Tracking Treatable Tissues: Change in qMRI Biomarkers and Future Cartilage Loss

项目摘要/摘要 骨关节炎是一种复杂的、异质性的疾病，是一种主要的公共健康问题，最 这是老年人口残疾的常见原因，并与巨大的经济负担有关。这个 骨性关节炎的病理生理学影响到整个关节，伴随着软骨的破坏，相关的改变 软骨下骨和邻近的软组织会导致疼痛等衰弱症状。随着年龄的增长， 人口和肥胖症的流行，对公众健康的影响，特别是膝骨性关节炎，已经并将 继续大幅增加，但不幸的是，没有FDA批准的治疗OA的疾病药物 (DMOADs)，即旨在阻碍或防止骨关节炎相关的软骨和骨骼结构改变的药物。 这是由于对骨性关节炎的特征和疾病之间的关系缺乏了解。 进步。然而，核磁共振成像提高了我们对组织病理学之间关系的理解 关节软骨、软骨下骨及周围软组织的变化及结构变化 在办公自动化中。因此，MRI比普通的膝关节X光照片有了改进，后者既不敏感，又 在骨性关节炎的发展和进展中，关节结构的关键变化是非特异性的。 这项工作的目的是了解BMLS和ES的轨迹对下游临床的影响。 结果，包括软骨丢失和残疾，短期(即两年后)和长期(即， 六年后)。对BMLS和ES轨迹的分析将考虑到 基准线和体积随时间的数量变化。 本研究的具体目的是：评估MRI检测的骨髓轨迹的影响 病变(BMLS)和渗出性滑膜炎(ES)对随后的软骨丢失的影响；并评估 MRI检测的膝关节特异性残疾的BMLS和ES的轨迹。

PROJECT SUMMARY/ABSTRACT Osteoarthritis (OA) is a complex, heterogeneous condition that is a major public health problem, the most common cause of disability in the aging population and is associated with a large economic burden. The pathophysiology of OA affects the whole joint, with breakdown of cartilage, associated changes in the subchondral bone and adjacent soft tissue that leads to debilitating symptoms such as pain. With the aging of the population and the epidemic of obesity, the public health impact of OA, especially knee OA, has and will continue to increase dramatically, but unfortunately, there are no FDA-approved disease-modifying OA drugs (DMOADs), i.e., drugs designed to impede or prevent the OA-related structural changes to cartilage and bone. This has been due to a lack of understanding of the relationship between features of OA and disease progression. MRI, however, has improved our understanding of the relationship between histopathologic changes and the structural changes to cartilage, subchondral bone and the surrounding soft tissues of the joint in OA. As such MRI represents an improvement over plain knee radiographs, which are both insensitive and nonspecific to critical changes in joint structure in the development and progression of OA. The objective of this work is to understand the impact of the trajectory of BMLs and ES on downstream clinical outcomes, including cartilage loss and disability, over the short-term (i.e., two years later) and long-term (i.e., six years later). Analysis of the trajectory of BMLs and ES will take into account the quantitative volume at baseline and the quantitative change in volume over time. The specific aims of this study are: To evaluate the impact of the trajectory of MRI-detected bone marrow lesions (BMLs) and effusion synovitis (ES) on subsequent cartilage loss; and to evaluate the impact of the trajectory of MRI-detected BMLs and ES on knee-specific disability.