Structural correlates of pain in joints with osteoarthritis

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Presentation transcript:

Structural correlates of pain in joints with osteoarthritis D.J. Hunter, A. Guermazi, F. Roemer, Y. Zhang, T. Neogi Osteoarthritis and Cartilage Volume 21, Issue 9, Pages 1170-1178 (September 2013) DOI: 10.1016/j.joca.2013.05.017 Copyright © 2013 Osteoarthritis Research Society International Terms and Conditions

Fig. 1 Biospsychosocial model depicting the relation of structural pathology to the experience of pain. Osteoarthritis and Cartilage 2013 21, 1170-1178DOI: (10.1016/j.joca.2013.05.017) Copyright © 2013 Osteoarthritis Research Society International Terms and Conditions

Fig. 2 Anteroposterior knee X-ray (2a) shows mild medial tibiofemoral joint space narrowing, tibial and femoral osteophytes (arrowheads) and faint calcifications of both medial and lateral menisci (arrows) in keeping with meniscocalcinosis. Coronal PDFS MRI (2b) confirms the tibial and femoral osteophytes (arrowheads) and demonstrates an extensive loss of medial tibial femoral cartilage with denuded bone contrasting with mild medial tibiofemoral joint space narrowing on X-ray. The MRI also discloses large subchondral medial tibial and femoral bone marrow lesions (thick arrows) and moderate size tibial subspinous bone marrow lesion at the ACL insertion (thin arrows). The medial meniscus is partially macerated and extruded. Coronal proton-density-weighted MRI (2c) shows a posterior root tear of the medial meniscus (arrow). Osteoarthritis and Cartilage 2013 21, 1170-1178DOI: (10.1016/j.joca.2013.05.017) Copyright © 2013 Osteoarthritis Research Society International Terms and Conditions

Fig. 3 Axial PDFS MRI (3a) shows homogeneous moderate size knee joint effusion (arrow). The axial T1w CE FS MRI (3b) differentiates between the true joint effusion which does not enhance after contrast administration (arrow) and true synovitis which does show enhancement after contrast administration (arrowheads). Osteoarthritis and Cartilage 2013 21, 1170-1178DOI: (10.1016/j.joca.2013.05.017) Copyright © 2013 Osteoarthritis Research Society International Terms and Conditions

Fig. 4 The natural history of OA and the purported roles of biomarkers during the disease process. Original attributed to V Kraus (originally presented at OARSI Congress 2009: Kraus, VB. 2009. Clinical perspective on the role of biomarkers and the diagnosis and monitoring of OA. Osteoarthritis Cartilage Sept 17 (Suppl 1): S1.) can also be found in78. Osteoarthritis and Cartilage 2013 21, 1170-1178DOI: (10.1016/j.joca.2013.05.017) Copyright © 2013 Osteoarthritis Research Society International Terms and Conditions