OSTEOARTHRITIS AND AGING

骨关节炎是老年人最常见的风湿性疾病， 据估计，有4000万美国人有骨性关节炎的放射证据。一个 关于已建立的射线照相的准确性存在争议 OA评分表(Kellgren，Lawrence 1957)，因为它假定 骨性关节炎的病史从未被纵向研究证实 学习。Kellgren/Lawrence量表最显著的缺点是 许多关节的骨性关节炎状态不容易纳入分级 系统。在这个项目中，我们开发了针对个人的评分标准 手部骨性关节炎的X线表现(骨赘、关节间隙) 狭窄、软骨下硬化症、侧方畸形和皮质 崩溃)。我们使用新的标尺来单独检查每一个 手部骨关节炎的X线表现：一项前瞻性研究 通常是上了年纪的男人。这种方法使我们能够同时建立 最初的发现和进展--简而言之， 手握办公用具。这表明：a)手部骨性关节炎的发生率 随年龄增长--那些没有发展成骨性关节炎到晚年的男性 几年的寿命仍然面临着更大的风险。B)手持办公自动化进展更快 在较老的受试者中。C)关节间隙变窄是常见的早期发现 手部骨关节炎。孤立的骨赘，即使是非常小的，也是一种 早期预测骨性关节炎的后期发展。 一个利用磁共振成像的项目被设计成 确定MRI是否可以显示患有 膝关节疼痛和正常的X光片，但我们的核磁共振无法区分 骨性关节炎的早期变化。

Osteoarthritis (OA) is the most common rheumatic disease of the elderly, with 40 million Americans estimated to have radiological evidence of OA. A controversy exists regarding the accuracy of the established radiographic OA grading scale (Kellgren, Lawrence 1957) because it assumes a natural history of osteoarthritis which has never been validated by longitudinal studies. The most notable shortcoming of the Kellgren/Lawrence scale is that the OA status of many joints doesn't fit easily into the grading system. In this project we developed grading scales for the individual radiographic features of hand osteoarthritis (osteophytes, joint space narrowing, subchondral sclerosis, lateral deformity, and cortical collapse). We use the new scales to individually examine each of the radiographic features of hand osteoarthritis, in a prospective study of normally aging men. This methodology allows us to establish both the initial findings and the progression -- in short, the natural history of hand OA. This has demonstrated that: a) The incidence of hand OA increases with age -- men who have escaped developing OA into their later years of life are still at an increased risk. b) Hand OA progresses faster in older subjects. c) Joint space narrowing is a common early finding of hand osteoarthritis. Lone osteophytes, even very small ones, are also an early predictor of the later development of OA. A project which utilized magnetic resonance imaging was designed to establish whether MRI can visualize joint abnormalities in subjects with knee pain and normal radiographs, however our MRI was unable to distinguish early changes in OA.