Osteoarthritis imaging最新文献_第3页

Shear wave elastography reveals elevated infrapatellar fat pad stiffness in patients with early osteoarthritis symptoms after ACL reconstruction 剪切波弹性成像显示前交叉韧带重建后早期骨关节炎症状患者髌下脂肪垫僵硬度升高

Osteoarthritis imaging

Pub Date : 2025-06-01 DOI: 10.1016/j.ostima.2025.100267

Matthew S. Harkey , Corey D. Grozier , Jessica Tolzman , Arjun Parmar , Toufic R. Jildeh , Micah Lissy , Robert Dima , Harvi F. Hart , Ryan Fajardo

Objective

The infrapatellar fat pad (IPFP) plays an important role in knee biomechanics and inflammation, particularly following anterior cruciate ligament reconstruction (ACLR). This study investigated whether IPFP stiffness, measured with shear wave elastography, is associated with early symptoms of osteoarthritis (OA) in individuals within one year after ACLR.

Design

In this cross-sectional study, 24 participants underwent bilateral IPFP stiffness assessments using shear wave elastography. Participants were positioned supine with 20° knee flexion. The stiffness limb symmetry index (LSI) was calculated to normalize stiffness between the ACLR and contralateral limbs. Early OA symptoms were defined as scores ≤85 % on at least two of four subscales of the Knee Injury and Osteoarthritis Outcome Score (KOOS). Independent t-tests were used to evaluate group differences in IPFP stiffness LSI, and receiver operating characteristic curve analysis determined the optimal LSI threshold for discriminating between groups.

Results

Eleven participants (46 %) showed early OA symptoms. Participants with early OA symptoms exhibited a significantly higher IPFP stiffness LSI compared to those without symptoms (49.2 ± 48.7 % vs. -17.3 ± 34.4 %, p < 0.001). An optimal stiffness LSI threshold of 7.1 % was identified, achieving 90.9 % sensitivity, 92.3 % specificity, and an area under the curve of 0.94.

Conclusions

Shear wave elastography shows potential as a non-invasive tool for detecting early IPFP stiffness changes associated with OA symptoms post-ACLR. These findings suggest that IPFP stiffness may be an early marker for OA risk, warranting further longitudinal studies to evaluate its progression and to further examine the clinical utility of shear wave elastography.

目的髌下脂肪垫（IPFP）在膝关节生物力学和炎症中起重要作用，特别是在前交叉韧带重建（ACLR）后。本研究调查了用剪切波弹性成像测量的IPFP刚度是否与ACLR后一年内个体骨关节炎（OA）的早期症状相关。在这项横断面研究中，24名参与者使用横波弹性图对双侧IPFP刚度进行了评估。受试者仰卧位，膝关节屈曲20°。计算刚度肢对称指数（LSI），将ACLR和对侧肢之间的刚度归一化。早期骨关节炎症状被定义为在膝关节损伤和骨关节炎结局评分（oos）的四个亚量表中至少两个得分≤85%。采用独立t检验评估IPFP硬度LSI的组间差异，并通过受试者工作特征曲线分析确定区分组间的最佳LSI阈值。结果6例患者（46%）出现早期OA症状。早期OA症状的参与者与无症状的参与者相比，IPFP僵硬度LSI明显更高(49.2±48.7% vs -17.3±34.4%,p <；0.001)。最佳硬度LSI阈值为7.1%，灵敏度为90.9%，特异度为92.3%，曲线下面积为0.94。结论剪切波弹性成像显示了作为一种无创工具检测与aclr后OA症状相关的早期IPFP刚度变化的潜力。这些发现表明，IPFP刚度可能是OA风险的早期标志，需要进一步的纵向研究来评估其进展，并进一步检查剪切波弹性成像的临床应用。

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引用次数: 0

Meniscal degeneration among knees without radiographic osteoarthritis correlates with changes in disease activity and subsequent cumulative damage: Data from the Osteoarthritis Initiative 无骨关节炎的膝关节半月板退变与疾病活动性的变化和随后的累积损伤相关：来自骨关节炎倡议的数据

Osteoarthritis imaging

Pub Date : 2025-06-01 DOI: 10.1016/j.ostima.2025.100264

Joshua T. Harvey , Timothy E. McAlindon , Jonggyu Baek , Jamie MacKay , Ming Zhang , Grace H. Lo , Shao-Hsien Liu , Charles B. Eaton , Matthew S. Harkey , Julieann C. Patarini , Jeffrey B. Driban

Objective

To explore the relationship between meniscal degeneration (intrameniscal signal alteration without a tear) and future osteoarthritis pathology as measured by composite scores based on magnetic resonance imaging (MRI) of disease activity (bone marrow lesions and effusion-synovitis volumes) and cumulative damage (articular cartilage damage).

Design

This analysis involved 225 participants from the Osteoarthritis Initiative with intact menisci (defined as normal or meniscal degeneration without tear) on MRI and no radiographic knee osteoarthritis at baseline. We used longitudinal MRIs from an existing study to calculate disease activity and cumulative damage. We used robust regression models to assess the association between baseline meniscal degeneration (exposure) and disease activity or cumulative damage at baseline and four annual follow-up visits (outcomes), adjusting for sex, race, age, static alignment, and body mass index.

Results

Our sample included 110 participants with normal menisci (77 % women, average age 55 [SD 7]) and 115 with meniscal degeneration (60 % women, average age 61 [SD 9]). Knees with meniscal degeneration were more likely to have, on average, 0.21 greater disease activity at 12 months than knees with normal menisci (parameter estimate = 0.21, 95 % confidence interval (CI) = 0.09, 0.33). The association persisted over time. In contrast, the association between meniscal degeneration and cumulative damage only became statistically significant at the 48-month visit (parameter estimate = 0.74, 95 % CI = 0.18, 1.31).

Conclusions

Meniscal degeneration was related to worsening disease activity earlier than articular cartilage damage among knees without radiographic osteoarthritis. Meniscal degeneration and disease activity are promising biomarkers for early detection and monitoring of osteoarthritis, and may inform potential early intervention strategies.

目的探讨半月板退变（无撕裂的半月板内信号改变）与未来骨关节炎病理的关系，通过基于疾病活动性（骨髓病变和积液-滑膜炎体积）和累积损伤（关节软骨损伤）的磁共振成像（MRI）综合评分来衡量。设计：本分析纳入225名来自骨关节炎倡议组织的参与者，他们在MRI上有完整的半月板（定义为正常或无撕裂的半月板变性），基线时没有膝骨关节炎影像学检查。我们使用一项现有研究的纵向核磁共振成像来计算疾病活动性和累积损伤。我们使用稳健回归模型来评估基线半月板变性（暴露）与疾病活动或基线和四次年度随访（结果）的累积损伤之间的关系，调整性别、种族、年龄、静态对齐和体重指数。结果我们的样本包括110名半月板正常（77%为女性，平均年龄55岁[SD 7]）和115名半月板变性（60%为女性，平均年龄61岁[SD 9]）的参与者。患有半月板变性的膝关节在12个月时的疾病活动性平均比半月板正常的膝关节高0.21（参数估计= 0.21,95%可信区间(CI) = 0.09, 0.33）。这种联系随着时间的推移而持续。相比之下，半月板退变和累积损伤之间的关联仅在48个月随访时才具有统计学意义（参数估计= 0.74,95% CI = 0.18, 1.31）。结论无影像学性骨关节炎患者的半月板退变比关节软骨损伤更早发生疾病活动度恶化。半月板变性和疾病活动是早期发现和监测骨关节炎的有希望的生物标志物，并可能为潜在的早期干预策略提供信息。

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引用次数: 0

Ultrasound-based statistical shape modeling for quantifying femoral trochlear bone shape post-ACLR 超声统计形状建模量化aclr术后股骨滑车骨形态

Osteoarthritis imaging

Pub Date : 2025-03-01 DOI: 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.

目的传统的股骨形状评估并不总是可用的，并且不能充分描述凹骨形状的全部复杂性。我们旨在开发和验证基于超声的统计形状模型（SSM）和衍生的骨形状评分（B-score），以量化与前交叉韧带重建（ACLR）相关的股骨滑车形态。这是一项横断面调查，包括20名有ACLR病史的人和28名没有ACLR病史的人。获取双侧股骨滑车沟超声图像并进行分析。SSM和B-score均采用5倍交叉验证进行验证，分别评估重建和分类准确性。结果SSM捕获了99%以上的骨形方差，重建误差最小（RMSE = 0.027±0.004 mm）。根据测试数据，B-score准确地量化了与ACLR相关的骨形状，具有较高的准确性（92.42%）、敏感性（97.37%）、特异性（85.71%）和AUROC（0.95）。b分阈值与平均健康骨骼形状的标准差为1.41，用于分类ACLR病史。结论超声SSM及衍生的b -评分为定量股骨滑车术后骨形态变化提供了一种有效、易行的方法。这种方法为早期发现与疾病和损伤相关的骨形状变化提供了潜力，改善了ACLR患者的长期预后。今后的研究应着重于提高模型的通用性和对骨形态变化的纵向评估。

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引用次数: 0

Deconstructing the “types” of osteoarthritis 解构骨关节炎的“类型”

Osteoarthritis imaging

Pub Date : 2025-03-01 DOI: 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.

社会认识到惊人的患病率和致残性骨关节炎，并迫切需要治疗进步。在我们寻求定义一个临床有意义的终点和确定生物标志物，可以作为短期治疗反应和可靠的预测长期结果的过程中，我们还必须努力更有效地靶向治疗。这篇前瞻性文章不仅旨在阐明骨关节炎类型的命名法，而且还提出了一条通往更大透明度的道路，这有可能激发研究和临床实践的新时代。

引用次数: 0

Classification approaches used to grade radiographic patellofemoral osteoarthritis: A scoping review 髌骨关节炎x线片分级的分类方法：范围检查综述

Osteoarthritis imaging

Pub Date : 2025-03-01 DOI: 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}

引用次数: 0

Wireless vs. traditional ultrasound assessed knee cartilage outcomes utilizing automated gain and normalization techniques 无线超声和传统超声利用自动增益和归一化技术评估膝关节软骨的预后

Osteoarthritis imaging

Pub Date : 2025-03-01 DOI: 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 (ICC_2,_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 (ICC_2,_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 (ICC_2,_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.

无线超声技术的进步使点护理软骨成像成为可能，但传统超声设备对膝关节软骨结果的验证仍有待建立。因此，我们研究的目的是利用自动增益和归一化技术，在传统和无线超声装置之间建立关节软骨厚度和回声强度测量的可复制性、可靠性和一致性。我们对71名NCAA一级赛区女性运动员（年龄：20.0±1.3岁，身高：171.7±8.7 cm，体重：69.4±11.0 kg）进行膝最大屈曲时的髌上横向扫描，采用传统超声和无线超声评估股骨软骨。将归一化前后的无线超声图像（自动增益和标准增益）与传统超声图像（标准增益）进行比较。超声图像像素值的代数缩放，以归一化在图像采集单位之间的差异。通过成像参数测量感兴趣的全局和子区域的平均厚度和回波强度。计算跨成像参数的超声单元之间的可靠性相关系数（ICC2,k）、测量标准误差、最小可检测差异和Bland-Altman图的一致性。无论增益和归一化如何，软骨厚度在所有区域均表现出良好至优异的可靠性（ICC2,k = 0.83-0.95）和最小偏差（-0.06-0.03 mm）。然而，无论增益和归一化如何，平均回波强度在所有区域都表现出较差至中等的可靠性（ICC2,k = 0.23-0.68）和中等偏倚（-9.8-6.5 au）。虽然在评估软骨厚度时，单元之间的可重复性很高，但对超声束形成的进一步研究可能会提高超声单元之间软骨回声强度的可重复性。

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引用次数: 0

Perspective: Empowering osteoarthritis drug development through assessment of synovitis by CE-MRI: A new approach in clinical trials 观点：通过CE-MRI评估滑膜炎来促进骨关节炎药物开发：一种临床试验的新方法

Osteoarthritis imaging

Pub Date : 2025-03-01 DOI: 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.

膝骨关节炎（OA）是一个全球性的健康挑战，有大量未满足的治疗需求。目前的治疗主要针对症状，而不改变疾病的进展。滑膜炎，滑膜组织的炎症，是OA疼痛和结构改变的关键驱动因素。这一观点提出了一种范式转变，将滑膜健康评估作为评估OA新疗法的基石。通过这样做，它旨在加速开发有效的疾病调节OA药物（DMOADs）并改善患者预后。它强调了对比增强mri （CE-MRI）作为滑膜健康的替代标志物的潜力，提供了炎症及其与疾病进展和疼痛的关系的精确可视化。

引用次数: 0

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 介入试验应采用哪些终点？-从针对药物作用机制的单一单维评估到多组分测量和多域复合评估

Osteoarthritis imaging

Pub Date : 2025-03-01 DOI: 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.

目前，骨关节炎流行病学家或临床试验学家可以获得大量的结构/成像和临床终点/结果。哪种评估最适合哪种研究仍未确定。当有几个评估可用时，可以使用统计建模和调整将这些评估一起分析（同时或分层）。或者，它们可以组合起来形成更复杂的多组件或复合（可能是多域）端点/结果。这篇综述描述了这些概念和他们的挑战，使用实例从目前的骨关节炎成像研究。进行了一次叙述性、非系统的文献检索（PubMed等），并与该领域的专家进行了非正式磋商。然后将确定的概念和实验结果组织成一个综合框架。结果单一影像学评估可包括一个（单维）或多个（多维）结构。跨解剖位置的一个结构/组织的图像评估集成提供了汇总措施。这也可以跨异质（多维）类型的评估（多成分/复合）创建，无论是在一个领域内（例如成像-单一领域）还是跨更广泛的健康和福祉领域（多领域）。权重、标准化和（临床）有用性是多组分/复合终点的关键特征。这些概念的例子在这里提供骨关节炎成像的背景下。结论骨关节炎研究中多组分/复合终点的选择几乎是无限的。需要聪明的研究策略来探索和验证这些巨大的可能性，适当的统计处理是至关重要的。在观察性和干预性研究中，单一尺寸/终点适合所有方法可能会失败。成像评估需要根据药物的独特作用机制和参与者的形态类型进行调整。

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引用次数: 0

Editorial for the Special -Issue on Biomechanics and Imaging 生物力学与成像特刊社论

Osteoarthritis imaging

Pub Date : 2025-03-01 DOI: 10.1016/j.ostima.2024.100254

Patrick Omoumi, Julien Favre

引用次数: 0

The importance of central sensitization for clinical trials of disease modifying osteoarthritis drugs (DMOADs) 中枢致敏对疾病调节性骨关节炎药物临床试验的重要性

Osteoarthritis imaging

Pub Date : 2025-03-01 DOI: 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.

骨关节炎（OA）疼痛与关节的结构改变有关，通常通过成像技术进行量化。预计结构疾病修饰性OA药物（DMOADs）将减轻OA疼痛的负担。然而，痛觉性疼痛是由中枢神经系统调节的。中枢致敏，即中枢神经系统神经元对标准伤害性输入的反应活动增加，是疾病改良可能无法有效缓解OA疼痛的原因之一。中枢致敏可能是由中枢神经元活动促进或内源性镇痛机制抑制不足引起的。它改变了痛苦的体验：它的严重程度、分布和质量，以及它的情感和认知维度。在随机对照试验中，中枢致敏可能是针对关节结构治疗的镇痛效果的障碍，中枢疼痛处理可能会掩盖结构改变带来的镇痛效果。中枢性疼痛超敏反应的指标可能反映了人类的中枢性致敏。它们包括自我报告问卷，如疼痛的中心方面（CAP）和简短的中央敏感化量表（CSI-9），以及距离受影响关节的压力疼痛检测阈值、时间总和和条件疼痛调节的定量感觉测试（QST）模式。对中枢性疼痛超敏反应的理解、测量、管理和调整应该增加临床试验的力量，以证明dmoad不仅改善关节成像结果，而且改善疼痛，OA的主要临床问题。

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引用次数: 0