Objective To evaluate 10 biomarkers in magnetic resonance imaging (MRI)–determined, pre–radiographically defined osteoarthritis (pre-ROA) and radiographically defined OA (ROA) in a population-based cohort of subjects with symptomatic knee pain. Methods Two hundred one white subjects with knee pain, ages 40–79 years, were classified into OA subgroups according to MRI-based cartilage (MRC) scores (range 0–4) and Kellgren/Lawrence (K/L) grades of radiographic severity (range 0–4): no OA (MRC score 0, K/L grade <2), pre-ROA (MRC score ≥1, K/L grade <2), or ROA (MRC score ≥1, K/L grade ≥2). Urine and serum samples were assessed for levels of the following biomarkers: urinary biomarkers C-telopeptide of type II collagen (uCTX-II), type II and types I and II collagen cleavage neoepitopes (uC2C and uC1,2C, respectively), and N-telopeptide of type I collagen, and serum biomarkers sC1,2C, sC2C, C-propeptide of type II procollagen (sCPII), chondroitin sulfate 846 epitope, cartilage oligomeric matrix protein, and hyaluronic acid. Multicategory logistic regression was performed to evaluate the association of OA subgroup with individual biomarker levels and biomarker ratios, adjusted for age, sex, and body mass index. Results The risk of ROA versus no OA increased with increasing levels of uCTX-II (odds ratio [OR] 3.12, 95% confidence interval [95% CI] 1.35–7.21), uC2C (OR 2.13, 95% CI 1.04–4.37), and uC1,2C (OR 2.07, 95% CI 1.06–4.04), and was reduced in association with high levels of sCPII (OR 0.53, 95% CI 0.30–0.94). The risk of pre-ROA versus no OA increased with increasing levels of uC2C (OR 2.06, 95% CI 1.05–4.01) and uC1,2C (OR 2.06, 95% CI 1.12–3.77). The ratios of type II collagen degradation markers to collagen synthesis markers were better than individual biomarkers at differentiating the OA subgroups, e.g., the ratio of [uCTXII][uC1,2C] to sCPII was associated with a risk of ROA versus no OA of 3.47 (95% CI 1.34–9.03) and a risk of pre-ROA versus no OA of 2.56 (95% CI 1.03–6.40). Conclusion Different cartilage degradation markers are associated with pre-ROA than are associated with ROA, indicating that their use as diagnostic markers depends on the stage of OA. Biomarker ratios contrasting cartilage degradation with cartilage synthesis are better able to differentiate OA stages compared with levels of the individual markers.

Objective. To determine the prevalence of pre-radiographic osteoarthritis (ROA) and ROA of the knee in a symptomatic population-based cohort, and to evaluate the clinical correlates of pre-ROA and ROA. Methods. Subjects ages 40 -79 years with knee pain were recruited as a random population sample and classified using magnetic resonance cartilage ( Conclusion. Cartilage defects were highly prevalent in this symptomatic population-based cohort, with 49% of subjects having pre-ROA and 38% having ROA. Prevalent cartilage defects were significantly associated with age, sports activity, abnormal gait, effusion, and flexion contracture.

The ability of dual-energy CT to diagnose early gout and its use as a problem-solving tool is shown here. Diagnosis of subclinical gout could avert associated long-term complications, thereby reducing disease burden and improving overall quality of life.

BML were present in 38% of PROA and 71% of ROA subjects in this symptomatic knee cohort. BML were significantly associated with Pain on Climbing Stairs but not Total WOMAC or Pain on Walking.

Pneumothorax is a potentially life-threatening condition in the setting of the neonatal special-care nursery (SCN) that may result in rapid deterioration and death. The familiar appearances associated with pneumothorax on AP supine chest radiograph are highly specific, but limited in sensitivity. In this case report, we describe the theory and technique of thoracic ultrasound for detection of pneumothorax in the SCN, providing a viable alternative to the cross-table lateral radiograph without ionising radiation, with highly accurate results, and with minimal patient positioning.