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Relationship Between Radiographic Grading of Osteoarthritis

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Relationship Between Radiographic Grading of Osteoarthritis
The aim of this study was to investigate the relationship between the biochemical markers of arthritis and the radiographic grading of osteoarthritis (OA) in knees. Seventy-one women aged 49–85 years with knee OA were studied. Anterior–posterior knee radiographs and hand radiographs were taken in all patients. The radiographic grading of OA in the knee was performed by using the Kellgren–Lawrence criteria and the joint space width. The 71 patients with knee OA were divided into two groups: 37 patients exhibiting generalized osteoarthritis (GOA) and 34 non-GOA patients, according to the grading of their hand radiograph. C-reactive protein (CRP), urinary pyridinoline, YKL-40, plasma matrix metalloproteinase (MMP)-3, MMP-9 and tissue inhibitor of metalloproteinases (TIMP)-1 were measured as the biochemical markers of arthritis. The radiographic grading with the Kellgren–Lawrence scale revealed a significant relationship to the joint space width (P = 0.003): the joint space width decreased with increasing Kellgren–Lawrence grade. All biochemical markers had negative correlations with the joint space width, but only urinary pyridinoline had a significant correlation (P = 0.039). Pyridinoline (P = 0.034) and TIMP-1 (P = 0.017) also exhibited a significant relationship to the Kellgren–Lawrence grade. In GOA evaluations, the joint space width did not differ between GOA and non-GOA patients. CRP, pyridinoline, YKL-40 and MMP-3 levels were significantly greater in GOA patients than in non-GOA patients. CRP, pyridinoline, YKL-40, MMP-3 and TIMP-1 levels each related to at least one of the radiographic gradings. Furthermore, pyridinoline related to every type of radiographic grading examined in the present study.

New approaches in the treatment of osteoarthritis (OA), including new drug development, are hindered by the lack of objective and measurable standards for disease progression by which such treatments can be evaluated. Current methods of evaluating disease progression, including radiographs and biochemical markers, are not accurate enough to be used in clinical trials of potential treatments. Generally, an interval of a year or two is needed to observe any significant change in radiographic grading, whereas only a few months may be sufficient with biochemical markers to observe changes in the joint, which is most advantageous for monitoring treatment efficacy in arthritis. There is a great potential in the use of biochemical markers of arthritis to diagnose the disease at an earlier stage, assess the severity of the disease and monitor the effect of any treatment. However, few sufficiently sophisticated biochemical markers are currently used in clinical applications.

If such markers were to become available, effective drug treatment would be possible or the timing and choice of surgery could be improved. It is therefore very important to make progress in the study of imaging and biochemical markers currently available. The aim of this study is to investigate the relationship between radiographic grading and biochemical markers for arthritis.

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