Knee osteoarthritis (OA) in the elderly is one of the most common degenerative age-related joint diseases leading to typical degradation of articular cartilage with severe pain and limitation of joint motion. Its increasing prevalence due to the demographic development of the society has major implications for individual and public healthcare with the increasing necessity for clinical imaging assessment in a high number of individuals. Although conventional X-ray radiographs are widely considered as gold standard for the assessment of knee OA, in clinical and scientific settings they increasingly bare significant limitations in situations when high resolution and detailed assessment of cartilage is demanded. New imaging modalities are broadening the possibilities in knee OA clinical practice and are offering new insights to help for a better understanding of the disease. X-ray analysis in OA of the knee is associated with many technical limitations and increasingly is replaced by high-quality assessment using magnetic resonance imaging or ultrasonography both in clinical routine and scientific situations. These novel imaging modalities enable an in vivo visualization of the quality of the cartilaginous structure and bone as well as all articular and periarticular tissues. Therefore, the limitations of radiographs in knee OA assessment could be overcome by these techniques. This review article should provide an insight into the most important radiological features of knee OA and their systematic visualization with different imaging approaches that can be used in clinical routine.
The stiffness of the intracarpal tunnel contents in untreated CTS patients is higher than that of healthy volunteers but decreases 6 weeks after corticosteroid injection.
A method to estimate the individual ankylosing spondylitis (AS) patient radiological progression of semi-quantitative magnetic resonance imaging (MRI) changes in the sacroiliac joints has not been described yet, which this study examines. Inflammatory disease activity and MRIs of the sacroiliac joints of 38 patients with recent onset established AS were analyzed at baseline and during follow-up. Sacroiliac MRIs were semi-quantitatively assessed using a modification of the "Spondylarthritis Research Consortium of Canada" (SPARCC) method. In each patient, the annual inflammatory disease activity was estimated by the time-averaged C-reactive protein (CRP; mg/l), calculated as the area under the curve. The mean (SD) CRP decreased from 1.3 (1.8) at baseline to 0.5 (0.6) at follow-up MRI (p < 0.04), which has been performed after a mean (SD) disease course of 2.8 (1.5) years. The mean (SD) annual increase (∆) of SPARCC score from baseline to follow-up MRI was 0.4 (0.4). Baseline individual SPARCC sub-score for bone marrow edema did not statistically significantly correlate with individual ∆SPARCC sub-score for erosions (p = N.S.). The individual AS patient correlation between annual time-averaged inflammatory disease activity and each annual ∆SPARCC sub-scores was only statistically significant for erosions (p < 0.01; r = 0.71). Our results show that bone marrow edema and contrast-medium enhancement at baseline do not relate to the progression of erosions but the calculation of the individual patient annual time-averaged inflammatory disease activity allows to estimate the annual progression of erosions in sacroiliac MRIs of patients with AS.
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