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ABSTRACT: OBJECTIVE: To investigate patterns of osteoarthritis (OA) progression within hand joints and the relationship between hand OA progression and progression of OA at the knee. METHODS: Radiographic progression over 6 years, defined as change in osteophytes or joint space narrowing above the smallest detectable change, was assessed on hand and knee radiographs of 236 hand OA patients participating in the Genetics, Arthrosis and Progression (GARP) sibling pair cohort study using OARSI atlas. Clustering of radiographic progression between hand joint groups (DIP, PIP, IP-1 and CMC-1) was assessed using χ(2) test. Symmetry, clustering by row and ray and familial aggregation in sibling pairs were also evaluated. The association between hand OA progression and progression of OA at the knee was assessed using generalised estimating equation analysis. RESULTS: There was clustering of OA progression between hand joint groups, the strongest relationship among DIP, PIP and IP-1 joints. Other patterns were symmetry (OR 4.7 (95% CI 3.3 to 6.5)) and clustering by row (OR 2.9 (95% CI 1.9 to 4.6)) but not by ray (OR 1.3 (95% CI 0.7 to 2.4)). There was familial aggregation of hand OA progression. Patients with progression of hand OA had a higher risk for radiographic change at the knee than those without hand OA progression (OR 2.3 (95% CI 1.3 to 4.0)). CONCLUSIONS: Progression of hand OA clusters between hand joint groups, especially between IP joints, and within sibling pairs. It is associated with OA change at the knee. These findings contribute to defining hand OA subsets and suggest a role for systemic factors.
Annals of the rheumatic diseases 02/2013; · 8.11 Impact Factor
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ABSTRACT: To validate a newly developed quantification method that automatically detects and quantifies the joint space width (JSW) in hand radiographs. Repeatability, accuracy and sensitivity to changes in JSW were determined. The influence of joint location and joint shape on the measurements was tested.
A mechanical micrometer set-up was developed to define and adjust the true JSW in an acrylic phantom joint and in human cadaver-derived phalangeal joints. Radiographic measurements of the JSW were compared to the true JSW. Repeatability, systematic error (accuracy) and sensitivity (defined as the smallest detectable difference (SDD)) were determined. The influence of joint position on the JSW measurement was assessed by varying the location of the acrylic phantom on the X-ray detector with respect to the X-ray beam and the influence of joint shape was determined by using morphologically different human cadaver joints.
The mean systematic error was 0.052 mm in the phantom joint and 0.210 mm in the cadaver experiment. In the phantom experiments, the repeatability was high (SDD = 0.028 mm), but differed slightly between joint locations (p = 0.046), and a change in JSW of 0.037 mm could be detected. Dependent of the joint shape in the cadaver hand, a change in JSW between 0.018 and 0.047 mm could be detected.
The automatic quantification method is sensitive to small changes in JSW. Considering the published data of JSW decline in the normal and osteoarthritic population, the first signs of OA progression with this method can be detected within 1 or 2 years.
Skeletal Radiology 02/2011; 41(1):41-9. · 1.54 Impact Factor
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ABSTRACT: To systematically evaluate the association between MRI findings (cartilage defects, bone marrow lesions (BML), osteophytes, meniscal lesion, effusion/synovitis, ligamentous abnormalities, subchondral cysts and bone attrition) and pain in patients with knee osteoarthritis (OA) in order to establish the relevance of such findings when assessing an individual patient.
The Medline, Web of Science, Embase and Cumulative Index to Nursing & Allied Health Literature (CINAHL) databases up to March 2010 were searched without language restriction to find publications with data on the association between MRI findings of knee OA (exposure of interest) and knee pain (outcome). The quality of included papers was scored using a predefined criteria set. The levels of evidence were determined qualitatively using best evidence synthesis (based on guidelines on systematic review from the Cochrane Collaboration Back Review Group). Five levels of evidence were used: strong, moderate, limited, conflicting and no evidence.
A total of 22 papers were included; 5 had longitudinal and 17 cross-sectional data. In all, 13 reported a single MRI finding and 9 multiple MRI findings. Moderate levels of evidence were found for BML and effusion/synovitis. The OR for BML ranged from 2.0 (no CI was given) to 5.0 (2.4 to 10.5). The OR of having pain when effusion/synovitis was present ranged between 3.2 (1.04 to 5.3) and 10.0 (1.1 to 149). The level of evidences between other MRI findings and pain were limited or conflicting.
Knee pain in OA is associated with BML and effusion/synovitis suggesting that these features may indicate the origin of pain in knee OA. However, due to the moderate level of evidence these features need to be explored further.
Annals of the rheumatic diseases 01/2011; 70(1):60-7. · 8.11 Impact Factor
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ABSTRACT: To define localized development of knee osteoarthritis (OA) that arises from anterior cruciate ligament (ACL) and meniscal injuries identified at magnetic resonance (MR) imaging performed a decade ago and the subsequent management of those findings in patients with subacute knee symptoms.
The present study was approved by local medical ethics review boards, and written informed consent was obtained. Three hundred twenty-six patients (mean age, 42 years; 108 female) from a previously reported series of 855 patients were followed up with regard to the effect of MR imaging-guided treatment for subacute knee problems. The mean follow-up period was 10 years. Initial findings and treatment were compared with the follow-up radiograph and 3.0-T MR image findings. Odds ratios (ORs), with corresponding 95% confidence intervals, were used to identify the effects between variables.
Patients with ACL ruptures had an increased risk of developing joint space narrowing (JSN), cartilaginous defects, osteophytes, bone marrow lesions, and subchondral cysts medially or laterally (OR, 2.4-9.8). Patients with medial meniscal tears had an increased risk of developing JSN, cartilaginous defects, osteophytes, and bone marrow lesions medially (OR, 2.0-15.3). Patients with lateral meniscal tears had an increased risk of developing JSN, cartilaginous defects, osteophytes, bone marrow lesions, and subchondral cysts laterally (OR, 2.1-10.5). Meniscectomy had no effect on the risk of developing OA.
Localized knee OA developed from risk factors identified from the findings of MR imaging performed a decade ago in patients with subacute knee symptoms and did not depend on the surgical treatment of those findings.
Radiology 08/2010; 256(2):536-46. · 5.73 Impact Factor
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ABSTRACT: To investigate the association of ultrasound (US) features-grey scale (GS) synovitis, synovial thickening, effusion and power Doppler signal (PDS)-with symptoms in hand osteoarthritis (HOA).
Fifty-five consecutive patients (mean age 62 years, 87% women) with HOA, fulfilling the American College of Rheumatology criteria, were assessed for pain upon palpation and filled in Australian/Canadian Osteoarthritis Index (AUSCAN) scores, visual analogue scale pain and Short Form-36 (SF-36). US was performed in all metacarpophalangeal, proximal interphalangeal, distal interphalangeal, first interphalangeal and first carpometacarpal joints, and features were semiquantitatively scored (0-3). Generalised estimating equations were used to calculate OR (95% CI) for the association between US features and pain per joint adjusted for relevant confounders. The association between US features summated scores and self-reported outcomes was studied by linear regression analysis.
GS synovitis, effusion, synovial thickening and PDS were shown in 96%, 91%, 73% and 86% of patients, respectively. US features were dose-dependently associated with pain upon palpation (OR 4.5 (95% CI 2.2 to 9.0), 4.4 (2.0 to 9.4), 4.9 (2.2 to 11.0) and 4.1 (2.2 to 7.9)). GS synovitis was associated with AUSCAN pain, stiffness and SF-36, and effusion with AUSCAN pain.
GS synovitis, effusion, synovial thickening and PDS are associated with pain in HOA, suggesting a role for inflammation. Further follow-up studies are warranted.
Annals of the rheumatic diseases 07/2010; 69(7):1367-9. · 8.11 Impact Factor
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ABSTRACT: Objective. To assess whether genetic variation in the interleukin-1 (IL-1) gene cluster contributes to familial osteoarthritis (OA) by influencing innate ex vivo production of IL-1 or IL-1 receptor antagonist (IL-1Ra). Methods. Innate ex vivo IL-1 and IL-1Ra pro-duction upon lipopolysaccharide (LPS) stimulation of whole blood cells was measured in subjects from the Genetics, Osteoarthritis and Progression (GARP) Study, which includes sibling pairs in which at least one sibling has symptomatic OA at multiple sites. Radio-graphic OA (ROA) was assessed by Kellgren/Lawrence score. Subjects from the GARP Study and controls from the Rotterdam Study were genotyped for 7 single-nucleo-tide polymorphisms (SNPs) encompassing the IL-1 gene cluster on chromosome 2q13. Linkage disequilibrium analysis and genotype and haplotype association analy-sis were performed to assess the relationship between the IL-1 gene cluster SNPs, innate ex vivo cytokine production, and OA. Results. Among subjects in the GARP Study, the haplotype variable-number tandem repeat in intron 2/T8006C/T11100C 2/2/1 of the IL1RN gene was significantly associated with reduced innate ex vivo bioavailability of IL-1 upon LPS stimulation (P 0.026) and with ROA at the highest number of joint locations. Conclusion. These results show that genetic vari-ation at the IL-1 gene cluster is associated with lower IL-1 bioavailability and with OA at a large number of joint locations. The data further indicate that, among subjects with OA affecting the highest number of joints, the innate immune system may be activated, thereby obscuring possible underlying mechanisms. Osteoarthritis (OA) is a common joint disease and an important cause of pain and disability in the general population. Genetic factors play an important role in the etiology of various subtypes of OA (1–5). There has been a large amount of interest in the role of cytokines as mediators of joint damage and inflamma-tion in the pathogenesis of OA. Chondrocytes are known to respond to interleukin-1 (IL-1) by reducing the synthesis of matrix components and increasing the syn-thesis of matrix metalloproteinases (MMPs) (6). MMPs degrade extracellular matrix components in articular cartilage. IL-1 receptor antagonist (IL-1Ra) is the nat-ural competitive inhibitor of IL-1, occupying the cell surface IL-1 receptor without triggering signal transduc-tion, and its levels might be considered critical in determining IL-1 bioavailability (6).
05/2010; 62:1119-1126.
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ABSTRACT: To assess whether genetic variation in the interleukin-1 (IL-1) gene cluster contributes to familial osteoarthritis (OA) by influencing innate ex vivo production of IL-1beta or IL-1 receptor antagonist (IL-1Ra).
Innate ex vivo IL-1beta and IL-1Ra production upon lipopolysaccharide (LPS) stimulation of whole blood cells was measured in subjects from the Genetics, Osteoarthritis and Progression (GARP) Study, which includes sibling pairs in which at least one sibling has symptomatic OA at multiple sites. Radiographic OA (ROA) was assessed by Kellgren/Lawrence score. Subjects from the GARP Study and controls from the Rotterdam Study were genotyped for 7 single-nucleotide polymorphisms (SNPs) encompassing the IL-1 gene cluster on chromosome 2q13. Linkage disequilibrium analysis and genotype and haplotype association analysis were performed to assess the relationship between the IL-1 gene cluster SNPs, innate ex vivo cytokine production, and OA.
Among subjects in the GARP Study, the haplotype variable-number tandem repeat in intron 2/T+8006C/T+11100C 2/2/1 of the IL1RN gene was significantly associated with reduced innate ex vivo bioavailability of IL-1beta upon LPS stimulation (P = 0.026) and with ROA at the highest number of joint locations.
These results show that genetic variation at the IL-1 gene cluster is associated with lower IL-1beta bioavailability and with OA at a large number of joint locations. The data further indicate that, among subjects with OA affecting the highest number of joints, the innate immune system may be activated, thereby obscuring possible underlying mechanisms.
Arthritis & Rheumatism 04/2010; 62(4):1119-26. · 7.87 Impact Factor
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ABSTRACT: Internal rotation contracture of the shoulder is common in children with neonatal brachial plexus palsy. A long-standing contracture may cause osseous deformities in the developing shoulder. The purpose of the study was to evaluate the relationship between osseous deformities of the glenohumeral joint and structural differences due to muscle denervation in the rotator cuff muscles.
One hundred and two children with residual neonatal brachial plexus palsy underwent magnetic resonance imaging of both shoulders. The glenoid version and posterior, medial, and superior subluxation of the humeral head were measured. The shapes of the glenoid and the humeral head were categorized, and the infraspinatus, supraspinatus, subscapularis, and deltoid muscles were scored as being normal, atrophic, or atrophic with fatty degeneration.
Muscle degeneration was most prominent in the subscapularis muscle. Glenoid version correlated with the structural differences in the subscapularis muscle. Posterior subluxation of the humeral head and the shape of the glenoid correlated with all abnormal rotator cuff muscles. Superior humeral subluxation correlated only with changes in the supraspinatus muscle. Medialization and the shape of the humeral head were not associated with atrophic changes of the rotator cuff. Regeneration of the rotator cuff muscles was not significantly different in patients with a C5-C6 (C7) or a complete brachial plexus lesion. However, the changes in glenoid version, the degree of posterior humeral subluxation, and the degree of medial humeral subluxation were significantly more severe in patients with a C5-C6 (C7) lesion compared with those in patients with a complete lesion of the brachial plexus.
Structural differences in the rotator cuff muscles alter the direction of the humeral head forces on the developing glenoid fossa and can lead to osseous deformities. Glenohumeral deformities are significantly greater with a C5-C6 (C7) lesion than with a complete brachial plexus lesion in which the large internal rotators are also affected. Reducing the muscular imbalance that occurs with a C5-C6 (C7) lesion could diminish glenohumeral joint incongruency and may improve the outcome of subsequent soft-tissue release or tendon transfer surgery.
The Journal of Bone and Joint Surgery 04/2010; 92(4):935-42. · 3.27 Impact Factor
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ABSTRACT: The purpose of the study was to determine if a positive association exists between arterial vessel wall thickness and generalized osteoarthritis (OA). Our hypothesis is that generalized OA is another facet of the metabolic syndrome.
The medical ethical review board of our institution approved the study. Written informed consent was obtained from each patient prior to the study. Magnetic resonance (MR) images of the knee were obtained in 42 patients who had been diagnosed with generalized OA at multiple joint sites. Another 27 MR images of the knee were obtained from a matched normal (non-OA) reference population. Vessel wall thickness of the popliteal artery was quantitatively measured by dedicated software. Linear regression models were used to investigate the association between vessel wall thickness and generalized OA. Adjustments were made for age, sex, and body mass index (BMI). Confidence intervals (CI) were computed at the 95% level and a significance level of alpha = 0.05 was used.
Patients in the generalized OA population had a significant higher average vessel wall thickness than persons from the normal reference population (p < or = alpha), even when correction was made for sex, age, and BMI. The average vessel wall thickness of the popliteal artery was 1.09 mm in patients with generalized OA, and 0.96 mm in the matched normal reference population.
The association found between increased popliteal artery vessel wall thickness and generalized osteoarthritis suggests that generalized OA might be another facet of the metabolic syndrome.
Skeletal Radiology 08/2009; 38(12):1147-51. · 1.54 Impact Factor
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Iain Watt
Skeletal Radiology 02/2009; 38(5):419-23. · 1.54 Impact Factor
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Fabrice Colas,
Ingrid Meulenbelt,
Jeanine J. Houwing-Duistermaat,
Margreet Kloppenburg, Iain Watt,
Stephanie M. van Rooden,
Martine Visser,
Johan Marinus,
Edward O. Cannon,
Andreas Bender,
Jacobus J. van Hilten,
P. Eline Slagboom,
Joost N. Kok
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ABSTRACT: We developed a methodology that both facilitates and enhances the search for homogeneous subtypes in data. We applied this
methodology to medical research on Osteoarthritis and Parkinson’s Disease and to chemoinformatics research on the chemical
structure of molecule profiles. We release this methodology as the R
SubtypeDiscovery package to enable reproducibility of our analyses. In this paper, we present the package implementation and we illustrate its output on molecular data from
chemoinformatics. Our methodology includes different techniques to process the data, a computational approach repeating data
modelling to select for a number of subtypes or a type of model, and additional methods to characterize, compare and evaluate
the top ranking models. Therefore, this methodology does not solely cluster data but it also produces a complete set of results
to conduct a subtype discovery analysis.
12/2008: pages 669-683;
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ABSTRACT: To describe changes in outcome measures in patients with knee and hip osteoarthritis (OA) over 2 years according to the International Classification of Functioning, Disability and Health, and to evaluate the sensitivity to change of available outcome instruments.
A total of 115 symptomatic knee or hip OA patients (mean age 60.0 years, 80% women) were followed for 2 years. Standardized knee and hip radiographs were scored for joint space narrowing (JSN) using the Osteoarthritis Research Society International Atlas. Pain intensity in knees and hips was graded during physical examination. Self-reported pain and functioning were assessed with the Western Ontario and McMaster Universities OA Index (WOMAC). Social functioning was assessed with social functioning scores of the RAND 36-item Health Survey. Standardized response means (SRMs) were calculated to evaluate sensitivity to change.
Substantial increases in JSN and pain intensity total scores over 2 years were observed (SRMs 0.43 and 0.41, respectively). Twenty-three percent of patients had an increase of at least 1 point in JSN total scores. An increase in pain intensity total scores was present in 46% of patients, whereas a decrease was observed in 19.1.% of patients. WOMAC pain and function scores showed small increases (SRMs 0.15 and 0.18, respectively). No change was seen in social functioning scores (SRM 0.01).
Objective instruments measuring impairment in body structures and function are more sensitive to change over 2 years in patients with OA than self-reported measurements of impairment in body function, activity limitation, and participation restriction. These findings encourage development of new instruments to improve measurement of disease outcome in OA.
Arthritis & Rheumatism 12/2008; 59(12):1750-5. · 7.87 Impact Factor
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Fabrice Colas,
Ingrid Meulenbelt,
Jeanine J. Houwing-Duistermaat,
Margreet Kloppenburg, Iain Watt,
Stephanie M. van Rooden,
Martine Visser,
Johan Marinus,
Jacobus J. van Hilten,
P. Eline Slagboom,
Joost N. Kok
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ABSTRACT: We aim to identify subtypes of diseases like Osteoarthritis (OA) and Parkinson's Disease (PD) that present clinical heterogeneity. We do so by searching for homogeneous clusters in values of markers that reflect the severity of the disease. In the current paper we consider two important items for a cluster analysis. First, as time can contribute largely to the measured variability in the data, we search for the most appropriate way to adjust for it. Second, as we aim for reliable cluster analyses, cluster results should exhibit robustness to little change in the data. To investigate these issues, we transform the data by adding noise of different levels before cluster modeling and we rely on a χ<sup>2</sup>-based measure of association to compare cluster results for different types of time adjustment. The results of our experiments suggest to adjust data for a logarithmic age effect for OA and a square root effect of the disease duration for PD because these adjustments lead more reliable cluster results.
Engineering in Medicine and Biology Society, 2008. EMBS 2008. 30th Annual International Conference of the IEEE; 09/2008
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ABSTRACT: To investigate the course of hand osteoarthritis over 2 years by currently available outcome measures.
189 participants of the Genetics, Arthrosis and Progression (GARP) study with hand osteoarthritis were followed for 2 years. Self-reported hand pain and functional limitations were assessed with the Australian/Canadian osteoarthritis hand index (AUSCAN LK 3.0). Pain intensity upon lateral pressure in the interphalangeal and thumb base joints was graded on a four-point scale. Osteophytes (0-3) and joint space narrowing (JSN) (0-3) was scored at baseline and after 2 years in interphalangeal and thumb base joints. Standardised response means (SRM) were calculated.
172 (91%) patients completed the 2-year follow-up (mean age 60.5 years, 78.5% women). Statistically significant increases in self-reported pain and function scores, in pain intensity scores as well as in osteophyte and JSN total scores were seen over 2 years. SRM were 0.25, 0.23, 0.67, 0.34 and 0.35, respectively, for self-reported pain and function scores, pain intensity scores, osteophyte and JSN total scores. Radiological progression was not associated with changes in self-reported pain and function. Women in an early post-menopausal stage were especially at risk of progressing radiologically.
Currently available outcome measures were able to assess progression over the relatively short time period of 2 years. Radiographic outcomes were more responsive than self-reported outcomes. Pain intensity upon lateral pressure seems to be a responsive measure but needs validation.
Annals of the rheumatic diseases 08/2008; 68(8):1260-4. · 8.11 Impact Factor
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ABSTRACT: The purpose of the study was to relate magnetic resonance imaging (MRI) features at baseline with radiographically determined joint space narrowing (JSN) in the medial compartment of the knee after 2 years in a group of patients with symptomatic osteoarthritis at multiple joint sites.
MRI of the knee and standardized radiographs were obtained at baseline and after 2 years in 186 patients (81% female; aged 43-76 years; mean 60 years). MRI was analyzed for bone marrow lesions, cysts, osteophytes, hyaline cartilage defects, joint effusion, and meniscal pathology in the medial compartment. Radiographs were scored semiquantitatively for JSN in the medial tibiofemoral joint using the Osteoarthritis Research Society International (OARSI) atlas. Radiological progression was defined as > or =1 grade increase. Associations between baseline magnetic resonance (MR) parameters and subsequent radiographic JSN changes were assessed using logistic regression. Relative risk (RR) was then calculated.
Radiographic progression of JSN was observed in 17 (9.1%) of 186 patients. Eleven patients had a Kellgren and Lawrence (KL) score of > or =2. A significant association was observed between all patients and meniscal tears (RR 3.57; confidence interval (CI) 1.08-10.0) and meniscal subluxation (RR 2.73; CI 1.20-5.41), between KL < 2 and meniscal subluxation (RR 11.3; CI 2.49-29.49) and KL > or = 2 and meniscus tears (RR 8.91; CI 1.13-22.84) and radiographic JSN 2 years later. Follow-up MR in 15 of 17 patients with progressive JSN showed only new meniscal abnormalities and no progression of cartilage loss.
Meniscal pathology (tears and/or meniscal subluxation) was the only MRI parameter to be associated with subsequent radiographic progression of JSN in the medial tibiofemoral compartment on a radiograph 2 years later, as assessed by the OARSI score.
Skeletal Radiology 06/2008; 37(9):805-11. · 1.54 Impact Factor
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Fabrice Colas,
Ingrid Meulenbelt,
Jeanine J Houwing-Duistermaat,
Margreet Kloppenburg, Iain Watt,
Stephanie M van Rooden,
Martine Visser,
Johan Marinus,
Jacobus J van Hilten,
P Slagboom,
Joost N Kok
[show abstract]
[hide abstract]
ABSTRACT: We aim to identify subtypes of diseases like Osteoarthritis (OA) and Parkinson's Disease (PD) that present clinical heterogeneity. We do so by searching for homogeneous clusters in values of markers that reflect the severity of the disease. In the current paper we consider two important items for a cluster analysis. First, as time can contribute largely to the measured variability in the data, we search for the most appropriate way to adjust for it. Second, as we aim for reliable cluster analyses, cluster results should exhibit robustness to little change in the data. To investigate these issues, we transform the data by adding noise of different levels before cluster modeling and we rely on a chi(2)-based measure of association to compare cluster results for different types of time adjustment. The results of our experiments suggest to adjust data for a logarithmic age effect for OA and a square root effect of the disease duration for PD because these adjustments lead more reliable cluster results.
Conference proceedings: ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Conference 02/2008; 2008:4601-4.
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ABSTRACT: It has been suggested that bone marrow edema-like (BME) lesions in the knee are associated with progression of osteoarthritis (OA). The purpose of our study in patients with OA was to evaluate prospectively changes of BME lesions over 2 years and their relationship with clinical features. Magnetic resonance (MR) images of the knee were obtained from 182 patients (20% male; aged 43-76 years; mean age 59 years) who had been diagnosed with familial symptomatic OA at multiple joint sites. MR images were made at baseline and at 2 years follow-up. BME lesions in 2 years were associated with clinical features assessed by Western Ontario and McMaster Universities Osteoarthritis (WOMAC) scores. A total of 327 BME lesions were recorded. Total size of BME lesions changed in 90 patients (66%). Size of individual lesions changed in 147 foci (45%): new lesions appeared in 69 (21%), existing lesions disappeared in 32 (10%), increased in size in 26 (8%) and decreased in size in 20 (6%) lesions. Increase or decrease of BME lesions, over a 2-year time period, was not associated with severity of WOMAC scores. BME lesions fluctuated in the majority of patients with OA over a 2-year time period. These changes were not associated with severity of WOMAC scores at the study end point.
European Radiology 01/2008; 17(12):3073-8. · 3.22 Impact Factor
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Fabrice Colas,
Ingrid Meulenbelt,
Jeanine J. Houwing-Duistermaat,
Margreet Kloppenburg, Iain Watt,
Stephanie M. van Rooden,
Martine Visser,
Johan Marinus,
Edward O. Cannon,
Andreas Bender,
Jacobus J. van Hilten,
P. Eline Slagboom,
Joost N. Kok
Leveraging Applications of Formal Methods, Verification and Validation, Third International Symposium, ISoLA 2008, Porto Sani, Greece, October 13-15, 2008. Proceedings; 01/2008
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Margreet Kloppenburg,
Tanja Stamm, Iain Watt,
Franz Kainberger,
Tim E Cawston,
Fraser N Birrell,
Ingemar F Petersson,
Tore Saxne,
Tore K Kvien,
Barbara Slatkowsky-Christensen,
Maxime Dougados,
Laure Gossec,
Ferdinand C Breedveld,
Josef S Smolen
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ABSTRACT: Osteoarthritis of the hands is a prevalent musculoskeletal disease with a considerable effect on patients' lives, but knowledge and research results in the field of hand osteoarthritis are limited. Therefore, the Disease Characteristics in Hand OA (DICHOA) initiative was founded in early 2005 with the aim of addressing key issues and facilitating research into hand osteoarthritis.
To review and discuss current knowledge on hand osteoarthritis with regard to aetiopathogenesis, diagnostic criteria, biomarkers and clinical outcome measures.
Recommendations were made based on a literature review.
Outcomes of hand osteoarthritis should be explored, including patient perspective on the separate components of disease activity, damage and functioning. All imaging techniques should be cross-validated for hand osteoarthritis with clinical status, including disease activity, function and performance, biomarkers and long-term outcome. New imaging modalities are available and need scoring systems and validation. The role of biomarkers in hand osteoarthritis has to be defined.
Future research in hand osteoarthritis is warranted.
Annals of the Rheumatic Diseases 10/2007; 66(9):1157-61. · 8.73 Impact Factor
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ABSTRACT: The contribution of genetics to osteoarthritis (OA) progression is not known. To gain more insight into whether familial factors play a role in disease progression of OA, we analyzed familial aggregation of radiologic OA progression in a study of sibling pairs (the Genetics, Arthrosis, and Progression [GARP] study).
A total of 105 white probands and their 105 siblings with OA at multiple joint sites were included in a prospective cohort study. Radiologic progression of OA was defined as a 1-point score increase in total scores for severity of joint space narrowing (JSN) or osteophytes on standardized radiographs of the hands, knees, and hips obtained at baseline and after 2 years. Odds ratios were calculated for siblings and probands sharing radiologic disease progression.
A total of 100 probands and 93 siblings were followed for 2 years (median age 60 years, 80% women). In 92 sibling pairs both the proband and sibling had complete radiographic followup. Radiologic progression of JSN and osteophytes was present in 47% and 42% of the probands and 34% and 37% of the siblings, respectively. The odds ratios (95% confidence intervals), adjusted for age, sex, and body mass index, of a sibling having radiologic progression if the proband had progression were 3.0 (1.2-7.8) for JSN progression and 1.5 (0.6-3.6) for osteophyte progression. A dose-response relationship was found between the amount of increase in JSN total scores among probands and the progression of JSN in siblings.
Familial factors played a role in the radiologic progression of JSN over 2 years in patients with OA at multiple sites.
Arthritis & Rheumatism 06/2007; 57(4):626-32. · 7.87 Impact Factor
