Evaluation of a Photographic Chondropathy Score (PCS) for pathological samples in a study of inflammation in tibiofemoral osteoarthritis

Walsh, David A.; Yousef, A; McWilliams, Daniel F.; Hill, R.; Hargin, E.; Wilson, D.

doi:10.1016/j.joca.2008.07.016

Cited by 32 publications

(46 citation statements)

References 31 publications

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“…Chondropathy scores for our high chondropathy group were similar to those previously observed at total joint replacement surgery for knee OA (257 (IQR 228–283)),5 all of whom fulfilled the American College of Rheumatology revised criteria for OA 61…”

Section: Discussionsupporting

confidence: 81%

“…Knees were collected post mortem from patients after consent from the next of kin (person identified by the patient or those accompanying the patient if the patient was incapacitated) 41. The Academic Rheumatology joint tissue repository containing 288 post-mortem cases was screened for cases displaying either high or low macroscopic chondropathy scores in the tibiofemoral joint as a measure of the presence and degree of OA 5. Identification of meniscal nerves required special fixation of tissues, available for a subgroup of 52 repository cases.…”

Section: Methodsmentioning

confidence: 99%

“…The extent and severity of loss of articular cartilage integrity for the medial and lateral femoral condyles and tibial plateaux were determined for each case by a single assessor (RH) immediately after tissue harvesting, as previously described 5 42. Severity of chondropathy was graded 0–4, and the percentage of the area of each articular surface that displayed each grade was estimated.…”

Section: Methodsmentioning

confidence: 99%

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Increased vascular penetration and nerve growth in the meniscus: a potential source of pain in osteoarthritis

et al. 2010

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Section: Discussionsupporting

confidence: 81%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Increased vascular penetration and nerve growth in the meniscus: a potential source of pain in osteoarthritis

et al. 2010

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“…Synovitis is particularly associated with more severe OA structural damage (17), whereas only 38% of the MOST participants had radiographic knee OA at baseline. Furthermore, central sensitization has been associated particularly with pain qualities more commonly associated with spontaneous neuropathic pain (18).…”

Section: David a Walshmentioning

confidence: 95%

Editorial: Synovitis and Pain Sensitization

Walsh

2016

Arthritis & Rheumatology

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Arthritis pain is a complex group of symptoms mediated by diverse mechanisms. Osteoarthritis (OA) is commonly considered a mechanical problem, and OA pain results from nociceptive input when a damaged joint is subjected to mechanical stress during weight bearing or movement. However, the experience of pain often bears little relationship to the extent of joint damage as determined by traditional radiography. Factors such as synovitis, osteochondral pathology, and sensitization of both peripheral and central pain pathways each contribute to the quality and severity of OA pain (1,2). Understanding which key aspects of joint pathology lead to arthritis pain is important if we are to develop treatments that will not only maintain joint structure, but also improve symptoms. Neogi et al provide evidence from the large Multicenter Osteoarthritis Study (MOST) prospective cohort that synovitis in knee OA might lead to widespread neuronal sensitization (3). This raises the possibility that targeting synovitis in OA might not only relieve inflammatory pain and progressive joint damage (4), but also prevent pain from becoming chronic, amplified, and spreading beyond the initially affected joint.The development of central sensitization has often been attributed to ongoing nociceptive input in OA. Indeed, augmented central pain processing is associated with more severe pain, and normalization of central pain processing accompanies pain relief after arthroplasty (5,6). However, in inflammatory arthritis models central sensitization develops alongside synovitis (7), and widespread reduced pressure pain thresholds are associated with inflammatory disease activity in rheumatoid arthritis (RA) (8,9). Central sensitization might therefore be mediated by inflammation, rather than its accompanying pain, and widespread augmentation of central pain processing might be driven by circulating factors such as cytokines (10) rather than directly by nociceptive drive. The data presented by Neogi et al support translational relevance to human OA of these findings in RA and in preclinical models. Central sensitization might also be driven by genetic constitution or comorbid fibromyalgia (11) and by concurrent psychological factors such as catastrophizing (12) and distress (13). The prospective study by Neogi and colleagues indicates a likely contribution of synovitis to progressive widespread sensitization, determined by quantitative sensory testing, that is largely independent of these other factors. Further research would be required to determine whether synovitis directly alters central pain processing or is a marker for a subpopulation of patients with OA who have a predisposition to sensitization.Neogi et al suggest that once developed, neuronal sensitization might be unresponsive to reductions in synovitis, emphasizing the potential value of preventative strategies. Reversal of augmented central pain processing following arthroplasty might justify greater optimism for treating those who already have arthritis pain. Lack of associated imp...

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“…None of the dogs had reports of hormonal or renal disease or had been treated with corticosteroids within 1 year of death. Bone samples were categorized into four groups adapted from the criteria of Walsh [13]: normal (n = 20)-smooth, unbroken surface, homogeneous white to off-white color; mild grade OA (n = 5)-cartilage swelling, softening or superficial fibrillation, a light brown homogeneous or white to off-white/light brown in coloration; moderate grade OA (n = 15)-deep fibrillation, coarsely broken cartilage surface, dark brown, gray, or red in color, and moderate osteophyte formation at articular cartilage boarder; and severe grade OA (n = 5)-subchondral bone exposure, stippled white and dark brown/red in color, and severe osteophyte formation at the articular cartilage border (Fig. 1).…”

Section: Bone Samplesmentioning

confidence: 99%

Comparison of Bone Tissue Elements Between Normal and Osteoarthritic Pelvic Bones in Dogs

Nganvongpanit

Buddhachat

Brown

2015

Biol Trace Elem Res

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Physiochemical analysis of bones affected with osteoarthritis (OA) can be used to better understand the etiology of this disease. We investigated the percentage of chemical elements in canine pelvic bone affected with varying degrees of OA using a handheld X-ray fluorescence (XRF) analyzer that discriminates magnesium (Mg(12)) through bismuth (Bi(83)). A total of 45 pelvic bones, including both ilium and subchondral acetabular bone plates, were categorized as normal (n = 20), mild grade OA (n = 5), moderate grade OA (n = 15), and severe grade OA (n = 5). In normal pelvic, seven elements (P, Ca, Mn, Ag, Cd, Sn, and Sb) differed (p < 0.005) in percentage between ilium and acetabulum. Comparisons among the four OA groups found Mn and Fe to be highest in severe grades (p < 0.05) in both ilium and acetabulum. Three heavy metals (Ag, Sn, and Sb) were detected in high percentages (p < 0.05) in the severe OA group in the acetabulum, but in ilium only Sn was high (p < 0.05) in severe OA. In conclusion, the percentages of several elements differed between pelvic types in dogs, and also with increasing severity of OA. The finding of high Mn and Fe in severe grade OA bone suggests these two elements may be useful in future studies of the etiology and pathophysiology of OA.

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Evaluation of a Photographic Chondropathy Score (PCS) for pathological samples in a study of inflammation in tibiofemoral osteoarthritis

Abstract: Macroscopic, microscopic and radiographical severity scores are complementary measures of structural severity in knee OA. Synovial inflammation was associated with increased OA structural severity, suggesting a possible role of chronic synovitis in cartilage damage.

Cited by 32 publications

References 31 publications

Increased vascular penetration and nerve growth in the meniscus: a potential source of pain in osteoarthritis

Increased vascular penetration and nerve growth in the meniscus: a potential source of pain in osteoarthritis

Editorial: Synovitis and Pain Sensitization

Comparison of Bone Tissue Elements Between Normal and Osteoarthritic Pelvic Bones in Dogs

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