Amanda E Nelson

University of North Carolina at Chapel Hill | UNC · Thurston Arthritis Research Center

Abstract Objective To determine the reliability and agreement of manual and automated morphological measurements, and agreement in morphological diagnoses. Methods Thirty pelvic radiographs were randomly selected from the World COACH consortium. Manual and automated measurements of acetabular depth-width ratio (ADR), modified acetabular index (mAI...

Idiopathic inflammatory myopathies (IIM) confer an increased risk of morbidity from atherosclerotic cardiovascular disease (ASCVD). While ASCVD risk has been studied in other countries, these results may not be applicable to patients with dermatomyositis (DM) and polymyositis (PM) in the United States. This retrospective analysis of a cohort of pat...

Objective The purpose of this study was to enhance the current knowledge of the relationship between the gut microbiome and osteoarthritis (OA) and associated pain using pet dogs as a clinically relevant translational model. Methods Fecal samples were collected from 93 owned pet dogs. Dogs were designated as either clinically healthy or OA pain us...

Objective To investigate the relationship between measures of radiographic joint space width (JSW) loss and magnetic resonance imaging (MRI)-based cartilage thickness loss in the medial weight-bearing region of the tibiofemoral joint over 12–24 months. To stratify this relationship by clinically meaningful subgroups (sex and pain status). Design W...

Introduction: To examine the incidence and progression of foot osteoarthritis (OA), as well as associated factors, in a community-based cohort. Methods: Baseline (2013-2015) and follow-up (2016-2018) foot radiographs were available for 541 participants (71% women, mean age 69 years; 35% Black, 53% with obesity). The LaTrobe Foot Atlas was used t...

Objective Translation of knee osteoarthritis (KOA) clinical practice guidelines (CPGs) to practice remains suboptimal. The primary purpose of this systematic review was to describe the use of implementation strategies to promote KOA CPG–recommended care. Methods Medline (via PubMed), Embase, CINAHL, and Web of Science were searched from inception...

Background Shoulder pain is a leading cause of disability. Occupations requiring high upper extremity demands may put workers at greater risk of shoulder injury and resulting pain. We examined associations of occupation with shoulder pain and upper extremity disability in the Johnston County Osteoarthritis Project. Methods Work industry and occupa...

Purpose: There is minimal and conflicting evidence linking body mass index (BMI) to OA-related outcomes after anterior cruciate ligament reconstruction (ACLR), and it is suggested that BMI is a poor indicator of the underlying body composition changes that may influence early OA-related outcomes. There are strong links between lower lean mass, grea...

Purpose Hip osteoarthritis (OA) is a major cause of pain and disability worldwide. Lack of effective therapies may reflect poor knowledge on its aetiology and risk factors, and result in the management of end-stage hip OA with costly joint replacement. The Worldwide Collaboration on OsteoArthritis prediCtion for the Hip (World COACH) consortium was...

Importance Tick-borne diseases (TBDs) other than Lyme disease, such as spotted fever group rickettsiosis, ehrlichiosis, and galactose-α-1,3-galactose (α-gal) syndrome, are an emerging public health issue. Long-term sequelae secondary to Ehrlichia or Rickettsia infection are uncommon; however, musculoskeletal symptoms are often attributed to prior t...

Physical activity and weight management are critical components of an effective knee and hip osteoarthritis (OA) management plan; yet most people with OA remain insufficiently active and/or overweight. Clinicians and their care teams play an important role in educating patients with OA about physical activity and weight management, eliciting patien...

Background The incidence of ehrlichiosis, spotted fever rickettsioses (SFR), and Alpha-gal syndrome (AGS) is high in North Carolina (NC). Post-infectious sequelae secondary to ehrlichiosis or SFR are uncommon, however patients often attribute persistent musculoskeletal symptoms, including arthralgia, to prior tick-borne exposure. It is uncertain if...

Purpose of review This review highlights recently published studies on osteoarthritis (OA) epidemiology, including topics related to understudied populations and joints, imaging, and advancements in artificial intelligence (AI) methods. Recent findings Contemporary research has improved our understanding of the burden of OA in typically understudi...

Objective Hydroxychloroquine (HCQ) use for the treatment of dermatomyositis (DM) has been associated with adverse cutaneous reactions. We applied a new user, active comparator, retrospective design to assess differences in adverse cutaneous reactions or hospitalizations between HCQ and methotrexate (MTX) use among patients with DM. Methods We used...

Objective To evaluate knee and multi-joint osteoarthritis (KOA and MJOA) and compare features by sex and race/ethnicity in a population-based cohort. Methods Participants (n=544) enrolled in the Johnston County Health Study (JoCoHS) as of January 2023 were categorized by radiographic and symptomatic KOA and MJOA phenotypes and frequencies were com...

Knee osteoarthritis (OA), a prevalent joint disease in the U.S., poses challenges in terms of predicting of its early progression. Although high-resolution knee magnetic resonance imaging (MRI) facilitates more precise OA diagnosis, the heterogeneous and multifactorial aspects of OA pathology remain significant obstacles for prognosis. MRI-based sc...

Hip osteoarthritis (OA) is common but understudied compared with knee OA, and insights into the impact of this condition on the general population are needed. This review article summarizes findings from the 30-year, longitudinal, population-based Johnston County Osteoarthritis Project cohort to address the prevalence, incidence, and progression of...

Purpose of Review Osteoarthritis (OA) is a complex heterogeneous disease with no effective treatments. Artificial intelligence (AI) and its subfield machine learning (ML) can be applied to data from different sources to (1) assist clinicians and patients in decision making, based on machine-learned evidence, and (2) improve our understanding of pat...

Far more publications are available for osteoarthritis of the knee than of the hip. Recognizing this research gap, the Arthritis Foundation, in partnership with the Hospital for Special Surgery, convened an in-person meeting of thought leaders to review the state of the science of and clinical approaches to hip osteoarthritis. This article summariz...

Objective We applied a precision medicine-based machine learning approach to discover underlying patient characteristics associated with differential improvement in knee osteoarthritis (OA) symptoms following standard physical therapy (PT), internet-based exercise training (IBET), and a usual care/waitlist (WT) control condition. Methods Participa...

Objective: Adults with foot symptoms (i.e., pain, aching, or stiffness) may be at increased risk of reduced time to all-cause mortality. The purpose of this study was to evaluate whether foot symptoms are independently associated with all-cause mortality in older adults. Methods: We analyzed longitudinal data from 2613 participants from the John...

Objective: To employ novel methodologies to identify phenotypes in knee OA based on variation among three baseline data blocks: 1) femoral cartilage thickness, 2) tibial cartilage thickness, and 3) participant characteristics and clinical features. Methods: Baseline data were from 3321 Osteoarthritis Initiative (OAI) participants with available...

Background Genetic variants within nearly 1000 loci are known to contribute to modulation of blood lipid levels. However, the biological pathways underlying these associations are frequently unknown, limiting understanding of these findings and hindering downstream translational efforts such as drug target discovery. Results To expand our understa...

Objective The lack of accurate biomarkers to predict knee osteoarthritis (OA) progression is a key unmet need in OA clinical research. The objective of this study was to develop baseline peripheral blood epigenetic biomarker models to predict knee OA progression. Methods Genome‐wide buffy coat DNA methylation patterns from 554 individuals from the...

Common single-nucleotide polymorphisms (SNPs) are predicted to collectively explain 40–50% of phenotypic variation in human height, but identifying the specific variants and associated regions requires huge sample sizes¹. Here, using data from a genome-wide association study of 5.4 million individuals of diverse ancestries, we show that 12,111 inde...

Objective To examine the plasma microbiome for differences between obese individuals with and without osteoarthritis (OA) and its association with serum lipopolysaccharide (LPS). Design Blood samples from 70 participants with body mass index (BMI) ≥ 30kg/m2 and age ≥55 years, with (cases) or without (controls) hand plus knee OA, were analyzed for...

Objective To evaluate quantitative joint space width (JSW) at 10‐, 30‐, and 50‐degree locations in relation to incident radiographic and symptomatic hip osteoarthritis (HOA) in a community‐based cohort. Methods Data were from Johnston County OA Project participants with supine hip radiographs at each of 4 time points; all had Kellgren/Lawrence (K/...

A major challenge of genome-wide association studies (GWASs) is to translate phenotypic associations into biological insights. Here, we integrate a large GWAS on blood lipids involving 1.6 million individuals from five ancestries with a wide array of functional genomic datasets to discover regulatory mechanisms underlying lipid associations. We fir...

There has been rapid growth in the use of artificial intelligence analytics in medicine in recent years, including in rheumatic and musculoskeletal diseases (RMDs). Such methods represent a challenge to clinicians, patients, and researchers given the "black box" nature of most algorithms and the unfamiliarity of the terms and lack of awareness of p...

Despite the high prevalence and burden of osteoarthritis (OA) worldwide, management of OA continues to primarily focus on symptom management due to the lack of approved pharmacologic agents that halt disease progression. Recent recommendations from 6 professional societies support the importance of education, self-management approaches, weight loss...

Objective To apply biclustering, a methodology originally developed for analysis of gene expression data, to simultaneously cluster observations and clinical features to explore candidate phenotypes of knee osteoarthritis (KOA) for the first time. Methods Data from the baseline Osteoarthritis Initiative (OAI) visit were cleaned, transformed, and s...

Osteoarthritis (OA) is the most common disabling joint disease. Magnetic resonance (MR) imaging has been commonly used to assess knee joint degeneration due to its distinct advantage in detecting morphologic cartilage changes. Although several statistical methods over conventional radiography have been developed to perform quantitative cartilage an...

Objective The effect of physical activity on the risk of developing knee osteoarthritis (OA) is unclear. We undertook this study to examine the relationship between recreational physical activity and incident knee OA outcomes using comparable physical activity and OA definitions. Methods Data were acquired from 6 global, community‐based cohorts of...

Objective To describe the point prevalence of hip symptoms, radiographic hip osteoarthritis (rHOA), severe rHOA, and symptomatic rHOA (sxHOA) at five time points in the longitudinal, population-based Johnston County Osteoarthritis Project (JoCoOA). Design Data were from 3068 JoCoOA participants who attended up to five study visits (1991–2018). Sta...

Objective To test the hypothesis that an altered gut microbiota (dysbiosis) plays a role in obesity‐associated osteoarthritis (OA). Methods Stool and blood samples were collected from 92 participants with a body mass index (BMI) ≥30 kg/m², recruited from the Johnston County Osteoarthritis Project. OA patients (n = 50) had hand and knee OA (Kellgre...

Introduction Biochemical biomarkers may provide insight into musculoskeletal pain reported at individual or multiple body sites. The purpose of this study was to determine if biomarkers or pressure-pain threshold (PPT) were associated with individual or multiple sites of pain. Methods This cross-sectional analysis included 689 community-based part...

Genetic variants within nearly 1,000 loci are known to contribute to modulation of blood lipid levels. However, the biological pathways underlying these associations are frequently unknown, limiting understanding of these findings and hindering downstream translational efforts such as drug target discovery. To expand our understanding of the underl...

Increased blood lipid levels are heritable risk factors of cardiovascular disease with varied prevalence worldwide owing to different dietary patterns and medication use¹. Despite advances in prevention and treatment, in particular through reducing low-density lipoprotein cholesterol levels², heart disease remains the leading cause of death worldwi...

A major challenge of genome-wide association studies (GWAS) is to translate phenotypic associations into biological insights. Here, we integrate a large GWAS on blood lipids involving 1.6 million individuals from five ancestries with a wide array of functional genomic datasets to discover regulatory mechanisms underlying lipid associations. We firs...

The knee is an accessible and relatively anatomically straightforward joint for ultrasonographic assessment. In this chapter, the nine standard anatomical views and two important additional views are discussed and demonstrated. Transducer positioning and patient positioning tips to obtain and optimize these images are discussed for the 11 views; fo...

Osteoarthritis (OA) is the most common type of arthritis and is increasing in prevalence with a large burden on the individual, society, and the health-care system. OA has traditionally been imaged with conventional radiography although this modality has several drawbacks including insensitivity to early/mild disease and change over time. Ultrasoun...

Objective The objective of this exploratory study was to determine if perturbations in gut microbial composition and the gut metabolome could be linked to individuals with obesity and osteoarthritis (OA). Methods Fecal samples were collected from obese individuals diagnosed with radiographic hand plus knee OA (n=59), defined as involvement of at l...

Objective Few studies have explored foot osteoarthritis (OA) in the general population. The purpose of this study was to determine the frequency of foot OA and identify associated factors in a cross‐sectional analysis of a large community‐based cohort. Methods Data were from the 2013–2015 study visit of the Johnston County OA Project. Radiographic...

Purpose of the Study Obesity is a major risk factor for development and worsening of osteoarthritis (OA). Managing obesity with effective weight loss strategies can improve patients’ OA symptoms, functionality, and quality of life. However, little is known about the clinical journey of patients with both OA and obesity. This study aimed to map the...

Objectives Identifying factors associated with opioid use in middle-aged and older adults is a fundamental step in the mitigation of potentially unnecessary opioid consumption and opioid-related harms. Methods Using longitudinal data on a community-based cohort of adults aged 50–90 years residing in Johnston County, North Carolina, we examined soc...