Jeff Duryea

Brigham and Women's Hospital, Boston, Massachusetts, United States

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Publications (13)35.19 Total impact

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    ABSTRACT: Objective To test the hypothesis that cartilage displays significant longitudinal thickening in the external subregions of the central medial femur (ecMF) and lateral femur (ecLF) in knees with early radiographic osteoarthritis (ROA) compared with contralateral knees without ROA, and to explore differences in change in other subregions and in radiographic joint space width (JSW). Methods Fifty participants (50% women, mean SD age 61.1 9.7 years, and mean +/- SD body mass index 27.7 +/- 4.7 kg/m(2)) were identified from the Osteoarthritis Initiative cohort with definite femorotibial osteophytes but no joint space narrowing (JSN) in 1 knee (early ROA), and no osteophytes or JSN in the contralateral knee (non-ROA). A longitudinal within-person, between-knee comparison was performed using measures of subregional cartilage thickness based on analyses of sagittal double-echo steady-state magnetic resonance images obtained at baseline and 1 year. Medial JSW was evaluated from fixed-flexion radiographs. ResultsThe change between baseline and 1 year was -6 +/- 94 m in ecMF and +18 +/- 91 m in ecLF in early ROA (P = 0.78) versus -1 +/- 68 m and +4 +/- 76 m in non-ROA knees (P = 0.38). The variability of cartilage thickness change tended to be greater in early ROA than in non-ROA knees. Greater cartilage thickness loss in the lateral tibia and a greater reduction in minimum medial JSW were observed in early ROA versus non-ROA knees. Conclusion There was no direct evidence of longitudinal cartilage thickening in external subregions of the central femur in knees with early ROA compared with contralateral non-ROA knees. The observed greater variability in longitudinal thickness change in early ROA knees (but not in non-ROA knees) might be due to cartilage thickening and thinning occurring simultaneously in these knees.
    04/2014; 66(4). DOI:10.1002/acr.22172
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    ABSTRACT: OBJECTIVE: To test whether cross-sectional or longitudinal measures of thigh muscle isometric strength differ between knees with and without subsequent radiographic progression of knee osteoarthritis (KOA), with particular focus on pre-osteoarthritic female knees (knees with risk factors but without definite radiographic KOA). METHODS: Of 4796 Osteoarthritis Initiative participants, 2835 knees with Kellgren Lawrence grade (KLG) 0-3 had central X-ray readings, annual quantitative joint space width (JSW) and isometric muscle strength measurements (Good strength chair). Separate slope ANCOVA models were used to determine differences in strength between "progressor" and "non-progressor" knees, after adjusting for age, body mass index, and pain. RESULTS: 466 participant knees exceeded the smallest detectable JSW change during each of two observation intervals (year 2→4 and year 1→3) and were classified as progressors (213 women, 253 men; 128 KLG0/1, 330 KLG2/3); 946 participant knees did not exceed this threshold in either interval and were classified as non-progressors (588 women, 358 from men; 288KLG0/1, 658KLG2/3). Female progressor knees, including those with KLG0/1, tended to have lower extensor and flexor strength at year2 and at baseline than those without progression, but the difference was not significant after adjusting for confounders. No significant difference was observed in longitudinal change of muscle strength (baseline→year2) prior to radiographic progression. No significant differences were found for muscle strength in men, and none for change in strength concomitant with progression. CONCLUSION: This study provides no strong evidence that (changes in) isometric muscle strength precedes or is associated with structural (radiographic) progression of KOA.
    Osteoarthritis and Cartilage 03/2013; 21(5). DOI:10.1016/j.joca.2013.02.658 · 4.66 Impact Factor
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    ABSTRACT: Osteoarthritis (OA) is the most prevalent joint disorder in the elderly, and there is no effective treatment. Imaging is essential for evaluating the synovial joint structures (including cartilage, meniscus, subchondral bone marrow and synovium) for diagnosis, prognosis, and follow-up. This article describes the roles and limitations of both conventional radiography and magnetic resonance (MR) imaging, and considers the use of other modalities (eg, ultrasonography, nuclear medicine, computed tomography [CT], and CT/MR arthrography) in clinical practice and OA research. The emphasis throughout is on OA of the knee. This article emphasizes research developments and literature evidence published since 2008.
    Rheumatic diseases clinics of North America 02/2013; 39(1):67-105. DOI:10.1016/j.rdc.2012.10.003 · 1.74 Impact Factor
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    ABSTRACT: OBJECTIVE: Minimum radiographic joint space width (mJSW) represents the FDA standard for demonstrating structural therapeutic benefits for knee osteoarthritis (KOA), but only shows moderate responsiveness (sensitivity to change). We directly compare the responsiveness of MRI-based cartilage thickness and JSW measures from fixed-flexion radiography (FFR) and explore the correlation of region-matched changes between both methods. METHODS: 967 knees of Osteoarthritis Initiative participants with radiographic KOA were studied: 445 over one year with coronal FLASH MRI and FFR, and 375/522 over one /two years with sagittal DESS MRI and FFR. Standardized response means (SRM) of cartilage thickness and mJSW were compared using the sign-test. RESULTS: With FLASH MRI, SRM was -0.28 for medial compartment (MFTC) cartilage loss vs. -0.15 for mJSW, and -0.32 vs. -0.22 for the most sensitive MRI subregion (central MFTC) vs. the most sensitive fixed location JSW(X=0.25) . With DESS MRI, one-year SRM was -0.34 for MFTC vs. -0.22 for mJSW and -0.44 vs. -0.28 for central MFTC vs. JSW(X=0.225). Over two years, the SRM was significantly greater for MFTC than for mJSW (-0.43 vs. -0.31, p=0.017) and for central MFTC than for JSW(X=0.225) (-0.51 vs. -0.44, p<0.001). Correlations between changes in spatially matched MRI subregions and fixed location JSW were not consistently higher (r=0.10-0.51) than those between non-matched locations (r=0.15-0.50). CONCLUSIONS: MRI displays greater responsiveness in KOA than JSW FFR-based JSW, with the greatest SRM observed in the central medial femorotibial compartment. Fixed-location radiographic measures appear not capable of determining the spatial distribution of femorotibial cartilage loss.
    Osteoarthritis and Cartilage 11/2012; 21(1). DOI:10.1016/j.joca.2012.10.017 · 4.66 Impact Factor
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    ABSTRACT: OBJECTIVE: To determine whether the presence of definite osteophytes (in absence of joint space narrowing [JSN]) by radiograph is associated with (subregional) increases in cartilage thickness, in a within-person, between-knee cross-sectional comparison of participants in the Osteoarthritis Initiative (OAI). Based on previous results, external medial (ecMF) and external lateral weight-bearing femoral (ecLF) subregions were selected as primary endpoints. METHODS: Both knees of 61 (of 4798) OAI participants displayed definite tibial or femoral marginal osteophytes and no JSN in one knee, and no signs of radiographic OA in the contra-lateral knee; this being confirmed by an expert central reader. In these participants, cartilage thickness was measured in 16 femorotibial subregions of each knee, based on sagittal DESSwe magnetic resonance images. Location-specific joint space width from fixed flexion radiographs was determined using dedicated software. Location-specific associations of osteophytes with cartilage thickness were evaluated using paired t-tests and mixed effect models. RESULTS: Of the 61 participants, 48% had only medial, 36% only lateral, and 16% bi-compartmental osteophytes. Osteophyte knees had significantly thicker cartilage than contra-lateral non-osteophyte knees in the ecMF (+71±223μm, equivalent to +5.5%, p=0.015) and ecLF (+64±195μm, +4.1%, p=0.013). No significant differences between knees were noted in other subregions, nor in joint space width. Cartilage thickness in ecMF and ecLF was significantly associated with tibial osteophytes in the same (medial or lateral) compartment (p=0.003). CONCLUSION: Knees with early radiographic OA display thicker cartilage than (contra-lateral) knees without radiographic findings of OA, specifically in the external femoral subregions of compartments with marginal osteophytes. © 2012 by the American College of Rheumatology.
    11/2012; 64(11). DOI:10.1002/acr.21719
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    ABSTRACT: Previously reported data on 5 computer-based programs for measurement of joint space width focusing on discriminating ability and reproducibility are updated, showing new data. Four of 5 different programs for measuring joint space width were more discriminating than observer scoring for change in narrowing in the 12 months interval. Three of 4 programs were more discriminating than observer scoring for the 0-18 month interval. The program that failed to discriminate in the 0-12 month interval was not the same program that failed in the 0-18 month interval. The committee agreed at an interim meeting in November 2007 that an important goal for computer-based measurement programs is a 90% success rate in making measurements of joint pairs in followup studies. This means that the same joint must be measured in images of both timepoints in order to assess change over time in serial radiographs. None of the programs met this 90% threshold, but 3 programs achieved 85%-90% success rate. Intraclass correlation coefficients for assessing change in joint space width in individual joints were 0.98 or 0.99 for 4 programs. The smallest detectable change was < 0.2 mm for 4 of the 5 programs, representing 29%-36% of the change within the 99th percentile of measurements.
    The Journal of Rheumatology 09/2009; 36(8):1825-8. DOI:10.3899/jrheum.090353 · 3.17 Impact Factor
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    ABSTRACT: The progression of osteoarthritis is traditionally measured using radiographic joint space width (JSW). Numerous knee radiograph protocols have been developed with various levels of complexity and performance as it relates to detecting JSW loss (ie, joint space narrowing). Sensitivity to joint space narrowing is improved when radioanatomic alignment of the medial tibial plateau is achieved. Semiautomated software has been developed to improve the accuracy of JSW measurement over manual methods. JSW measurements include minimum JSW, mean JSW or joint space area, and JSW at fixed locations.
    Rheumatic diseases clinics of North America 08/2009; 35(3):485-502. DOI:10.1016/j.rdc.2009.08.005 · 1.74 Impact Factor
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    ABSTRACT: Accurate and highly reproducible measurements of the rate of progression of osteoarthritis is crucial to assessing structural change, and requires adherence to exacting standards of positioning, which include specifications for flexion and rotation of the joint, and angulation of the x-ray beam. The progression of osteoarthritis traditionally has been measured using radiographic joint space width (JSW). Over the past two decades, numerous knee radiographic protocols have been developed with various levels of complexity and performance as they relate to detecting JSW loss (ie, joint space narrowing). Semiautomated software has been developed to improve the accuracy of JSW measurement over manual methods. JSW measurements include minimum JSW, mean JSW or joint space area and JSW at fixed locations.
    Radiologic Clinics of North America 08/2009; 47(4):567-79. DOI:10.1016/j.rcl.2009.04.004 · 1.83 Impact Factor
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    ABSTRACT: Comparison of performances of 5 (semi)automated methods in measuring joint space width (JSW) in rheumatoid arthritis. Change in JSW was determined by 5 measurement methods on 4 radiographs per patient from 107 patients included in the COBRA trial (comparing sulfasalazine alone or in combination with methotrexate and corticosteroids). For each method the number of patients with sufficient available results was assessed (efficiency). An independent repeated measurement was carried out on a random sample of 30 patients' baseline and 1-year radiographs, to evaluate within-method reliability of change scores. Discriminatory ability (DA) of the measurement methods (between the 2 treatment arms) was compared with the DA of the Sharp-van der Heijde score (SHS) and its 2 components (erosion and JSW scores). The overall success rate varied widely between methods. Applying the chosen threshold of a minimum of 50% available joints with a change score per patient resulted in a success rate > 92% in 4/5 methods. Repeatability of measurements was good for most methods (intraclass correlation coefficient > or = 0.80 in 4/5 methods). Almost all measurement methods in 3 followup periods (12/14) showed a lower mean loss of JSW in patients from the intensive treatment group, although this was rarely statistically significant, confirming the known difference in structural damage. JSW as measured by the (semi)automated systems often showed higher DA than the JSW score of the SHS, but was lower than the total SHS and erosion scores. Although efficiency of the methods should be improved further, results already show good reliability and encouraging DA of most methods. Optimal information may be obtained with a combination of scoring of erosions and (semi)automated measurement of JSW.
    The Journal of Rheumatology 07/2008; 35(7):1288-93. · 3.17 Impact Factor
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    ABSTRACT: The ability of nonfluoroscopically guided radiography of the knee to assess joint space loss is an important issue in studies of progression and treatment of knee osteoarthritis (OA), given the practical limitations of protocols involving fluoroscopically guided radiography of the knee. We evaluated the ability of the nonfluoroscopically guided fixed-flexion radiography protocol to detect knee joint space loss over 3 years. We assessed the same-day test-retest precision for measuring minimum joint space width (JSW), the sensitivity for detection of joint space loss using serial films obtained a median of 37 months (range 23-47 months) apart, and the relationship of joint space loss to radiographic and magnetic resonance imaging (MRI) measures of knee OA. Participants were men and women (ages 70-79 years) with knee pain who were participating in the Health, Aging, and Body Composition Study. We assessed baseline radiographic OA and measured JSW using a computerized algorithm. Serial knee MRIs obtained over the same interval were evaluated for cartilage lesions. A total of 153 knees were studied, 35% of which had radiographic OA at baseline. The mean +/- SD joint space loss for all knees over 3 years was 0.24 +/- 0.59 mm (P < 0.001 for change). In knees with OA at baseline, the mean +/- SD joint space loss over 3 years was 0.43 +/- 0.66 mm (P < 0.001), and in knees with joint space narrowing at baseline, joint space loss was 0.50 +/- 0.67 mm (P < 0.001). Joint space loss and its standardized response mean increased with the severity of baseline joint space narrowing and with the presence of cartilage lesions at baseline and worsening during followup. Radiography of the knee in the fixed-flexion view provides a sensitive and valid measure of joint space loss in multiyear longitudinal studies of knee OA, without the use of fluoroscopy to aid knee positioning.
    Arthritis & Rheumatology 05/2007; 56(5):1512-20. DOI:10.1002/art.22557 · 7.87 Impact Factor
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    ABSTRACT: Computer-based methods of measuring joint space width (JSW) could potentially have advantages over scoring joint space narrowing, with regard to increased standardization, sensitivity, and reproducibility. In an early exercise, 4 different methods showed good agreement on measured change in JSW over time in the small joints of the hands and feet. Despite differences in measurement values between methods, measurement of within-joint change over time showed no systematic differences. The within-method variation was small, with intra-operator variation being smaller than inter-operator variation. Although this initial study was limited in terms of the number of patients and timepoints (total 10), the number of joints was relatively high (340 joints), so the results were considered strong evidence supporting the validity of computer-based JSW measurements to continue the study of the potential value of JSW by comparison of measurements to manual scoring of joint space narrowing using the COBRA trial images.
    The Journal of Rheumatology 05/2007; 34(4):874-83. · 3.17 Impact Factor
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    ABSTRACT: Measurement of radiographic abnormalities in metric units has been reported by several investigators during the last 15 years. Measurement of joint space in large joints has been employed in a few trials to evaluate therapy in osteoarthritis. Measurement of joint space width in small joints has been reported by several investigators but has not yet found a place in clinical trials in rheumatoid arthritis or osteoarthritis. We review methods for measuring joint space width in finger, toe, and wrist joints; special attention is given to how the joint edges are found, the method used to measure distance between joint margins, size of an area of the sampled joint, and reproducibility of measurements. Methods for measurement of erosion size, which have had less attention, are briefly discussed.
    The Journal of Rheumatology 01/2006; 32(12):2456-61. · 3.17 Impact Factor

Publication Stats

155 Citations
35.19 Total Impact Points

Institutions

  • 2013–2014
    • Brigham and Women's Hospital
      Boston, Massachusetts, United States
  • 2009–2013
    • Harvard University
      Cambridge, Massachusetts, United States
  • 2007–2009
    • Harvard Medical School
      Boston, Massachusetts, United States
    • University of Washington Seattle
      Seattle, Washington, United States