Ali Guermazi

• Doctor of Medicine
• Professor at Boston University

Background/Aims There is an urgent need for new OA therapies. Excess neurotrophins are implicated in OA pain. Previous OA therapies selectively targeting NGF provided analgesia but resulted in significant joint pathologies. LEVI-04, a p75NTR-Fc, first-in-class fusion protein, supplements endogenous p75NTR, inhibiting neurotrophin-3 and modulating n...

Synovitis remains an important marker of osteoarthritis (OA) disease incidence and progression, and is best assessed using imaging. In general, MRI with intravenous contrast is considered the gold standard method for assessing synovitis because it can effectively differentiate inflamed synovium and adjacent joint effusion and other surrounding stru...

Bone marrow is found in the center of most bones and is divided into two types of marrow that contains distinct cells and biochemical composition and specific vascularization: (1) the red bone marrow contains hematopoietic stem cells (60%) differentiating into red blood cells, white blood cells, or platelets and adipocytes (40%) and (2) the yellow...

Calcium pyrophosphate deposition (CPPD) disease is an arthropathy with increasing prevalence in the aging population that is associated with significant musculoskeletal morbidity. Although synovial fluid analysis (SFA) has been considered the gold standard for diagnosis, imaging is gaining an increasing role in the diagnosis and assessment of CPPD...

Osteoarthritis is a widely prevalent disease of the whole joint including cartilage, bone, and soft tissues. The increasing importance of imaging and assessment of all joint structures has been recognized. Conventional radiography is still the first and most commonly used imaging technique for evaluation of patients with a known or suspected diagno...

Knee subchondral bone marrow lesions (BMLs) are one of the hallmark features of structural osteoarthritis (OA) and are potential targets for statins’ disease-modifying effect. We aimed to determine the association between statin use and longitudinal changes in magnetic resonance imaging (MRI)-based BML volume in participants without radiographic kn...

To determine the accuracy of automatic Cobb angle measurements by deep learning (DL) on full spine radiographs. Full spine radiographs of patients aged > 2 years were screened using the radiology reports to identify radiographs for performing Cobb angle measurements. Two senior musculoskeletal radiologists and one senior orthopedic surgeon independ...

Background Precise lower limb measurements are crucial for assessing musculoskeletal health; fully automated solutions have the potential to enhance standardization and reproducibility of these measurements. This study compared the measurements performed by BoneMetrics (Gleamer, Paris, France), a commercial artificial intelligence (AI)-based softwa...

Objective To assess whether change of semiquantitatively magnetic resonance imaging (MRI)-defined bone marrow lesions (BMLs) and inflammatory markers is associated with change in quantitatively-assessed cartilage loss in the femorotibial joint (FTJ) in knees with radiographic osteoarthritis (OA) over 24 months. Design Participants were included fr...

Objective In individuals without radiographic knee osteoarthritis (OA), we investigated whether magnetic resonance imaging (MRI)–defined knee OA at baseline was associated with incident radiographic and symptomatic disease during up to 11 years of follow‐up. Methods Osteoarthritis Initiative participants without tibiofemoral radiographic knee OA a...

Vertebral compression fractures (VFs) and spinal degeneration are both common causes of back pain, particularly in older adults. Previous cross-sectional studies have shown a potential association between these entities, but there is limited evidence on the role of VFs in spinal degeneration. In this longitudinal study, we evaluated the association...

Background Preventing worsening osteoarthritis (OA) in persons with early OA is a major treatment goal. We evaluated if different early OA definitions yielded enough cases of worsening OA within 2–5 years to make trial testing treatments feasible. Methods We assessed different definitions of early OA using data from Multicenter Osteoarthritis (MOS...

The clinical significance of osteoporosis lies in the occurrence of fragility fractures (FFx), and the most relevant fracture site is the hip. The T -score is defined as follows: (BMD patient –BMD young adult mean )/SDy oung adult population , where BMD is bone mineral density and SD is the standard deviation. When the femoral neck (FN) is measured...

Background Bone marrow lesions (BMLs) are a known risk factor for incident knee osteoarthritis (OA), and deep learning (DL) methods can assist in automated segmentation and risk prediction. Purpose To develop and validate a DL model for quantifying tibiofemoral BML volume on MRI scans in knees without radiographic OA and to assess the association b...

Background Preclinical rheumatoid arthritis (Pre‐RA) is defined as the early stage before the development of clinical RA. While cachexia is a well‐known and potentially modifiable complication of RA, it is not known if such an association exists also in the Pre‐RA stage. To investigate such issue, we aimed to compare the longitudinal alterations in...

For older Caucasian women and men, the QCT (quantitative CT) lumbar spine (LS) bone mineral density (BMD) threshold for classifying osteoporosis is 80 mg/ml. It was recently proposed that, for older East Asian women, the QCT LS BMD value equivalent to the Caucasian women’s threshold of 80 mg/mL is about 45∼50 mg/ml. For a data of 328 cases of Chine...

Greater trochanteric pain syndrome (GTPS) is a frequent disorder characterized by lateral hip pain related to different structural causes including gluteus medius and minimus tendinopathy, bursitis, enthesitis, and others and is predominantly seen in middle-aged women. It was referred to in the past as “trochanteric bursitis,” but multiple studies...

To assess the accuracy of an artificial intelligence (AI) software (BoneMetrics, Gleamer) in performing automated measurements on weight-bearing forefoot and lateral foot radiographs. Consecutive forefoot and lateral foot radiographs were retrospectively collected from three imaging institutions. Two senior musculoskeletal radiologists independentl...

Objective Intra‐articular (IA) mineralization may contribute to osteoarthritis (OA) structural progression. We studied the association of IA mineralization on knee computed tomography (CT) with cartilage damage worsening on knee magnetic resonance imaging (MRI), with a focus on location‐ and tissue‐specific effects. Methods Participants from the M...

Transcatheter arterial embolization (TAE) is a novel minimally invasive therapy for painful tendinopathy in patients with pain refractory to conservative management. The purpose of this study was to evaluate evidence on the efficacy of TAE for tendinopathy related pain. Using Embase, PubMed, and Web of Science, a systematic review and meta-analysis...

Background Recent reports suggested that dual-energy CT (DECT) may help discriminate between different types of calcium phosphate crystals in vivo, which would have important implications for the characterization of crystal deposition occurring in osteoarthritis. Purpose Our aim was to test the hypothesis that DECT can effectively differentiate ba...

Objective Knee osteoarthritis (OA) is a disease of the whole joint involving multiple tissue types. MRI-based semi-quantitative (SQ) scoring of knee OA is a method to perform multi-tissue joint assessment and has been shown to be a valid and reliable way to measure structural multi-tissue involvement and progression of the disease. While recent wor...

For Caucasian women, the QCT (quantitative CT) lumbar spine (LS) bone mineral density (BMD) cutpoint value for classifying osteoporosis is 80 mg/ml. At the age of approximate 78 years, US Caucasian women QCT LS BMD population mean is 80 mg/ml, while that of Chinese women and Japanese women is around 50 mg/ml. Correlation analyses show, for Chinese...

Currently no disease-modifying osteoarthritis drug has been approved for the treatment of osteoarthritis (OA) that can reverse, hold, or slow the progression of structural damage of OA-affected joints. The reasons for failure are manifold and include the heterogeneity of structural disease of the OA joint at trial inclusion, and the sensitivity of...

We developed a new tool to assess the severity of osteoporotic vertebral fracture using radiographs of the spine. Our technique can be used in patient care by helping to stratify patients with osteoporotic vertebral fractures into appropriate treatment pathways. It can also be used for research purposes. The aim of our study was to propose a semi-q...

Objectives There is no evidence linking specific osteoarthritis (OA) types, such as erosive hand OA (EHOA), with distant generalised changes in muscle composition (sarcopenia), which can potentially be modified. This study pioneers the exploration of the association between EHOA and sarcopenia, both of which are predominantly observed in the older...

Background To assess the prognostic value of short-term change in biochemical markers as it relates to bone marrow lesions (BMLs) on MRI in knee osteoarthritis (OA) over 24 months and, furthermore, to assess the relationship between biochemical markers involved with tissue turnover and inflammation and BMLs on MRI. Methods Data from the Foundation...

While musculoskeletal imaging volumes are increasing, there is a relative shortage of subspecialized musculoskeletal radiologists to interpret the studies. Will artificial intelligence (AI) be the solution? For AI to be the solution, the wide implementation of AI-supported data acquisition methods in clinical practice requires establishing trusted...

Musculoskeletal infections in the ER are not an uncommon presentation. The clinical context is critical in determining the suspicion for infection and degree of tissue involvement which can involve all layers from the skin to bones. The location, extent, and severity of clinically suspected infection directly relate to the type of imaging performed...

Accurate diagnosis of muscle injuries is a challenge in everyday clinical practice and may have profound impact on the recovery and return-to-play decisions of professional athletes particularly in soccer. Imaging techniques such as ultrasound and magnetic resonance imaging (MRI), in addition to the medical history and clinical examination, make a...

Background Osteoarthritis (OA), the leading cause of disability among adults, has no cure and is associated with significant comorbidities. The premise of this randomized clinical trial is that, in a population at risk, a 48-month program of dietary weight loss and exercise will result in less incident structural knee OA compared to control. Metho...

The 1994 WHO criterion of a T-score ≤ -2.5 for densitometric osteoporosis was chosen because it results in a prevalence commensurate with the observed lifetime risk of fragility fractures in Caucasian women aged ≥ 50 years. Due to the much lower risk of fragility fracture among East Asians, the application of the conventional WHO criterion to East...

To assess whether changes in MRI-based measures of thigh muscle quality associated with statin use in participants with and without/at-risk of knee osteoarthritis. This retrospective cohort study used data from the Osteoarthritis Initiative study. Statin users and non-users were matched for relevant covariates using 1:1 propensity-score matching. P...

Objective Intra‐articular (IA) calcium crystal deposition is common in knee osteoarthritis (OA), but of unclear significance. It is possible that low‐grade, crystal‐related inflammation may contribute to knee pain. We examined the longitudinal relation of computed tomography (CT)–detected IA mineralization to the development of knee pain. Methods...

Objective Meniscal tear in persons aged ≥45 years is typically managed with physical therapy (PT), and arthroscopic partial meniscectomy (APM) is offered to those who do not respond. Prior studies suggest APM may be associated with greater progression of radiographic changes. Methods We assessed changes between baseline and 60 months in the Kellgr...

The subchondral bone is an important structural component of the knee joint relevant for osteoarthritis (OA) incidence and progression once disease is established. Experimental studies have demonstrated that subchondral bone changes are not simply the result of altered biomechanics, i.e., pathologic loading. In fact, subchondral bone alterations ha...

The 2013 ISCD consensus recommended a Caucasian female reference database for T-score calculation in men, which says "A uniform Caucasian (non-race adjusted) female reference database should be used to calculate T-scores for men of all ethnic groups." However, this statement was recommended for the US population, and no position was taken with resp...

The prevalence and severity of spine degenerative changes have been noted to be lower among older Chinese women than among older Caucasian women. Spine degenerative changes associated with marginal osteophytosis, trabecular thickening, subchondral sclerosis, facet joint arthrosis, and disc space narrowing can all lead to artificially higher spine a...

This article describes recent advances in quantitative imaging of musculoskeletal extremity sports injuries, citing the existing literature evidence and what additional evidence is needed to make such techniques applicable to clinical practice. Compositional and functional MRI techniques including T2 mapping, diffusion tensor imaging, and sodium im...

CT is one of the most widely used modalities for musculoskeletal imaging. Recent advancements in the field include the introduction of four-dimensional CT, which captures a CT image during motion; cone-beam CT, which uses flat-panel detectors to capture the lower extremities in weight-bearing mode; and dual-energy CT, which operates at two differen...

Objective: Due to the risk of rapidly progressive osteoarthritis (RPOA), the phase III studies of subcutaneous (SC) tanezumab in patients with moderate to severe hip or knee osteoarthritis (OA) included comprehensive joint safety surveillance. This pooled analysis summarizes these findings. Method: Joint safety events in the phase III studies of...

Introduction: Following ACL reconstruction (ACLR), deficits in hip muscle strength and relationships to future outcomes are unknown. Methods: 111 participants one year after ACLR, completed hip external rotation (ER) and internal rotation (IR) strength assessment. At 1 (n = 111) and 5 (n = 74) years post-ACLR, participants completed a battery of...

Intra-articular corticosteroids injections are a widely used treatment for pain from symptomatic osteoarthritis. Systematic reviews show that the treatment effect is modest compared with intra-articular saline (often considered as placebo) and lasts for 2–4 weeks on average. Potentially as a consequence of limited therapeutic duration, repeated inj...

OBJECTIVE: To describe the knee- and overall health-related quality of life (QOL) 3 to 12 years after anterior cruciate ligament (ACL) tear, and to assess the association of clinical and structural features with QOL after ACL tear. DESIGN: Cross-sectional analysis of combined data from Australian (n = 76, 5.4 years postinjury) and Canadian (n = 50,...

Background Due to its major public health impact, knee osteoarthritis (KOA) has been designated as a serious disease by the US Food and Drug Administration (FDA). Approval of a disease modifying osteoarthritis drug (DMOAD) to slow or prevent disease progression hinges on demonstrating both symptomatic (i.e., how a patient feels or functions) and st...

Background People with knee osteoarthritis (OA) (KOA) desire therapies which delay disease progression [1] supporting the need for disease-modifying OA drugs (DMOADs). Sprifermin, truncated recombinant human fibroblast growth factor-18, promotes chondrocyte proliferation and extracellular matrix production [2], improves cartilage biomechanical prop...

Nerve growth factor (a-NGF) inhibitors have been developed for pain treatment including symptomatic osteoarthritis (OA) and have proven analgesic efficacy and improvement in functional outcomes in patients with OA. However, despite initial promising data, a-NGF clinical trials focusing on OA treatment had been suspended in 2010. Reasons were based...

Conventional radiography is the most commonly used imaging modality for the evaluation of osteoarthritis (OA) in clinical trials of disease-modifying OA drugs (DMOADs). Unfortunately, radiography has many shortcomings as an imaging technique to meaningfully assess the pathological features of OA. In this perspective paper, we will describe the reas...

Purpose: To compare the evaluation metrics for deep learning methods that were developed using imbalanced imaging data in osteoarthritis (OA) studies. Materials and methods: This retrospective study utilized 2996 sagittal intermediate-weighted (IW) fat-suppressed (FS) knee MRIs with MRI Osteoarthritis Knee Score (MOAKS) readings from 2467 partic...

Objective Although magnetic resonance imaging (MRI) is the imaging modality of choice for research, there is no widely accepted MRI definition of knee osteoarthritis (OA). We undertook this study to test the performance of different MRI definitions of OA. Methods We studied Multicenter Osteoarthritis Study participants with knee symptoms using pos...

Background We examined the association between levothyroxine use and longitudinal MRI biomarkers for thigh muscle mass and composition in at-risk participants for knee osteoarthritis (KOA) and their mediatory role in subsequent KOA incidence. Methods Using the Osteoarthritis Initiative (OAI) data, we included the thighs and corresponding knees of...

Background: Hyperthyroidism is associated with lower lean body mass, as a result of catabolic actions of thyroid hormone. Therefore, higher thyroid hormone levels could be a factor in the development of sarcopenia and age associated functional decline. The relationship between thyroid hormone and muscle mass in ambulatory, euthyroid older adults is...