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Shane AM, Reeves CL, Nguyen GB, Ferrise TD, Calaj PM. Soft Tissue Pathology. Clin Podiatr Med Surg 2023; 40:381-395. [PMID: 37236677 DOI: 10.1016/j.cpm.2023.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
A wide spectrum of pathologies can lead to soft tissue abnormalities within the ankle joint. Many of these disorders can develop into irreversible joint degeneration if left untreated. Arthroscopy is frequently used to treat these soft tissue conditions such as instability, synovitis, impingement, arthrofibrosis, and other inflammatory disorders in the rearfoot and ankle. In general, the etiology of these ankle soft tissue disorders can be classified as traumatic, inflammatory, and congenital/neoplastic. Overall, the goal of diagnosing and treating soft tissue pathologies of the ankle is to restore anatomic and physiologic motion, reduce pain, optimize functional return to activity, and decrease the chance of recurrence while minimizing complications.
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Affiliation(s)
- Amber M Shane
- Department of Podiatric Surgery Advent Health System, Advent Health East Orlando Podiatric Surgery Residency, Upperline Health, 250 North Alafaya Trail Suite 1115, Orlando, FL 32828, USA; Department of Podiatric Surgery, Advent Health East Orlando Podiatric Surgery Residency, 250 North Alafaya Trail Suite 1115, Orlando, FL 32828, USA.
| | - Christopher L Reeves
- Department of Podiatric Surgery, Advent Health East Orlando Podiatric Surgery Residency, 250 North Alafaya Trail Suite 1115, Orlando, FL 32828, USA; Rothman Institute, Foot and Ankle Surgery, Advent Health East Orlando Hospital, 7727 Lake Underhill Road, Orlando, FL 32822, USA
| | - Garrett B Nguyen
- Department of Podiatric Surgery, Advent Health East Orlando Podiatric Surgery Residency, 250 North Alafaya Trail Suite 1115, Orlando, FL 32828, USA
| | - Thomas D Ferrise
- Department of Podiatric Surgery, Advent Health East Orlando Podiatric Surgery Residency, 250 North Alafaya Trail Suite 1115, Orlando, FL 32828, USA
| | - Phillip M Calaj
- Department of Podiatric Surgery, Advent Health East Orlando Podiatric Surgery Residency, 250 North Alafaya Trail Suite 1115, Orlando, FL 32828, USA
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Ike RW, Kalunian KC. Regarding Arthroscopy: Can Orthopedists and Rheumatologists Be Friends? J Clin Rheumatol 2022; 28:177-181. [PMID: 35325902 DOI: 10.1097/rhu.0000000000001802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND/OBJECTIVE Rheumatologists' interest in arthroscopy began before the 1980s, when many era practitioners began to take up the procedure in earnest. Some of the important players in pre-World War II explorations of arthroscopy were rheumatologists, and the father of modern arthroscopy Makei Watanabe counted many rheumatologists among his postwar students, who were publishing about arthroscopic insights into rheumatic conditions in the 1960s and 1970s. We chose to review this evolution to demonstrate the diverging interests of rheumatologists and orthopedists in arthroscopy and emphasize the chances for reconciliation and cooperation. Methods involve our personal recollection and review of the literature. RESULTS Guidelines for the practice of arthroscopy were published by the American Rheumatism Association (now the American College of Rheumatology) 7 years before similar guidelines appeared from the Arthroscopy Association of North America. American rheumatologists ceased arthroscopy when controlled trials showed no effect in osteoarthritis beyond placebo and biologics for synovitis virtually eliminated situations in which synovectomy might be considered. The research potential of arthroscopy has been realized mainly by European rheumatologists, although the ultrasound-guided biopsy is supplanting arthroscopy as means to secure synovium for investigation, despite the advantages of the latter, such as the ability to obtain larger amounts of tissue, select tissue based on macroscopic appearance, sample multiple area in the same joint, and deliver the potentially therapeutic effect of washout. New miniscopes suitable for office use could restore some of the lagging interest in arthroscopy for investigation. Orthopedists have generally been resistant to rheumatologists doing arthroscopy but would not be sharing any turf with rheumatologists using the miniscope. CONCLUSIONS We hope that we orthopedists and rheumatologists could be friends as we enter this new phase of arthroscopy as we use the technique for different purposes.
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Affiliation(s)
- Robert W Ike
- From the Division of Rheumatology, Department of Internal Medicine, University of Michigan Health System, Ann Arbor, MI (ORCiD ID https://orcid.org/0000-0003-4715-4384 )
| | - Kenneth C Kalunian
- Division of Rheumatology, Allergy and Immunology, Department of Medicine, University of California at San Diego, San Diego, CA (ORCiD ID: Orcid.com/0000-0003-0261-3102 )
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Vasavada K, Jazrawi LM, Samuels J. Perioperative Management of Immunosuppressive Medications in Rheumatic Disease Patients Undergoing Arthroscopy. Curr Rev Musculoskelet Med 2021; 14:421-428. [PMID: 34755277 PMCID: PMC8733073 DOI: 10.1007/s12178-021-09720-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/17/2021] [Indexed: 11/27/2022]
Abstract
PURPOSE OF REVIEW This manuscript reviews relevant prior literature regarding management of immunosuppressants in patients with rheumatic diseases around the time of orthopedic surgery, highlighting important considerations specifically regarding arthroscopy. RECENT FINDINGS Utilization rates of arthroscopic surgery in patients with rheumatic diseases are on the rise, as immunosuppressive treatment options enable them to lead more active lives and hence experience more injuries. Physicians regularly manage patients' glucocorticoids and conventional synthetic and biologic disease modifying antirheumatic drugs around the time of orthopedic surgery, aiming to minimize infection risk while optimizing disease control. However, there is a paucity of randomized controlled trial data for orthopedic surgery-and specifically nothing in the literature pertaining to arthroscopic surgery. Recent guidelines for rheumatic disease patients undergoing elective total hip and knee arthroplasty recommend that most immunosuppressive medications should be held perioperatively, citing the high-risk profile of arthroplasty cases and arthroplasty patients. While 2017 societal guidelines for perioperative immunosuppression during arthroplasty currently serve as a guide for physicians, they may not be applicable to arthroscopy. The less aggressive arthroscopic surgeries span a broader range of patient ages and risk profiles, indications for surgery, and procedural complexity and associated risks. Given these considerations, the majority of routine arthroscopic patients may not require holding of their immunosuppressive medications in the perioperative period.
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Affiliation(s)
- Kinjal Vasavada
- Division of Sports Medicine, Department of Orthopaedic Surgery, New York University Langone Orthopedic Center, New York, NY USA
| | - Laith M. Jazrawi
- Department of Orthopaedic Surgery, New York University Langone Orthopedic Center, New York, NY USA
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Ike RW, Kalunian KC. Will rheumatologists ever pick up the arthroscope again? Int J Rheum Dis 2021; 24:1235-1246. [PMID: 34323382 DOI: 10.1111/1756-185x.14184] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 06/26/2021] [Accepted: 07/12/2021] [Indexed: 02/04/2023]
Abstract
Conditions prompting physicians and surgeons first adapting endoscopes to peer into joints were mainly the sort of synovial conditions that would concern today's rheumatologists. Rheumatologists were among the pre-World War II pioneers developing and documenting arthroscopy. The post-War father of modern arthroscopy, Watanabe, found rheumatologists among his early students, who took back the technique to their home countries, teaching orthopedists and rheumatologists alike. Rheumatologists described and analyzed the intra-articular features of their common diseases in the '60s and '70s. A groundswell of interest from academic rheumatologists in adapting arthroscopy grew considerably in the '90s with development of "needle scopes" that could be used in an office setting. Rheumatologists helped conduct the very trials the findings of which reduced demand for their arthroscopic services by questioning the efficacy of arthroscopic debridement in osteoarthritis (OA) and also developing biological compounds that greatly reduced the call for any resective intervention in inflammatory arthropathies. The arthroscope has proven an excellent tool for viewing and sampling synovium and continues to serve this purpose at several international research centers. While cartilage is now imaged mainly by magnetic resonance imaging, some OA features - such as a high prevalence of visible calcinosis - beg further arthroscopy-directed investigation. A new generation of "needle scopes" with far superior optics awaits future investigators, should they develop interest.
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Affiliation(s)
- Robert W Ike
- Department of Internal Medicine, Division of Rheumatology, University of Michigan Health System, Ann Arbor, MI, USA
| | - Kenneth C Kalunian
- Department of Medicine, Division of Rheumatology, Allergy and Immunology, University of California at San Diego, San Diego, CA, USA
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5
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Xie Y, Li L, Luo R, Xu T, Yang L, Xu F, Lin H, Zhang G, Zhang X. Diagnostic efficacy of joint ultrasonography, dual-energy computed tomography and minimally invasive arthroscopy on knee gouty arthritis, a comparative study. Br J Radiol 2021; 94:20200493. [PMID: 33861155 DOI: 10.1259/bjr.20200493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE This study aimed to investigate the diagnostic performance of minimally invasive arthroscopy for knee gout when comparing with joint ultrasonography and dual-energy computed tomography (DECT). METHODS From January 2016 to December 2018, 121 inpatients with knee joint swelling and pain were prospectively enrolled, including 63 gout patients and 58 non-gout patients. All patients underwent pre-operative ultrasonography and DECT to evaluate knee joint monosodium urate (MSU) deposits, followed by minimally invasive arthroscopy. The gold-standard for gout diagnosis was defined as the detection of MSU crystals in the synovial fluid under polarizing microscopic or pathological analysis. RESULTS The diagnostic results of ultrasonic double contour sign, hyperechogenic foci, MSU deposition (detected by DECT), MSU deposition (detected by arthroscopy) and MSU deposition in cartilage (detected by arthroscopy) were significantly associated with that of the gold-standard. Except for hyperechogenic foci, the other four indexes had high sensitivity and specificity (approximately or over 80%) and a large odds ratio (OR) (14.73 to 36.56), indicating good diagnostic performance. Detection of MSU deposition in cartilage by arthroscopy had a good diagnostic agreement with the ultrasonic double contour sign (κ = 0.711, p < 0.001). CONCLUSION Joint ultrasonography, DECT, and minimally invasive arthroscopy had high sensitivity and specificity for the diagnosis of knee gouty arthritis. Minimally invasive arthroscopy was superior to joint ultrasonography and DECT, which can be a useful supplement for the diagnosis of gout. ADVANCES IN KNOWLEDGE This is the first study comparing the diagnostic performance for knee gout among the joint ultrasonography, DECT, and minimally invasive arthroscopy.
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Affiliation(s)
- Yuesheng Xie
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China.,Department of Rheumatology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Ling Li
- Department of Rheumatology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Riqiang Luo
- Department of Rheumatology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Ting Xu
- Department of Rheumatology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Lin Yang
- Department of Radiology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Fangping Xu
- Department of Pathology and Laboratory Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Haobo Lin
- Department of Rheumatology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Guangfeng Zhang
- Department of Rheumatology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Xiao Zhang
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China.,Department of Rheumatology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
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Ike RW, Arnold WJ, Kalunian KC. Arthroscopy in rheumatology: where have we been? Where might we go? Rheumatology (Oxford) 2020; 60:518-528. [DOI: 10.1093/rheumatology/keaa560] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 07/15/2020] [Accepted: 07/31/2020] [Indexed: 12/12/2022] Open
Abstract
Abstract
The aim of our manuscript is to illustrate the past, present and future role of rheumatologists performing arthroscopy. Doctors first began adapting endoscopes to inspect joints to assess synovial conditions that concern rheumatologists. Rheumatologists were among the pioneers developing arthroscopy. Students of the father of modern arthroscopy, Watanabe, included rheumatologists, who taught others once home. Rheumatologists assessed the intra-articular features of their common diseases in the 60s and 70s. Improvements in instrumentation and efforts by a few orthopaedists adapted a number of common joint surgical procedures for arthroscopy. Interest from rheumatologists in arthroscopy grew in the 90s with ‘needle scopes’ used in an office setting. Rheumatologists conducting the first prospective questioning arthroscopic debridement in OA and developing biological compounds reduced the call for arthroscopic interventions. The arthroscope has proven an excellent tool for viewing and sampling synovium, which continues to at several international centres. Some OA features—such as calcinosis—beg further arthroscopic investigation. A new generation of ‘needle scopes’ with far superior optics awaits future investigators.
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Affiliation(s)
- Robert W Ike
- Division of Rheumatology, Department of Internal Medicine, University of Michigan Health System, Ann Arbor, MI, USA
| | - William J Arnold
- Orthopaedics and Rheumatology of the North Shore, Wilmette, IL, USA
| | - Kenneth C Kalunian
- Division of Rheumatology, Allergy and Immunology, Department of Medicine, University of California at San Diego, San Diego, CA, USA
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Romão VC, Polido-Pereira J, Barros R, Luís R, Vidal B, Vieira-Sousa E, Vitorino E, Humby F, Kelly S, Pitzalis C, Saraiva F, Fonseca JE. Efficacy, Safety, and Sample Quality of Ultrasound-Guided Synovial Needle Biopsy in Clinical Practice and Research: A Prospective Observational Study. Arthritis Care Res (Hoboken) 2020; 72:1497-1505. [PMID: 31421034 DOI: 10.1002/acr.24050] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Accepted: 08/13/2019] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To study the efficacy, tolerability, safety, and sampling variation of ultrasound (US)-guided synovial biopsies performed in clinical practice and research. METHODS We included all patients who had a US-guided synovial needle biopsy from November 2013 to January 2018. Patients were evaluated for procedure safety and tolerability. Usefulness of synovial biopsy was considered based on contribution for achieving the proposed aims. We analyzed samples for presence and quality of synovial tissue, synovitis score/grade, and pathotype. Variation across patients, samples, section levels, and sampling order was assessed. RESULTS A total of 64 US-guided synovial biopsies were performed (n = 52 in clinical practice, n = 12 in research). Patient tolerability (70% no/mild discomfort) was remarkably high. There was no significant aggravation of symptoms or US synovitis in the biopsied joint. Procedures were overall safe, with few minor, 2 moderate, and no major adverse events. Usefulness of US-guided synovial biopsies was high, both in clinical practice (37% direct diagnostic impact, 100% positive/95% negative predictive values for infection) and in research (92% success). Synovial tissue was retrieved in 88% of biopsies, with a median of 75% gradable samples. There was significant variation in sample quality and synovitis features across patients and samples, but not between different section levels. Samples collected later in the procedure had a lower frequency of synovial tissue and were poorly concordant in pathotype with those collected earlier. CONCLUSION US-guided synovial needle biopsy is an effective, safe, and well-tolerated means to collect good quality synovial tissue for clinical and research purposes. Samples collected for different aims should be retrieved in parallel, rather than sequentially.
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Affiliation(s)
- Vasco C Romão
- Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, and Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon Academic Medical Centre, Lisbon, Portugal
| | - Joaquim Polido-Pereira
- Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, and Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon Academic Medical Centre, Lisbon, Portugal
| | - Rita Barros
- Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, and Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon Academic Medical Centre, Lisbon, Portugal
| | - Rita Luís
- Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, and Faculdade de Medicina, Universidade de Lisboa, Lisbon Academic Medical Centre, Lisbon, Portugal
| | - Bruno Vidal
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon Academic Medical Centre, Lisbon, Portugal
| | - Elsa Vieira-Sousa
- Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, and Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon Academic Medical Centre, Lisbon, Portugal
| | - Emília Vitorino
- Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon Academic Medical Centre, London, United Kingdom
| | - Frances Humby
- William Harvey Research Institute, Barts and the London School of Medicine , London, United Kingdom
| | - Stephen Kelly
- Mile End Hospital, Barts Health NHS Trust, London, UK
| | - Costantino Pitzalis
- William Harvey Research Institute, Barts and the London School of Medicine , London, United Kingdom
| | - Fernando Saraiva
- Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon Academic Medical Centre, London, United Kingdom
| | - João Eurico Fonseca
- Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, and Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon Academic Medical Centre, Lisbon, Portugal
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8
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Rakhymzhan A, Reuter L, Raspe R, Bremer D, Günther R, Leben R, Heidelin J, Andresen V, Cheremukhin S, Schulz-Hildebrandt H, Bixel MG, Adams RH, Radbruch H, Hüttmann G, Hauser AE, Niesner RA. Coregistered Spectral Optical Coherence Tomography and Two-Photon Microscopy for Multimodal Near-Instantaneous Deep-Tissue Imaging. Cytometry A 2020; 97:515-527. [PMID: 32293804 DOI: 10.1002/cyto.a.24012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 03/17/2020] [Accepted: 03/19/2020] [Indexed: 12/23/2022]
Abstract
Two-photon microscopy (2PM) has brought unique insight into the mechanisms underlying immune system dynamics and function since it enables monitoring of cellular motility and communication in complex systems within their genuine environment-the living organism. However, use of 2PM in clinical settings is limited. In contrast, optical coherence tomography (OCT), a noninvasive label-free diagnostic imaging method, which allows monitoring morphologic changes of large tissue regions in vivo, has found broad application in the clinic. Here we developed a combined multimodal technology to achieve near-instantaneous coregistered OCT, 2PM, and second harmonic generation (SHG) imaging over large volumes (up to 1,000 × 1,000 × 300 μm3 ) of tendons and other tissue compartments in mouse paws, as well as in mouse lymph nodes, spleens, and femurs. Using our multimodal imaging approach, we found differences in macrophage cell shape and motility behavior depending on whether they are located in tendons or in the surrounding tissue compartments of the mouse paw. The cellular shape of tissue-resident macrophages, indicative for their role in tissue, correlated with the supramolecular organization of collagen as revealed by SHG and OCT. Hence, the here-presented approach of coregistered OCT and 2PM has the potential to link specific cellular phenotypes and functions (as revealed by 2PM) to tissue morphology (as highlighted by OCT) and thus, to build a bridge between basic research knowledge and clinical observations. © 2020 The Authors. Cytometry Part A published by Wiley Periodicals, Inc. on behalf of International Society for Advancement of Cytometry.
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Affiliation(s)
- Asylkhan Rakhymzhan
- Biophysical Analytics, Deutsches Rheumaforschungszentrum (DRFZ), Berlin, Germany
| | - Lucie Reuter
- Biophysical Analytics, Deutsches Rheumaforschungszentrum (DRFZ), Berlin, Germany
| | - Raphael Raspe
- Immundynamics, Deutsches Rheumaforschungszentrum (DRFZ), Berlin, Germany.,Immundynamics and Intravital Microscopy, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Daniel Bremer
- Biophysical Analytics, Deutsches Rheumaforschungszentrum (DRFZ), Berlin, Germany
| | - Robert Günther
- Biophysical Analytics, Deutsches Rheumaforschungszentrum (DRFZ), Berlin, Germany.,Immundynamics, Deutsches Rheumaforschungszentrum (DRFZ), Berlin, Germany
| | - Ruth Leben
- Biophysical Analytics, Deutsches Rheumaforschungszentrum (DRFZ), Berlin, Germany
| | - Judith Heidelin
- LaVision BioTec-A Miltenyi Biotec Company, Bielefeld, Germany
| | - Volker Andresen
- LaVision BioTec-A Miltenyi Biotec Company, Bielefeld, Germany
| | | | | | - Maria G Bixel
- Max-Plank-Institut for Molecular Biomedicine, Tissue Morphogenesis, Münster, Germany
| | - Ralf H Adams
- Max-Plank-Institut for Molecular Biomedicine, Tissue Morphogenesis, Münster, Germany
| | - Helena Radbruch
- Institute for Neuropathology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Gereon Hüttmann
- Institute of Biomedical Optics, University of Lübeck, Lübeck, Germany.,Airway Research Center North (ARCN), Member of the German Center for Lung Research (DZL), Lübeck, Germany
| | - Anja E Hauser
- Immundynamics, Deutsches Rheumaforschungszentrum (DRFZ), Berlin, Germany.,Immundynamics and Intravital Microscopy, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Raluca A Niesner
- Biophysical Analytics, Deutsches Rheumaforschungszentrum (DRFZ), Berlin, Germany.,Dynamic and Functional in vivo Imaging, Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
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Affiliation(s)
- Robert W Ike
- Department of Internal Medicine, Rheumatology Division, University of Michigan, Ann Arbor, Michigan
| | - Kenneth C Kalunian
- Department of Medicine, Division of Rheumatology, Allergy and Immunology, University of California at San Diego, San Diego, California, USA
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Huang YP, Zhong J, Chen J, Yan CH, Zheng YP, Wen CY. High-Frequency Ultrasound Imaging of Tidemark In Vitro in Advanced Knee Osteoarthritis. ULTRASOUND IN MEDICINE & BIOLOGY 2018; 44:94-101. [PMID: 28965723 DOI: 10.1016/j.ultrasmedbio.2017.08.1884] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Revised: 07/20/2017] [Accepted: 08/28/2017] [Indexed: 06/07/2023]
Abstract
High-frequency ultrasound imaging has been widely adopted for assessment of the degenerative changes of articular cartilage in osteoarthritis (OA). Yet, there are few reports on investigating its capability to evaluate subchondral bone. Here, we employed high-frequency ultrasound imaging (25 MHz) to examine in vitro the tidemark in cylindrical osteochondral disks (n = 33) harvested from advanced OA knees of humans. We found good correspondence in morphology observed by ultrasound imaging and micro-computed tomography. Ultrasound roughness index (URI) of tidemark was derived from the raw radiofrequency signals to compare with bone quality factors, including bone volume fraction (BV/TV) and bone mineral density (BMD) measured by micro-computed tomography, using the Spearman correlation (ρ). URI of the tidemark was negatively associated with the subchondral plate BV/TV (ρ = -0.73, p <0.001), BMD (ρ = -0.40, p = 0.020), as well as the underneath trabecular bone BV/TV (ρ = -0.39, p = 0.025) and BMD (ρ = -0.43, p = 0.012). In conclusion, this preliminary study demonstrated that morphology measured by high-frequency ultrasound imaging could reflect the quality of the subchondral bone. High-frequency ultrasound is a promising imaging tool to evaluate the changes of the subchondral bone in addition to those of the overlying cartilage in OA.
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Affiliation(s)
- Yan-Ping Huang
- Interdisciplinary Division of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, China; School of Electronic and Information Engineering, South China University of Technology, Guangzhou, China
| | - Jin Zhong
- Interdisciplinary Division of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, China
| | - Jie Chen
- Interdisciplinary Division of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, China; Department of Orthopedics, Shanghai Institute of Traumatology and Orthopedics, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Chun-Hoi Yan
- Department of Orthopaedics & Traumatology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Yong-Ping Zheng
- Interdisciplinary Division of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, China
| | - Chun-Yi Wen
- Interdisciplinary Division of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, China.
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