Osteoarthritis imaging最新文献

{"title":"Classification approaches used to grade radiographic patellofemoral osteoarthritis: A scoping review","authors":"Jonathan R. Hill ,&nbsp;Edwin H.G. Oei ,&nbsp;Kay M. Crossley ,&nbsp;Hylton B. Menz ,&nbsp;Erin M. Macri ,&nbsp;Michelle D. Smith ,&nbsp;Narelle Wyndow ,&nbsp;Liam R. Maclachlan ,&nbsp;Megan H. Ross ,&nbsp;Natalie J. Collins","doi":"10.1016/j.ostima.2024.100258","DOIUrl":"10.1016/j.ostima.2024.100258","url":null,"abstract":"<div><h3>Objective</h3><div>Conduct a scoping review to describe the use and application of different radiographic classification approaches to grade patellofemoral osteoarthritis (PFOA) in literature published during a representative period (2014–2018), and describe reported measurement properties of these grading criteria.</div></div><div><h3>Design</h3><div>The scoping review was conducted in accordance with PRISMA-ScR guidelines. Eight electronic databases were searched using keywords relating to “patellofemoral” and “radiograph”. Two independent assessors screened each record for eligibility. English-language studies published in the years 2014 to 2018 were included if they acquired patellofemoral joint (PFJ) radiographs, described the method of radiograph acquisition, and reported grading PFOA. We excluded non-human and cadaveric studies, single-case studies, and studies with mean participant age &lt;10 years. Studies that reported measurement properties underwent quality appraisal using the COSMIN Risk of Bias Tool. Descriptive statistics were reported.</div></div><div><h3>Results</h3><div>Of 18,678 records identified, 177 articles were selected. Twenty-six classification approaches to grade radiographic PFOA were reported, with Kellgren-Lawrence (KL) (<em>n</em> = 70, 40 %), OsteoArthritis Research Society International (OARSI) (<em>n</em> = 26, 15 %), and Iwano (<em>n</em> = 25, 14 %) most prevalent. Axial projections (<em>n</em> = 81, 46 %) were most commonly used to grade PFOA, followed by lateral (<em>n</em> = 31, 18 %) and frontal (<em>n</em> = 16, 9 %) projections. KL was most frequently used across settings, disciplines, and regions. Reliability data was reported by 32 (18 %) studies.</div></div><div><h3>Conclusions</h3><div>Multiple radiographic OA classification approaches were used to grade PFOA during the representative period, although few are specific to the PFJ. We recommend that a reliable and valid PFOA radiographic grading approach be developed using standardized PFJ radiograph acquisition techniques.</div></div>","PeriodicalId":74378,"journal":{"name":"Osteoarthritis imaging","volume":"5 1","pages":"Article 100258"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143684671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Wireless vs. traditional ultrasound assessed knee cartilage outcomes utilizing automated gain and normalization techniques","authors":"Arjun Parmar ,&nbsp;Corey D Grozier ,&nbsp;Robert Dima ,&nbsp;Jessica E Tolzman ,&nbsp;Ilker Hacihaliloglu ,&nbsp;Kenneth L Cameron ,&nbsp;Ryan Fajardo ,&nbsp;Matthew S Harkey","doi":"10.1016/j.ostima.2024.100260","DOIUrl":"10.1016/j.ostima.2024.100260","url":null,"abstract":"<div><div>Advancements in wireless ultrasound technology allow for point of care cartilage imaging, yet validation against traditional ultrasound units remains to be established for knee cartilage outcomes. Therefore, the purpose of our study was to establish the replicability, reliability and agreement, of articular cartilage thickness and echo-intensity measures between traditional and wireless ultrasound units utilizing automatic-gain and normalization techniques. We used traditional and wireless ultrasound to assess the femoral cartilage via transverse suprapatellar scans with the knee in maximum flexion in 71 female NCAA Division I athletes (age: 20.0 ± 1.3 years, height: 171.7 ± 8.7 cm, mass: 69.4 ± 11.0 kg). Wireless ultrasound images (auto-gain and standard gain) were compared to traditional ultrasound images (standard gain) before and after normalization. Ultrasound image pixel values were algebraically scaled to normalize differences between units in image acquisition. Mean thickness and echo-intensity of the global and sub-regions of interest were measured across imaging parameters. Intraclass correlation coefficients (ICC_2,<em>_k</em>) for reliability, standard error of the measurement, minimum detectable difference, and Bland-Altman plots for agreement were calculated between ultrasound units across imaging parameters. Cartilage thickness demonstrated good to excellent reliability (ICC_2,<em>_k</em> = 0.83–0.95) and minimal bias (-0.06–0.03 mm), in all regions regardless of gain and normalization. However, mean echo-intensity demonstrated poor to moderate reliability (ICC_2,<em>_k</em> = 0.23–0.68) and moderate bias (-9.8–6.5 au) in all regions, regardless of gain and normalization. While there was a high level of replicability between units when assessing cartilage thickness, further research in ultrasound beam forming may lead to improvements in replicability of cartilage echo-intensity between ultrasound units.</div></div>","PeriodicalId":74378,"journal":{"name":"Osteoarthritis imaging","volume":"5 1","pages":"Article 100260"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143684675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perspective: Empowering osteoarthritis drug development through assessment of synovitis by CE-MRI: A new approach in clinical trials","authors":"Francis Berenbaum","doi":"10.1016/j.ostima.2024.100259","DOIUrl":"10.1016/j.ostima.2024.100259","url":null,"abstract":"<div><div>Knee osteoarthritis (OA) is a global health challenge with substantial unmet therapeutic needs. Current treatments primarily target symptoms without altering the disease's progression. Synovitis, the inflammation of synovial tissue, is a key driver of both pain and structural changes in OA. This Perspective proposes a paradigm shift, positioning synovial health assessment as a cornerstone in the evaluation of new OA therapies. By doing so, it aims to accelerate development of effective disease modifying OA drugs (DMOADs) and improving patient outcomes. It highlights the potential of contrast enhanced-MRI (CE-MRI) to serve as a surrogate marker for synovial health, offering precise visualization of inflammation and its relationship with disease progression and pain.</div></div>","PeriodicalId":74378,"journal":{"name":"Osteoarthritis imaging","volume":"5 1","pages":"Article 100259"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143684676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial for the Special -Issue on Biomechanics and Imaging","authors":"Patrick Omoumi,&nbsp;Julien Favre","doi":"10.1016/j.ostima.2024.100254","DOIUrl":"10.1016/j.ostima.2024.100254","url":null,"abstract":"","PeriodicalId":74378,"journal":{"name":"Osteoarthritis imaging","volume":"5 1","pages":"Article 100254"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143684677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Which endpoints should be applied in interventional trials? – From single uni-dimensional assessment tailored to a drug's mechanism of action to multi-component measures and multi-domain composites","authors":"Felix Eckstein ,&nbsp;Tanja Stamm ,&nbsp;Jamie Collins","doi":"10.1016/j.ostima.2024.100256","DOIUrl":"10.1016/j.ostima.2024.100256","url":null,"abstract":"<div><h3>Objective</h3><div>A vast array of structural/imaging and clinical endpoints/outcomes are available today to osteoarthritis epidemiologists or trialists. Which assessments are best suited for which studies remains unsettled. When several assessments are available, these may be analyzed together (simultaneously or hierarchically), using statistical modeling and adjustment. Or, alternatively, they may be combined to form more complex multi-component or composite (potentially multi-domain) endpoints/outcomes. This review describes such concepts and their challenges, using examples from current osteoarthritis imaging research.</div></div><div><h3>Design</h3><div>A narrative, non-systematic literature search (PubMed and others) was conducted, and informal consultations were held with experts in the field. The identified concepts and experimental findings were then organized to present an integrated framework.</div></div><div><h3>Results</h3><div>Single imaging assessments can encompass one (uni-dimensional) or more (multi-dimensional) structures. Integration of image assessments of one structure/tissue across anatomical locations provides aggregate measures. This can also be created across heterogeneous (multi-dimensional) types of assessments (multi-component/composite), either within an area (such as imaging - single domain) or across broader areas of health and well-being (multi-domain). Weighting, standardization, and (clinical) usefulness are crucial characteristics of multi-component/composite endpoints. Examples of these concepts are here provided in the context of osteoarthritis imaging.</div></div><div><h3>Conclusions</h3><div>Options for multi-component/composite endpoints in osteoarthritis research are virtually infinite. Smart research strategies are required to explore and validate these vast possibilities, with appropriate statistical treatment being paramount. A one-size/endpoint-fits-all approach will likely fail in observational and interventional studies. Imaging assessment needs to be tailored to both the drug's unique mechanism of action, and to the participants’ morpho-type.</div></div>","PeriodicalId":74378,"journal":{"name":"Osteoarthritis imaging","volume":"5 1","pages":"Article 100256"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143684764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The importance of central sensitization for clinical trials of disease modifying osteoarthritis drugs (DMOADs)","authors":"David A Walsh ,&nbsp;Daniel F McWilliams","doi":"10.1016/j.ostima.2025.100261","DOIUrl":"10.1016/j.ostima.2025.100261","url":null,"abstract":"<div><div>Osteoarthritis (OA) pain is associated with structural changes in the joint, which are usually quantified by imaging techniques. It is anticipated that structural disease modifying OA drugs (DMOADs) would reduce the burden of OA pain. However, nociceptive pain is moderated by the central nervous system. Central sensitization, increased activity in central nervous system neurones in response to a standard nociceptive input, is one reason why disease modification might not effectively relieve OA pain. Central sensitization may result from facilitated central neuronal activity, or inadequate inhibition by endogenous analgesic mechanisms. It changes the experience of pain: its severity, distribution and qualities, and its emotional and cognitive dimensions. Central sensitization can be a barrier to analgesic benefit from treatments directed at joint structure, and central pain processing can obscure analgesic benefit from structural modification in randomised controlled trials. Indices of central pain hypersensitivity might reflect central sensitization in humans. They include self-report questionnaires such as the Central Aspects of Pain (CAP) and short form Central Sensitization Inventory (CSI-9), and quantitative sensory testing (QST) modalities of Pressure Pain detection Thresholds distant to the affected joint, Temporal Summation, and Conditioned Pain Modulation. Understanding, measuring, managing and adjusting for central pain hypersensitivity should increase the power of clinical trials to demonstrate that DMOADs not only improve joint imaging outcomes, but also improve pain, the predominant clinical problem of OA.</div></div>","PeriodicalId":74378,"journal":{"name":"Osteoarthritis imaging","volume":"5 1","pages":"Article 100261"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143684672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum regarding missing Editor Disclosure statements in previously published articles","authors":"","doi":"10.1016/j.ostima.2024.100253","DOIUrl":"10.1016/j.ostima.2024.100253","url":null,"abstract":"","PeriodicalId":74378,"journal":{"name":"Osteoarthritis imaging","volume":"5 1","pages":"Article 100253"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143684678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"VALIDATING INTERNAL DENSITY CALIBRATION IN THE PROXIMAL HUMERUS TO ESTIMATE BONE STIFFNESS FOR STEMLESS SHOULDER ARTHROPLASTY","authors":"C.K.A. Stiles ,&nbsp;B.E. Matheson ,&nbsp;S.K. Boyd ,&nbsp;G.S. Arthwal ,&nbsp;J.P. Callaghan ,&nbsp;C.R. Dickerson ,&nbsp;N.K. Knowles","doi":"10.1016/j.ostima.2025.100321","DOIUrl":"10.1016/j.ostima.2025.100321","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;INTRODUCTION&lt;/h3&gt;&lt;div&gt;Stemless humeral head components have emerged as a popular choice for patients undergoing shoulder arthroplasty for end-stage OA since they preserve non-diseased bone for future surgical revisions. Current pre-operative clinical measures are limited in assessing volumetric bone mineral density (vBMD) and mechanical properties in the region of bone directly supporting the component. Gold-standard phantom calibration, used to determine vBMD in CT images, is seldom utilized in clinical practice requiring alternative density measures for accurate vBMD. Internal density calibration using internal tissues as references has yet to be validated in the proximal humerus, and vBMD values have yet to be linked to finite element model (FEM) estimated stiffness in the context of stemless shoulder arthroplasty.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;OBJECTIVE&lt;/h3&gt;&lt;div&gt;1) To determine the correlation between vBMD and finite element model (FEM) estimated stiffness 2) To determine the bias in internal density-based vBMD using three different referent tissue combinations compared to phantom-based vBMD, in the proximal humerus.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;METHODS&lt;/h3&gt;&lt;div&gt;Non-pathologic cadaveric single-energy CT images (n = 25), containing a K&lt;sub&gt;2&lt;/sub&gt;HPO&lt;sub&gt;4&lt;/sub&gt; phantom, were used to analyze a 10 mm region directly below the anatomic neck. Phantom-based vBMD was calculated for each region and used as input to image-based FEMs (ROD). Internal calibration used air (A), adipose (A), skeletal muscle (M), and cortical bone (C) to generate calibrated images from three different referent tissue combinations (AACM, ACM, AAC). Images were used to generate FEMs for each tissue combination. Results were compared between vBMD (mg K&lt;sub&gt;2&lt;/sub&gt;HPO&lt;sub&gt;4&lt;/sub&gt;/cc) and apparent modulus (E&lt;sub&gt;app&lt;/sub&gt;) for each internal calibration tissue combination to the phantom calibration using linear regression. Bland-Altman analysis was used to determine the agreement between tissue combination and phantom calibration for estimated stiffness values (E&lt;sub&gt;app&lt;/sub&gt;).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;RESULTS&lt;/h3&gt;&lt;div&gt;Linear regression (Figure 1) showed strong correlations between estimated stiffness and vBMD values for each calibration method (AACM R&lt;sup&gt;2&lt;/sup&gt; = 0.7524; ACM R&lt;sup&gt;2&lt;/sup&gt; = 0.7723; AAC R&lt;sup&gt;2&lt;/sup&gt; = 0.7384; ROD R&lt;sup&gt;2&lt;/sup&gt; = 0.7854) and slopes not significantly different from 1 (p &lt; 0.001). Bland-Altman analysis (Figure 2) revealed the ACM tissue combination had the lowest error bounds in apparent modulus, compared to phantom-vBMD derived FEMs, with a mean bias of 80.15 MPa and 95% limits of agreement ranging from -164.55 to 324.86 MPa.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;CONCLUSION&lt;/h3&gt;&lt;div&gt;The results of this study support the use of internal density calibration as a valid method for using internal density calibrated images as input to FEMs for estimating stiffness in the proximal humerus. The ACM tissue combination provided the highest agreement with the gold standard phantom ca","PeriodicalId":74378,"journal":{"name":"Osteoarthritis imaging","volume":"5 ","pages":"Article 100321"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144523456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"LONGITUDINAL PROGRESSION OF TRAUMATIC BONE MARROW LESIONS FOLLOWING ANTERIOR CRUCIATE LIGAMENT INJURY: ASSOCIATIONS WITH KNEE PAIN AND CONCOMITANT INJURIES","authors":"C.E. Stirling ,&nbsp;N. Pavlovic ,&nbsp;S.L. Manske ,&nbsp;R.E.A. Walker ,&nbsp;S.K. Boyd","doi":"10.1016/j.ostima.2025.100323","DOIUrl":"10.1016/j.ostima.2025.100323","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;INTRODUCTION&lt;/h3&gt;&lt;div&gt;Traumatic BM lesions occur in about 80% of ACL injuries, typically caused by tibia-femur collisions, indicating significant joint damage and an increased risk of post-traumatic OA (PTOA). MRI is effective for detecting BM lesions, but quantitative assessment of their volume and distribution over time can help identify PTOA risk factors. While BM lesions typically resolve over time, their relationship with knee pain and functional outcomes remains unclear.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;OBJECTIVE&lt;/h3&gt;&lt;div&gt;This study aimed to investigate the longitudinal prevalence, characteristics, and progression of BM lesions following ACL injury, with a focus on their association with knee pain, ligamentous injuries, and meniscal tears.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;METHODS&lt;/h3&gt;&lt;div&gt;This prospective observational study analyzed data from 100 individuals (68 females, 32 males) with acute ACL tears in previously uninjured knees. MRI scans were obtained within 6 weeks of their injury using a 1.5-T MR scanner (GE OptimaMR430S, 1.5T, Waukesha, WI, USA). The imaging protocol included T2‐weighted fat‐suppressed fast spin echo images [TR/TE, 4300/56 ms; echo train length, 11; matrix, 320 × 256; field of view, 140 mm; slice thickness, 3.5 mm; gap, 0.3 mm;] for evaluating BM lesions. BM lesion volume quantified using a previously developed automated segmentation tool. Knee pain and symptoms were assessed using the Knee Injury and Osteoarthritis Outcome Score (KOOS). Statistical analyses included paired t-tests, Mann-Whitney U tests, Pearson’s Chi-squared test, and Spearman’s rank correlation. Multiple comparisons were corrected using the Benjamini-Hochberg procedure to control for false discovery rate. A subset of 77 participants completed follow-up KOOS surveys, and 19 participants who did not undergo ACL reconstruction had follow-up MRIs at one year.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;RESULTS&lt;/h3&gt;&lt;div&gt;BM lesions were present in 95% of participants (N=100), predominantly in the lateral tibial plateau and lateral femoral condyle. Males exhibited significantly higher BM lesion volumes than females (p = 0.03). Significant associations were identified between medial collateral ligament tears and both lateral collateral ligament (p = 0.01) and posterior cruciate ligament tears (p &lt; 0.01). The BM lesion volume at baseline was negatively correlated with KOOS Symptoms at baseline (r = -0.270, p = 0.01). Longitudinal analyses revealed strong predictive relationships between baseline KOOS scores and future outcomes, with baseline KOOS Pain predicting follow-up Symptoms (r = 0.500) and Pain (r = 0.542). At the one-year follow-up, BM lesions in non-surgical participants (N=19) showed substantial resolution (mean change = -96.7%). Surgery had no significant impact on pain or functional outcomes compared to non-surgical participants.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;CONCLUSION&lt;/h3&gt;&lt;div&gt;BM lesion volume had only a weak association with knee pain after ACL injury, but longitudinal KOOS analyses revea","PeriodicalId":74378,"journal":{"name":"Osteoarthritis imaging","volume":"5 ","pages":"Article 100323"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144523427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CAN COMBINED NEUROPHYSIOLOGICAL AND MRI EVALUATION HELP GAIN NEW INSIGHTS IN ARTHROGENIC MUSCLE INHIBITION AMONG PATIENTS WITH KNEE PAIN? PROOF OF CONCEPT","authors":"D. Sherman ,&nbsp;J. Stefanik ,&nbsp;A. Guermazi ,&nbsp;W. Issa ,&nbsp;X. He ,&nbsp;A.W. Jang ,&nbsp;F. Liu ,&nbsp;M. Jarraya","doi":"10.1016/j.ostima.2025.100318","DOIUrl":"10.1016/j.ostima.2025.100318","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;INTRODUCTION&lt;/h3&gt;&lt;div&gt;Arthrogenic muscle inhibition (AMI) is a neuromuscular impairment that is commonly described in patients after knee joint injuries and surgeries. AMI is characterized by profound quadriceps muscle atrophy and persistent muscle weakness secondary to neural inhibition of motor pathways due to altered afferent feedback. While AMI is well-recognized in rehabilitation research, there is a critical lack of standard clinical diagnostic criteria limiting rehabilitation practitioners’ ability to prescribe treatments. In this context, MRI can be a helpful adjunct tool to neurophysiological testing by identifying joint pathology causing AMI and quadriceps muscle inhibition resulting from it.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;OBJECTIVE&lt;/h3&gt;&lt;div&gt;Describe MRI and neurophysiological findings of the knee joint and thighs among patients with AMI secondary to knee injury or surgery.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;MEHTODS&lt;/h3&gt;&lt;div&gt;Four patients with marked quadriceps weakness (presumed AMI) following knee joint injury or surgery are presented. All patients had MR imaging data, including two with unilateral thigh MRI (Patients A-B), 1 with unilateral knee and thigh MRI (Patient C), and 1 with bilateral knee and thigh MRIs, as well as neurophysiological testing (Patient D). Neurophysiological testing included muscle activation failure, Hoffman stretch reflex testing, and cortical inhibition using peripheral nerve and transcranial magnetic stimulation techniques. All imaging data was acquired 12-16 weeks post knee injury or surgery.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;RESULTS&lt;/h3&gt;&lt;div&gt;Patients A-C (each 12-14 weeks status-post ACL reconstruction, uni-compartment arthroplasty, and arthroscopic drilling, respectively) present with marked quadriceps volume loss and diffuse increased T2 signal, resembling denervation edema (&lt;strong&gt;Figure 1&lt;/strong&gt;). Patient C, who underwent arthroscopic drilling, had osteochondral fracture prior to surgery which worsened on the postoperative imaging. Patient D (12-16 weeks post soccer injury) presented with osteochondral fracture of the lateral trochlea with marked atrophy of the quadriceps muscle (&lt;strong&gt;Figure 2A-B&lt;/strong&gt;). Neurophysiological testing revealed volitional quadricep activation failure (51%, &lt;strong&gt;Figure 2C&lt;/strong&gt;), as well as intracortical inhibition (37%, &lt;strong&gt;Figure 2D&lt;/strong&gt;), afferent inhibition (81%, &lt;strong&gt;Figure 2E&lt;/strong&gt;), and Hoffmann reflex facilitation on the involved limb (cf. 29%, &lt;strong&gt;Figure 2F&lt;/strong&gt; vs. 15%, &lt;strong&gt;Figure 2G&lt;/strong&gt;). These findings suggest a cortically mediated muscle activation failure and paradoxical reflex facilitation to preserve strength (spinal cord involvement). The absence of denervation edema could be plausibly explained by the central nervous involvement rather than a peripheral nerve or neuromuscular problem.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;CONCLUSION&lt;/h3&gt;&lt;div&gt;These cases highlight the value of combined MR imaging and neurophysiological assessment in AMI. The presence of dener","PeriodicalId":74378,"journal":{"name":"Osteoarthritis imaging","volume":"5 ","pages":"Article 100318"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144524029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}