Improving OA detection & therapies

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2003 Research Conference Summary

IntroductionPreventing disability in knee OAUsing imaging to improve OA detection and therapies Profiling who needs aggressive RA therapyEpstein-Barr virus and lupusPortrait in Research: H. Kang, MDResearchers in the NewsContact UsSign UpArchives

Using imaging to improve OA detection and therapies

What problem was studied?Doctors are limited in their ability to detect early signs of osteoarthritis (OA) and to evaluate the effectiveness of new surgical or medical treatments. X-rays don't show signs of OA until significant cartilage breakdown has already occurred. A research team funded by the Arthritis Foundation has been evaluating a type of molecular MRI (magnetic resonance imaging) that measures the concentration of molecules called glycosaminoglycans (GAG) which give strength to cartilage. They have shown that this imaging test (called "dGEMRIC") may be a more sensitive tool for detecting very early signs of cartilage breakdown that are not evident on X-ray. For instance, Figures A and B show two patients' molecular MRIs of a part of the knee that looked normal on X-ray. Figure A shows normal cartilage, but in Figure B, there are low GAG levels (red areas) indicating early signs of cartilage breakdown. Before this test can be more widely used, more data must be obtained about the range of GAG levels that can be expected in normal, injured or unhealthy cartilage.Arthritis Foundation-funded researchers involved in the study: Deborah Burstein, PhD, Beth Israel Deaconess Medical Center, Boston, supported by a Clinical Science Grant and Leena Sharma, MD, Northwestern University, Chicago supported by an OA Biomarkers Grant

What was done in the study?The researchers conducted a series of preliminary studies with 23 volunteers who had their knees examined using the molecular MRI technique. The study group included professional dancers, as well as people with knee ligament injuries or with knee OA. Ten individuals who were taking a glucosamine and chondroitin supplement had repeat MRIs at six months.

What were the study results? The study yielded many important observations. The professional dancers had high GAG levels supporting other recent evidence that individuals who exercise more have higher GAG levels than those who are sedentary. Those with knee OA or with knee injuries had low GAG levels. The molecular MRI was able to detect specific parts of the joint where cartilage breakdown was greater. Individuals who had low GAG values initially who took the glucosamine supplements showed an increase in GAG levels after 6 months, suggesting that this tool may be a sensitive way of monitoring change in cartilage when evaluating new OA treatments.

What's the relevance to people with arthritis?While larger, long-term studies are needed to confirm these findings, they show the potential for using this tool to measure tissue health and to better understand those factors that cause arthritis. Adds Dr. Burstein: "The ability to see the actual cartilage damage at the molecular level is unprecedented. Now we can strive towards halting and reversing very early disease, rather than only treating symptoms at the latter stages of joint damage."

Source: American Journal of Roentgenology, January 2004 http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_uids=14684534 & dopt=Abstract

Research Update is compiled by Michele Boutaugh, BSN, MPH, Medical and Scientific Affairs Department, National Office.