Osteoarthritis

MRI is uniquely suited to providing comprehensive assessment of joint status. It is widely used for understanding articular cartilage morphology and composition, particularly in large joints, such as the knee. MRI has greater sensitivity to change then any other modality and allows disclosing cartilage defects and thinning in regions of the joints.

Additionally, it is possible to qualify early inflammatory changes leading to the joint damage. Dynamika enable accurate assessment of early changes and assessment of treatment effect.  Morphological defects in different regions of cartilage and volume or thickness changes can be quantified in repeatable and reliable manner.

Figure: analysis of synovial inflammation in the knee using maps of Gd-DTPA update, Maximum Enhancement and Initial Enhancement

Osteoarthritis (OA) is the most common arthritic disease, and is becoming more prevalent as the population ages. Between 2002 and 2007, OA moved from the twelfth to the sixth leading cause of years lost to disability or morbidity (World Health Organization data). In the UK, more than 6 million people have painful osteoarthritis (OA) in one or both knees. OA prevalence increases with age; knee OA affects approximately 20% of adults aged 50–59, rising to almost 50% in adults aged ≥80 (Peat et al., 2008). For the hip, approximately 1.5 million UK residents have X-ray evidence of hip OA (Lanyon et al., 2003); approximately 650,000 are symptomatic (Odding et al., 1998). A further 8.5 million persons in the UK have X-ray evidence of OA of the spine, a common cause of chronic back pain in the elderly. Whereas other anatomical sites have a slight female preponderance, spinal OA is more common in men than women (3:2 ratio) (Pye et al., 2004).

Direct and indirect costs of OA for the UK are substantial; annually over 2 million people consult their general practitioner (GP) with symptoms due to OA (Arthritis Research Campaign, 2002) Currently, joint replacement surgery offers the only effective treatment for patients with end-stage disease. In 2000, more than 80,000 hip or knee surgical replacements were performed in the UK, at a direct cost of £405 million in 2000. By 2010, the number of hip or knee replacements had nearly doubled, to 155,400, mirroring the increase in primary joint replacements in other industrialized countries over this same time frame (National Joint Registry, 2010). Due to the aging population, the OA disease burden is predicted to increase in prevalence through 2030. OA places a substantial burden on the UK economy, with its total cost estimated as equivalent to 1% of gross national product (GNP) per year (National Institute for Health and Clinical Excellence, 2005). Approximately 36 million working days are lost each year because of osteoarthritis, costing the economy £3.197 billion in lost production (Arthritis Research Campaign, 2002). Notably, at present there are no disease-modifying agents which demonstrably slow or reverse progression of osteoarthritis