Enhanced Clinical Diagnosis of Early Osteoarthritis

骨关节炎预计将在全球范围内达到流行的程度。预防的关键之一是 及早诊断Cartliage退变过程，以便进行疾病修正治疗。 光学相干层析成像(OCT)是一种可以对人体关节软骨进行成像的新型成像技术 在不破坏或移除组织的情况下，在微观分辨率下。初步数据显示，OCT的损失 可检测到的软骨形态双折射预示着潜在的可逆的早期代谢变化 已被认为与骨关节炎的发病机制有关。PI还成功地使用了一种临床 纤维光学OCT系统评价人关节软骨的微结构和双折射 活着。这项建议的中心假设是OCT可用于临床改善关节镜检查 早期关节软骨退变的诊断。提出了三个相关的具体目标：(1)测试 假说OCT可提高常规关节镜诊断早期骨性关节炎的敏感性和特异性 人类的软骨退化。(2)检验OCT可检测微结构损伤的假设 在接受关节镜检查的受试者中，普遍存在于外观正常的负重软骨中 治疗退行性半月板撕裂。(3)检验OCT可用于临床预测的假设。 急性前十字韧带损伤后进行性软骨退变的系列MRI研究 韧带(前交叉韧带)损伤。 实现所提出的目标将为人类早期的变化提供有价值的新数据 通过新的成像技术(OCT)、3.0T磁共振成像和常规关节镜可识别的骨关节炎。 初步数据显示，OCT可以在人类软骨发育之前识别出软骨退变 不可逆转的变化。因此，该提案具有很高的创新性和重大意义，因为实现这些目标可以 提供诊断能力，潜在地支持向软骨治疗的临床范式转变 退化过程比目前可能的情况早了几年。早期治疗的潜在优势 包括延缓甚至预防致残性骨关节炎的可能性。

Osteoarthritis is expected to reach epidemic proportions worldwide. One of the keys to prevention is to diagnose cartliage degenerative processes early enough for disease modifying treatment. Optical coherence tomography (OCT) is a novel imaging technology that can image human articular cartilage at microscopic resolutions without damaging or removing the tissue. Preliminary data shows that loss of OCT detectable cartilage form birefringence was predictive of potentially reversible early metabolic changes that have been implicated in the pathogenesis of osteoarthritis. The PI has also successfully used a clinical fiberoptic OCT system to assess the microstructure and form birefringence of human articular cartilage in vivo. The central hypothesis of this proposal is that OCT can be used clinically to improve arthroscopic diagnosis of early articular cartilage degeneration. Three related specific aims are proposed: (1) To test the hypothesis that OCT enhances the sensitivity and specificity of conventional arthroscopic diagnosis of early cartilage degeneration in humans. (2) To test the hypothesis that OCT detectable microstructural damage is prevalent in grossly normal appearing weight bearing cartilage of human subjects undergoing arthroscopy to treat degenerative meniscal tears. (3) To test the hypothesis that OCT can be used clinically to predict the development of progressive cartilage degeneration as determined by serial MRI after acute anterior cruciate ligament (ACL) injury. Accomplishing the proposed aims will introduce valuable new data on the early changes in human osteoarthritis as discernible by novel imaging technology (OCT), 3.0 T MRI, and conventional arthroscopy. Preliminary data shows that OCT can identify human cartilage degeneration prior to the development of irreversible changes. As such, the proposal is highly innovative and significant in that achieving the aims can provide the diagnostic capability to potentially support a clinical paradigm shift towards treatment of cartilage degenerative processes years before what is currently possible. Potential advantages of earlier treatment include the possibility of delaying or even preventing the onset of disabling osteoarthritis.