudinally.
{"title":"Ultrasound-based statistical shape modeling for quantifying femoral trochlear bone shape post-ACLR","authors":"Arjun Parmar , Anthony A. Gatti , Ryan Fajardo , Matthew S. Harkey","doi":"10.1016/j.ostima.2024.100255","DOIUrl":"10.1016/j.ostima.2024.100255","url":null,"abstract":"<div><h3>Objective</h3><div>Traditional assessments of femoral bone shape are not always available and do not adequately describe the full complexity of concave bone shape. We aimed to develop and validate an ultrasound-based statistical shape model (SSM) and a derived bone shape score (B-score) to quantify the femoral trochlear morphology associated with anterior cruciate ligament reconstruction (ACLR).</div></div><div><h3>Design</h3><div>This was a cross-sectional investigation involving 20 individuals with and 28 individuals without a history of ACLR. Bilateral ultrasound images of the femoral trochlear groove were acquired and analyzed. Both the SSM and B-score were validated using 5-fold cross-validation, assessing reconstruction and classification accuracy, respectively.</div></div><div><h3>Results</h3><div>In held-out test data, the SSM captured over 99% of the bone shape variance with minimal reconstruction error (RMSE = 0.027 ± 0.004 mm). On test data, the B-score accurately quantified bone shape associated with ACLR, demonstrating high accuracy (92.42%), sensitivity (97.37%), specificity (85.71%), and AUROC (0.95). A B-score threshold of 1.41 standard deviations from the mean healthy bone shape was identified for classifying ACLR history.</div></div><div><h3>Conclusions</h3><div>The ultrasound-based SSM and derived B-score provide a valid and accessible method for quantifying femoral trochlear bone shape changes post-ACLR. This approach offers potential for early detection of bone shape changes associated with disease and injury, improving long-term outcomes for ACLR patients. Future research should focus on enhancing model generalizability and assessment of bone shape changes longitudinally.</div></div>","PeriodicalId":74378,"journal":{"name":"Osteoarthritis imaging","volume":"5 1","pages":"Article 100255"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143684763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-01DOI: 10.1016/j.ostima.2024.100257
David J. Hunter , Leticia A. Deveza
The community acknowledges the staggering prevalence and disabling nature of osteoarthritis, and the crucial need for therapeutic advancement. In our quest to define a clinically meaningful endpoint and identify biomarkers that can serve as short-term treatment responses and reliable predictors of long-term outcomes, we must also strive to target therapies more effectively. This perspective article not only aims to elucidate the nomenclature of osteoarthritis types but also proposes a path towards greater transparency that has the potential to inspire a new era of both research and clinical practice.
{"title":"Deconstructing the “types” of osteoarthritis","authors":"David J. Hunter , Leticia A. Deveza","doi":"10.1016/j.ostima.2024.100257","DOIUrl":"10.1016/j.ostima.2024.100257","url":null,"abstract":"<div><div>The community acknowledges the staggering prevalence and disabling nature of osteoarthritis, and the crucial need for therapeutic advancement. In our quest to define a clinically meaningful endpoint and identify biomarkers that can serve as short-term treatment responses and reliable predictors of long-term outcomes, we must also strive to target therapies more effectively. This perspective article not only aims to elucidate the nomenclature of osteoarthritis types but also proposes a path towards greater transparency that has the potential to inspire a new era of both research and clinical practice.</div></div>","PeriodicalId":74378,"journal":{"name":"Osteoarthritis imaging","volume":"5 1","pages":"Article 100257"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143684765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-01DOI: 10.1016/j.ostima.2024.100258
Jonathan R. Hill , Edwin H.G. Oei , Kay M. Crossley , Hylton B. Menz , Erin M. Macri , Michelle D. Smith , Narelle Wyndow , Liam R. Maclachlan , Megan H. Ross , Natalie J. Collins
Objective
Conduct a scoping review to describe the use and application of different radiographic classification approaches to grade patellofemoral osteoarthritis (PFOA) in literature published during a representative period (2014–2018), and describe reported measurement properties of these grading criteria.
Design
The scoping review was conducted in accordance with PRISMA-ScR guidelines. Eight electronic databases were searched using keywords relating to “patellofemoral” and “radiograph”. Two independent assessors screened each record for eligibility. English-language studies published in the years 2014 to 2018 were included if they acquired patellofemoral joint (PFJ) radiographs, described the method of radiograph acquisition, and reported grading PFOA. We excluded non-human and cadaveric studies, single-case studies, and studies with mean participant age <10 years. Studies that reported measurement properties underwent quality appraisal using the COSMIN Risk of Bias Tool. Descriptive statistics were reported.
Results
Of 18,678 records identified, 177 articles were selected. Twenty-six classification approaches to grade radiographic PFOA were reported, with Kellgren-Lawrence (KL) (n = 70, 40 %), OsteoArthritis Research Society International (OARSI) (n = 26, 15 %), and Iwano (n = 25, 14 %) most prevalent. Axial projections (n = 81, 46 %) were most commonly used to grade PFOA, followed by lateral (n = 31, 18 %) and frontal (n = 16, 9 %) projections. KL was most frequently used across settings, disciplines, and regions. Reliability data was reported by 32 (18 %) studies.
Conclusions
Multiple radiographic OA classification approaches were used to grade PFOA during the representative period, although few are specific to the PFJ. We recommend that a reliable and valid PFOA radiographic grading approach be developed using standardized PFJ radiograph acquisition techniques.
目的对代表性时期(2014-2018年)发表的文献中不同放射学分级方法对髌骨股骨关节炎(PFOA)分级的使用和应用进行范围综述,并描述这些分级标准的测量特性。根据PRISMA-ScR指南进行范围审查。使用与“髌骨”和“x线摄影”相关的关键词检索8个电子数据库。两名独立评审员对每条记录的资格进行了筛选。2014年至2018年发表的英文研究包括获得髌骨股骨关节(PFJ) x线片、描述x线片获取方法和报告PFOA分级的研究。我们排除了非人类和尸体研究、单病例研究和参与者平均年龄为10岁的研究。使用COSMIN偏倚风险工具对报告测量特性的研究进行质量评估。进行描述性统计。结果从18678条文献中筛选出177篇文献。报道了26种放射学PFOA分级方法,其中kellglen - lawrence (n = 70,40 %), OsteoArthritis Research Society International (OARSI) (n = 26,15 %)和Iwano (n = 25,14 %)最流行。轴位投影(n = 81, 46%)最常用于PFOA分级,其次是侧位投影(n = 31, 18%)和额位投影(n = 16, 9%)。KL最常用于各种设置、学科和地区。32项(18%)研究报告了可靠性数据。结论在代表性时期,有多种放射学OA分级方法用于对PFOA进行分级,但很少有针对PFJ的分级方法。我们建议使用标准化的PFJ x线片采集技术开发一种可靠有效的PFOA x线片分级方法。
{"title":"Classification approaches used to grade radiographic patellofemoral osteoarthritis: A scoping review","authors":"Jonathan R. Hill , Edwin H.G. Oei , Kay M. Crossley , Hylton B. Menz , Erin M. Macri , Michelle D. Smith , Narelle Wyndow , Liam R. Maclachlan , Megan H. Ross , Natalie J. Collins","doi":"10.1016/j.ostima.2024.100258","DOIUrl":"10.1016/j.ostima.2024.100258","url":null,"abstract":"<div><h3>Objective</h3><div>Conduct a scoping review to describe the use and application of different radiographic classification approaches to grade patellofemoral osteoarthritis (PFOA) in literature published during a representative period (2014–2018), and describe reported measurement properties of these grading criteria.</div></div><div><h3>Design</h3><div>The scoping review was conducted in accordance with PRISMA-ScR guidelines. Eight electronic databases were searched using keywords relating to “patellofemoral” and “radiograph”. Two independent assessors screened each record for eligibility. English-language studies published in the years 2014 to 2018 were included if they acquired patellofemoral joint (PFJ) radiographs, described the method of radiograph acquisition, and reported grading PFOA. We excluded non-human and cadaveric studies, single-case studies, and studies with mean participant age <10 years. Studies that reported measurement properties underwent quality appraisal using the COSMIN Risk of Bias Tool. Descriptive statistics were reported.</div></div><div><h3>Results</h3><div>Of 18,678 records identified, 177 articles were selected. Twenty-six classification approaches to grade radiographic PFOA were reported, with Kellgren-Lawrence (KL) (<em>n</em> = 70, 40 %), OsteoArthritis Research Society International (OARSI) (<em>n</em> = 26, 15 %), and Iwano (<em>n</em> = 25, 14 %) most prevalent. Axial projections (<em>n</em> = 81, 46 %) were most commonly used to grade PFOA, followed by lateral (<em>n</em> = 31, 18 %) and frontal (<em>n</em> = 16, 9 %) projections. KL was most frequently used across settings, disciplines, and regions. Reliability data was reported by 32 (18 %) studies.</div></div><div><h3>Conclusions</h3><div>Multiple radiographic OA classification approaches were used to grade PFOA during the representative period, although few are specific to the PFJ. We recommend that a reliable and valid PFOA radiographic grading approach be developed using standardized PFJ radiograph acquisition techniques.</div></div>","PeriodicalId":74378,"journal":{"name":"Osteoarthritis imaging","volume":"5 1","pages":"Article 100258"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143684671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-01DOI: 10.1016/j.ostima.2024.100260
Arjun Parmar , Corey D Grozier , Robert Dima , Jessica E Tolzman , Ilker Hacihaliloglu , Kenneth L Cameron , Ryan Fajardo , Matthew S Harkey
Advancements in wireless ultrasound technology allow for point of care cartilage imaging, yet validation against traditional ultrasound units remains to be established for knee cartilage outcomes. Therefore, the purpose of our study was to establish the replicability, reliability and agreement, of articular cartilage thickness and echo-intensity measures between traditional and wireless ultrasound units utilizing automatic-gain and normalization techniques. We used traditional and wireless ultrasound to assess the femoral cartilage via transverse suprapatellar scans with the knee in maximum flexion in 71 female NCAA Division I athletes (age: 20.0 ± 1.3 years, height: 171.7 ± 8.7 cm, mass: 69.4 ± 11.0 kg). Wireless ultrasound images (auto-gain and standard gain) were compared to traditional ultrasound images (standard gain) before and after normalization. Ultrasound image pixel values were algebraically scaled to normalize differences between units in image acquisition. Mean thickness and echo-intensity of the global and sub-regions of interest were measured across imaging parameters. Intraclass correlation coefficients (ICC2,k) for reliability, standard error of the measurement, minimum detectable difference, and Bland-Altman plots for agreement were calculated between ultrasound units across imaging parameters. Cartilage thickness demonstrated good to excellent reliability (ICC2,k = 0.83–0.95) and minimal bias (-0.06–0.03 mm), in all regions regardless of gain and normalization. However, mean echo-intensity demonstrated poor to moderate reliability (ICC2,k = 0.23–0.68) and moderate bias (-9.8–6.5 au) in all regions, regardless of gain and normalization. While there was a high level of replicability between units when assessing cartilage thickness, further research in ultrasound beam forming may lead to improvements in replicability of cartilage echo-intensity between ultrasound units.
{"title":"Wireless vs. traditional ultrasound assessed knee cartilage outcomes utilizing automated gain and normalization techniques","authors":"Arjun Parmar , Corey D Grozier , Robert Dima , Jessica E Tolzman , Ilker Hacihaliloglu , Kenneth L Cameron , Ryan Fajardo , Matthew S Harkey","doi":"10.1016/j.ostima.2024.100260","DOIUrl":"10.1016/j.ostima.2024.100260","url":null,"abstract":"<div><div>Advancements in wireless ultrasound technology allow for point of care cartilage imaging, yet validation against traditional ultrasound units remains to be established for knee cartilage outcomes. Therefore, the purpose of our study was to establish the replicability, reliability and agreement, of articular cartilage thickness and echo-intensity measures between traditional and wireless ultrasound units utilizing automatic-gain and normalization techniques. We used traditional and wireless ultrasound to assess the femoral cartilage via transverse suprapatellar scans with the knee in maximum flexion in 71 female NCAA Division I athletes (age: 20.0 ± 1.3 years, height: 171.7 ± 8.7 cm, mass: 69.4 ± 11.0 kg). Wireless ultrasound images (auto-gain and standard gain) were compared to traditional ultrasound images (standard gain) before and after normalization. Ultrasound image pixel values were algebraically scaled to normalize differences between units in image acquisition. Mean thickness and echo-intensity of the global and sub-regions of interest were measured across imaging parameters. Intraclass correlation coefficients (ICC<sub>2,</sub><em><sub>k</sub></em>) for reliability, standard error of the measurement, minimum detectable difference, and Bland-Altman plots for agreement were calculated between ultrasound units across imaging parameters. Cartilage thickness demonstrated good to excellent reliability (ICC<sub>2,</sub><em><sub>k</sub></em> = 0.83–0.95) and minimal bias (-0.06–0.03 mm), in all regions regardless of gain and normalization. However, mean echo-intensity demonstrated poor to moderate reliability (ICC<sub>2,</sub><em><sub>k</sub></em> = 0.23–0.68) and moderate bias (-9.8–6.5 au) in all regions, regardless of gain and normalization. While there was a high level of replicability between units when assessing cartilage thickness, further research in ultrasound beam forming may lead to improvements in replicability of cartilage echo-intensity between ultrasound units.</div></div>","PeriodicalId":74378,"journal":{"name":"Osteoarthritis imaging","volume":"5 1","pages":"Article 100260"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143684675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-01DOI: 10.1016/j.ostima.2024.100259
Francis Berenbaum
Knee osteoarthritis (OA) is a global health challenge with substantial unmet therapeutic needs. Current treatments primarily target symptoms without altering the disease's progression. Synovitis, the inflammation of synovial tissue, is a key driver of both pain and structural changes in OA. This Perspective proposes a paradigm shift, positioning synovial health assessment as a cornerstone in the evaluation of new OA therapies. By doing so, it aims to accelerate development of effective disease modifying OA drugs (DMOADs) and improving patient outcomes. It highlights the potential of contrast enhanced-MRI (CE-MRI) to serve as a surrogate marker for synovial health, offering precise visualization of inflammation and its relationship with disease progression and pain.
{"title":"Perspective: Empowering osteoarthritis drug development through assessment of synovitis by CE-MRI: A new approach in clinical trials","authors":"Francis Berenbaum","doi":"10.1016/j.ostima.2024.100259","DOIUrl":"10.1016/j.ostima.2024.100259","url":null,"abstract":"<div><div>Knee osteoarthritis (OA) is a global health challenge with substantial unmet therapeutic needs. Current treatments primarily target symptoms without altering the disease's progression. Synovitis, the inflammation of synovial tissue, is a key driver of both pain and structural changes in OA. This Perspective proposes a paradigm shift, positioning synovial health assessment as a cornerstone in the evaluation of new OA therapies. By doing so, it aims to accelerate development of effective disease modifying OA drugs (DMOADs) and improving patient outcomes. It highlights the potential of contrast enhanced-MRI (CE-MRI) to serve as a surrogate marker for synovial health, offering precise visualization of inflammation and its relationship with disease progression and pain.</div></div>","PeriodicalId":74378,"journal":{"name":"Osteoarthritis imaging","volume":"5 1","pages":"Article 100259"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143684676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-01DOI: 10.1016/j.ostima.2024.100254
Patrick Omoumi, Julien Favre
{"title":"Editorial for the Special -Issue on Biomechanics and Imaging","authors":"Patrick Omoumi, Julien Favre","doi":"10.1016/j.ostima.2024.100254","DOIUrl":"10.1016/j.ostima.2024.100254","url":null,"abstract":"","PeriodicalId":74378,"journal":{"name":"Osteoarthritis imaging","volume":"5 1","pages":"Article 100254"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143684677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-01DOI: 10.1016/j.ostima.2024.100256
Felix Eckstein , Tanja Stamm , Jamie Collins
Objective
A vast array of structural/imaging and clinical endpoints/outcomes are available today to osteoarthritis epidemiologists or trialists. Which assessments are best suited for which studies remains unsettled. When several assessments are available, these may be analyzed together (simultaneously or hierarchically), using statistical modeling and adjustment. Or, alternatively, they may be combined to form more complex multi-component or composite (potentially multi-domain) endpoints/outcomes. This review describes such concepts and their challenges, using examples from current osteoarthritis imaging research.
Design
A narrative, non-systematic literature search (PubMed and others) was conducted, and informal consultations were held with experts in the field. The identified concepts and experimental findings were then organized to present an integrated framework.
Results
Single imaging assessments can encompass one (uni-dimensional) or more (multi-dimensional) structures. Integration of image assessments of one structure/tissue across anatomical locations provides aggregate measures. This can also be created across heterogeneous (multi-dimensional) types of assessments (multi-component/composite), either within an area (such as imaging - single domain) or across broader areas of health and well-being (multi-domain). Weighting, standardization, and (clinical) usefulness are crucial characteristics of multi-component/composite endpoints. Examples of these concepts are here provided in the context of osteoarthritis imaging.
Conclusions
Options for multi-component/composite endpoints in osteoarthritis research are virtually infinite. Smart research strategies are required to explore and validate these vast possibilities, with appropriate statistical treatment being paramount. A one-size/endpoint-fits-all approach will likely fail in observational and interventional studies. Imaging assessment needs to be tailored to both the drug's unique mechanism of action, and to the participants’ morpho-type.
{"title":"Which endpoints should be applied in interventional trials? – From single uni-dimensional assessment tailored to a drug's mechanism of action to multi-component measures and multi-domain composites","authors":"Felix Eckstein , Tanja Stamm , Jamie Collins","doi":"10.1016/j.ostima.2024.100256","DOIUrl":"10.1016/j.ostima.2024.100256","url":null,"abstract":"<div><h3>Objective</h3><div>A vast array of structural/imaging and clinical endpoints/outcomes are available today to osteoarthritis epidemiologists or trialists. Which assessments are best suited for which studies remains unsettled. When several assessments are available, these may be analyzed together (simultaneously or hierarchically), using statistical modeling and adjustment. Or, alternatively, they may be combined to form more complex multi-component or composite (potentially multi-domain) endpoints/outcomes. This review describes such concepts and their challenges, using examples from current osteoarthritis imaging research.</div></div><div><h3>Design</h3><div>A narrative, non-systematic literature search (PubMed and others) was conducted, and informal consultations were held with experts in the field. The identified concepts and experimental findings were then organized to present an integrated framework.</div></div><div><h3>Results</h3><div>Single imaging assessments can encompass one (uni-dimensional) or more (multi-dimensional) structures. Integration of image assessments of one structure/tissue across anatomical locations provides aggregate measures. This can also be created across heterogeneous (multi-dimensional) types of assessments (multi-component/composite), either within an area (such as imaging - single domain) or across broader areas of health and well-being (multi-domain). Weighting, standardization, and (clinical) usefulness are crucial characteristics of multi-component/composite endpoints. Examples of these concepts are here provided in the context of osteoarthritis imaging.</div></div><div><h3>Conclusions</h3><div>Options for multi-component/composite endpoints in osteoarthritis research are virtually infinite. Smart research strategies are required to explore and validate these vast possibilities, with appropriate statistical treatment being paramount. A one-size/endpoint-fits-all approach will likely fail in observational and interventional studies. Imaging assessment needs to be tailored to both the drug's unique mechanism of action, and to the participants’ morpho-type.</div></div>","PeriodicalId":74378,"journal":{"name":"Osteoarthritis imaging","volume":"5 1","pages":"Article 100256"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143684764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-01DOI: 10.1016/j.ostima.2025.100261
David A Walsh , Daniel F McWilliams
Osteoarthritis (OA) pain is associated with structural changes in the joint, which are usually quantified by imaging techniques. It is anticipated that structural disease modifying OA drugs (DMOADs) would reduce the burden of OA pain. However, nociceptive pain is moderated by the central nervous system. Central sensitization, increased activity in central nervous system neurones in response to a standard nociceptive input, is one reason why disease modification might not effectively relieve OA pain. Central sensitization may result from facilitated central neuronal activity, or inadequate inhibition by endogenous analgesic mechanisms. It changes the experience of pain: its severity, distribution and qualities, and its emotional and cognitive dimensions. Central sensitization can be a barrier to analgesic benefit from treatments directed at joint structure, and central pain processing can obscure analgesic benefit from structural modification in randomised controlled trials. Indices of central pain hypersensitivity might reflect central sensitization in humans. They include self-report questionnaires such as the Central Aspects of Pain (CAP) and short form Central Sensitization Inventory (CSI-9), and quantitative sensory testing (QST) modalities of Pressure Pain detection Thresholds distant to the affected joint, Temporal Summation, and Conditioned Pain Modulation. Understanding, measuring, managing and adjusting for central pain hypersensitivity should increase the power of clinical trials to demonstrate that DMOADs not only improve joint imaging outcomes, but also improve pain, the predominant clinical problem of OA.
{"title":"The importance of central sensitization for clinical trials of disease modifying osteoarthritis drugs (DMOADs)","authors":"David A Walsh , Daniel F McWilliams","doi":"10.1016/j.ostima.2025.100261","DOIUrl":"10.1016/j.ostima.2025.100261","url":null,"abstract":"<div><div>Osteoarthritis (OA) pain is associated with structural changes in the joint, which are usually quantified by imaging techniques. It is anticipated that structural disease modifying OA drugs (DMOADs) would reduce the burden of OA pain. However, nociceptive pain is moderated by the central nervous system. Central sensitization, increased activity in central nervous system neurones in response to a standard nociceptive input, is one reason why disease modification might not effectively relieve OA pain. Central sensitization may result from facilitated central neuronal activity, or inadequate inhibition by endogenous analgesic mechanisms. It changes the experience of pain: its severity, distribution and qualities, and its emotional and cognitive dimensions. Central sensitization can be a barrier to analgesic benefit from treatments directed at joint structure, and central pain processing can obscure analgesic benefit from structural modification in randomised controlled trials. Indices of central pain hypersensitivity might reflect central sensitization in humans. They include self-report questionnaires such as the Central Aspects of Pain (CAP) and short form Central Sensitization Inventory (CSI-9), and quantitative sensory testing (QST) modalities of Pressure Pain detection Thresholds distant to the affected joint, Temporal Summation, and Conditioned Pain Modulation. Understanding, measuring, managing and adjusting for central pain hypersensitivity should increase the power of clinical trials to demonstrate that DMOADs not only improve joint imaging outcomes, but also improve pain, the predominant clinical problem of OA.</div></div>","PeriodicalId":74378,"journal":{"name":"Osteoarthritis imaging","volume":"5 1","pages":"Article 100261"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143684672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-22DOI: 10.1016/j.ostima.2024.100252
David B. Jordan , Sohail Daulat , Trevour Greene , John C. Elfar , C. Kent Kwoh , Zong-Ming Li
Objective
Functional hand activity induces complex motion of the trapeziometacarpal (TMC) joint. Analyzing the TMC joint motion in vivo can aid in understanding joint behavior and lead to advancements in joint health evaluation. The purpose of this study was to quantify TMC joint motion during pinching using ultrasonography.
Design
Healthy participants (n = 10) held a pinch meter in key pinch configuration and pinched to three prescribed force levels. Ultrasonography was used to record the motion of the TMC joint. The position and rotation of the first metacarpal were calculated. Repeated measures one-way ANOVAs were used for comparisons (α = 0.05).
Results
When the pinch force was increased from 0 to 10, 20 and 30 N, the first metacarpal translated in the dorsal(+)/volar(-) direction -0.3 mm [95 % CI: (-0.5 mm, -0.1 mm); p = 0.0151], -0.5 mm [95 % CI: (-0.8 mm, -0.1 mm); p = 0.0113] and -0.8 mm [95 % CI: (-1.4 mm, -0.2 mm); p = 0.0146]. Significance was not observed for proximal(+)/distal(-) translation (p = 0.224). The metacarpal rotated in the abduction(+)/adduction(-) direction 0.7° [95 % CI: (-0.8°, 2.1°); p = 0.3239], 2.6° [95 % CI: (0.1°, 5.1°); p = 0.0416] and 3.3° [95 % CI: (0.2°, 6.3°); p = 0.0393], at pinch forces of 10, 20 and 30 N, respectively.
Conclusions
The TMC joint undergoes volar translation and abduction rotation during pinch tasks. Ultrasonography can be used to quantify this motion and aid in the advancement of joint behavioral study.
目的手部功能活动会引起梯形掌(TMC)关节的复杂运动。分析 TMC 关节的活体运动有助于理解关节行为,并促进关节健康评估。本研究的目的是利用超声波成像技术量化捏挤过程中的 TMC 关节运动。设计健康的参与者(n = 10)手持捏挤仪,以关键捏挤姿势捏挤三个规定的力值。超声波检查用于记录 TMC 关节的运动。计算第一掌骨的位置和旋转。结果当捏合力从 0 增加到 10、20 和 30 N 时,第一掌骨向背侧(+)/侧(-)方向平移 -0.3 mm [95 % CI: (-0.5 mm, -0.1 mm); p = 0.0151]、-0.5 mm [95 % CI: (-0.8 mm, -0.1 mm); p = 0.0113]和-0.8 mm [95 % CI: (-1.4 mm, -0.2 mm); p = 0.0146]。近端(+)/远端(-)平移无显著性差异(p = 0.224)。掌骨向内收(+)/外展(-)方向旋转了 0.7° [95 % CI:(-0.8°,2.1°);p = 0.3239]、2.6° [95 % CI:(0.1°,5.1°);p = 0.0416] 和 3.3° [95 % CI:(0.结论 TMC 关节在夹持过程中会发生外翻和外展旋转。超声波检查可用于量化这种运动,并有助于推进关节行为学研究。
{"title":"Trapeziometacarpal joint movement during pinching measured by ultrasonography","authors":"David B. Jordan , Sohail Daulat , Trevour Greene , John C. Elfar , C. Kent Kwoh , Zong-Ming Li","doi":"10.1016/j.ostima.2024.100252","DOIUrl":"10.1016/j.ostima.2024.100252","url":null,"abstract":"<div><h3>Objective</h3><div>Functional hand activity induces complex motion of the trapeziometacarpal (TMC) joint. Analyzing the TMC joint motion in vivo can aid in understanding joint behavior and lead to advancements in joint health evaluation. The purpose of this study was to quantify TMC joint motion during pinching using ultrasonography.</div></div><div><h3>Design</h3><div>Healthy participants (<em>n</em> = 10) held a pinch meter in key pinch configuration and pinched to three prescribed force levels. Ultrasonography was used to record the motion of the TMC joint. The position and rotation of the first metacarpal were calculated. Repeated measures one-way ANOVAs were used for comparisons (α = 0.05).</div></div><div><h3>Results</h3><div>When the pinch force was increased from 0 to 10, 20 and 30 N, the first metacarpal translated in the dorsal(+)/volar(-) direction -0.3 mm [95 % CI: (-0.5 mm, -0.1 mm); <em>p</em> = 0.0151], -0.5 mm [95 % CI: (-0.8 mm, -0.1 mm); <em>p</em> = 0.0113] and -0.8 mm [95 % CI: (-1.4 mm, -0.2 mm); <em>p</em> = 0.0146]. Significance was not observed for proximal(+)/distal(-) translation (<em>p</em> = 0.224). The metacarpal rotated in the abduction(+)/adduction(-) direction 0.7° [95 % CI: (-0.8°, 2.1°); <em>p</em> = 0.3239], 2.6° [95 % CI: (0.1°, 5.1°); <em>p</em> = 0.0416] and 3.3° [95 % CI: (0.2°, 6.3°); <em>p</em> = 0.0393], at pinch forces of 10, 20 and 30 N, respectively.</div></div><div><h3>Conclusions</h3><div>The TMC joint undergoes volar translation and abduction rotation during pinch tasks. Ultrasonography can be used to quantify this motion and aid in the advancement of joint behavioral study.</div></div>","PeriodicalId":74378,"journal":{"name":"Osteoarthritis imaging","volume":"4 4","pages":"Article 100252"},"PeriodicalIF":0.0,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142593279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}