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Semin Musculoskelet Radiol 2012; 16(05): 410-418
DOI: 10.1055/s-0032-1329894
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Osteoarthritis: What Does Imaging Tell Us about Its Etiology?

Victoria L. Johnson
1   Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
,
Bruno M. Giuffre
2   Department of Radiology, Royal North Shore Hospital, St. Leonards, Sydney, New South Wales, Australia
,
David J. Hunter
3   Department of Rheumatology, Royal North Shore Hospital, St. Leonards, NSW Australia
4   Northern Clinical School, University of Sydney, Sydney, New South Wales, Australia
› Author Affiliations
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Publication History

Publication Date:
04 December 2012 (online)

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Abstract

Osteoarthritis (OA) is the most common joint disorder and a leading cause of disability. Due to an aging population and increasing obesity, the incidence of OA is rising. The etiology of OA is multifactorial and complex; thus prevention of OA remains challenging. Risk factors can be divided into person-level factors such as age, sex, obesity, genetics, race/ethnicity, and diet, and joint-level factors including injury, malalignment, and abnormal loading of the joints. This review provides a brief overview of the person-level risk factors and a more in-depth analysis of those at the joint level. It is only through an improved understanding of risk factors for the disease that we may be able to intervene meaningfully and prevent its occurrence.

Keywords

osteoarthritis - etiology - radiography
 

  • References

  • 1 Guccione AA, Felson DT, Anderson JJ , et al. The effects of specific medical conditions on the functional limitations of elders in the Framingham Study. Am J Public Health 1994; 84 (3) 351-358
    CrossrefPubMedGoogle Scholar
  • 2 Lawrence RC, Felson DT, Helmick CG , et al; National Arthritis Data Workgroup. Estimates of the prevalence of arthritis and other rheumatic conditions in the United States. Part II. Arthritis Rheum 2008; 58 (1) 26-35
    CrossrefPubMedGoogle Scholar
  • 3 Kellgren J, Lawrence J. The epidemiology of chronic rheumatism. In: Kellgren JH, JeVrey M, Ball J, , eds. Atlas of Standard Radiographs. Oxford, UK: Blackwell Scientific Publications; 1963
    Google Scholar
  • 4 Hannan MT, Felson DT, Pincus T. Analysis of the discordance between radiographic changes and knee pain in osteoarthritis of the knee. J Rheumatol 2000; 27 (6) 1513-1517
    PubMedGoogle Scholar
  • 5 Zhang Y, Niu J, Kelly-Hayes M, Chaisson CE, Aliabadi P, Felson DT. Prevalence of symptomatic hand osteoarthritis and its impact on functional status among the elderly: the Framingham Study. Am J Epidemiol 2002; 156 (11) 1021-1027
    CrossrefPubMedGoogle Scholar
  • 6 Felson DT, Naimark A, Anderson J, Kazis L, Castelli W, Meenan RF. The prevalence of knee osteoarthritis in the elderly. The Framingham Osteoarthritis Study. Arthritis Rheum 1987; 30 (8) 914-918
    CrossrefPubMedGoogle Scholar
  • 7 Jordan JM, Helmick CG, Renner JB , et al. Prevalence of hip symptoms and radiographic and symptomatic hip osteoarthritis in African Americans and Caucasians: the Johnston County Osteoarthritis Project. J Rheumatol 2009; 36 (4) 809-815
    CrossrefPubMedGoogle Scholar
  • 8 Felson DT, Lawrence RC, Dieppe PA , et al. Osteoarthritis: new insights. Part 1: the disease and its risk factors. Ann Intern Med 2000; 133 (8) 635-646
    CrossrefPubMedGoogle Scholar
  • 9 Srikanth VK, Fryer JL, Zhai G, Winzenberg TM, Hosmer D, Jones G. A meta-analysis of sex differences prevalence, incidence and severity of osteoarthritis. Osteoarthritis Cartilage 2005; 13 (9) 769-781
    CrossrefPubMedGoogle Scholar
  • 10 Anderson JJ, Felson DT. Factors associated with osteoarthritis of the knee in the first national Health and Nutrition Examination Survey (HANES I). Evidence for an association with overweight, race, and physical demands of work. Am J Epidemiol 1988; 128 (1) 179-189
    PubMedGoogle Scholar
  • 11 Nevitt MC, Xu L, Zhang YQ , et al. Very low prevalence of hip osteoarthritis among Chinese elderly in Beijing compared to Caucasians in the U.S.: the Beijing Osteoarthritis Study. Arthritis Rheum 2002; 46: 1773-1779
    CrossrefPubMedGoogle Scholar
  • 12 Messier SP, Gutekunst DJ, Davis C, DeVita P. Weight loss reduces knee-joint loads in overweight and obese older adults with knee osteoarthritis. Arthritis Rheum 2005; 52 (7) 2026-2032
    CrossrefPubMedGoogle Scholar
  • 13 Felson DT, Zhang Y, Anthony JM, Naimark A, Anderson JJ. Weight loss reduces the risk for symptomatic knee osteoarthritis in women. The Framingham Study. Ann Intern Med 1992; 116 (7) 535-539
    CrossrefPubMedGoogle Scholar
  • 14 Karlson EW, Mandl LA, Aweh GN, Sangha O, Liang MH, Grodstein F. Total hip replacement due to osteoarthritis: the importance of age, obesity, and other modifiable risk factors. Am J Med 2003; 114 (2) 93-98
    CrossrefPubMedGoogle Scholar
  • 15 Gkretsi V, Simopoulou T, Tsezou A. Lipid metabolism and osteoarthritis: lessons from atherosclerosis. Prog Lipid Res 2011; 50 (2) 133-140
    CrossrefPubMedGoogle Scholar
  • 16 Spector TD, MacGregor AJ. Risk factors for osteoarthritis: genetics. Osteoarthritis Cartilage 2004; 12 (Suppl A) S39-S44
    CrossrefPubMedGoogle Scholar
  • 17 McAlindon TE, Jacques P, Zhang Y , et al. Do antioxidant micronutrients protect against the development and progression of knee osteoarthritis?. Arthritis Rheum 1996; 39 (4) 648-656
    CrossrefPubMedGoogle Scholar
  • 18 Felson DT, Niu J, Clancy M , et al. Low levels of vitamin D and worsening of knee osteoarthritis: results of two longitudinal studies. Arthritis Rheum 2007; 56 (1) 129-136
    CrossrefPubMedGoogle Scholar
  • 19 Lane NE, Gore LR, Cummings SR , et al; Study of Osteoporotic Fractures Research Group. Serum vitamin D levels and incident changes of radiographic hip osteoarthritis: a longitudinal study. Arthritis Rheum 1999; 42 (5) 854-860
    CrossrefPubMedGoogle Scholar
  • 20 Curtis CL, Rees SG, Little CB , et al. Pathologic indicators of degradation and inflammation in human osteoarthritic cartilage are abrogated by exposure to n-3 fatty acids. Arthritis Rheum 2002; 46 (6) 1544-1553
    CrossrefPubMedGoogle Scholar
  • 21 Messier SP, Legault C, Mihalko S , et al. The Intensive Diet and Exercise for Arthritis (IDEA) trial: design and rationale. BMC Musculoskelet Disord 2009; 10: 93
    CrossrefPubMedGoogle Scholar
  • 22 Croft P, Coggon D, Cruddas M, Cooper C. Osteoarthritis of the hip: an occupational disease in farmers. BMJ 1992; 304 (6837) 1269-1272
    CrossrefPubMedGoogle Scholar
  • 23 Heymsfield SB, van Mierlo CA, van der Knaap HC, Heo M, Frier HI. Weight management using a meal replacement strategy: meta and pooling analysis from six studies. Int J Obes Relat Metab Disord 2003; 27 (5) 537-549
    CrossrefPubMedGoogle Scholar
  • 24 Minor MA, Hewett JE, Webel RR, Anderson SK, Kay DR. Efficacy of physical conditioning exercise in patients with rheumatoid arthritis and osteoarthritis. Arthritis Rheum 1989; 32 (11) 1396-1405
    CrossrefPubMedGoogle Scholar
  • 25 Vingård E, Alfredsson L, Goldie I, Hogstedt C. Sports and osteoarthrosis of the hip. An epidemiologic study. Am J Sports Med 1993; 21 (2) 195-200
    CrossrefPubMedGoogle Scholar
  • 26 Hunter DJ, Eckstein F. Exercise and osteoarthritis. J Anat 2009; 214 (2) 197-207
    CrossrefPubMedGoogle Scholar
  • 27 Frobell RB, Roos HP, Roos EM , et al. The acutely ACL injured knee assessed by MRI: are large volume traumatic bone marrow lesions a sign of severe compression injury?. Osteoarthritis Cartilage 2008; 16 (7) 829-836
    CrossrefPubMedGoogle Scholar
  • 28 Lohmander LS, Englund PM, Dahl LL, Roos EM. The long-term consequence of anterior cruciate ligament and meniscus injuries: osteoarthritis. Am J Sports Med 2007; 35 (10) 1756-1769
    CrossrefPubMedGoogle Scholar
  • 29 Buckwalter JA. Articular cartilage injuries. Clin Orthop Relat Res 2002; 402 (402) 21-37
    CrossrefPubMedGoogle Scholar
  • 30 Lohmander LS, Atley LM, Pietka TA, Eyre DR. The release of crosslinked peptides from type II collagen into human synovial fluid is increased soon after joint injury and in osteoarthritis. Arthritis Rheum 2003; 48 (11) 3130-3139
    CrossrefPubMedGoogle Scholar
  • 31 Gelber AC, Hochberg MC, Mead LA, Wang NY, Wigley FM, Klag MJ. Joint injury in young adults and risk for subsequent knee and hip osteoarthritis. Ann Intern Med 2000; 133 (5) 321-328
    CrossrefPubMedGoogle Scholar
  • 32 Chaudhari AMW, Briant PL, Bevill SL, Koo S, Andriacchi TP. Knee kinematics, cartilage morphology, and osteoarthritis after ACL injury. Med Sci Sports Exerc 2008; 40 (2) 215-222
    CrossrefPubMedGoogle Scholar
  • 33 Lohmander LS, Ostenberg A, Englund M, Roos H. High prevalence of knee osteoarthritis, pain, and functional limitations in female soccer players twelve years after anterior cruciate ligament injury. Arthritis Rheum 2004; 50 (10) 3145-3152
    CrossrefPubMedGoogle Scholar
  • 34 von Porat A, Roos EM, Roos H. High prevalence of osteoarthritis 14 years after an anterior cruciate ligament tear in male soccer players: a study of radiographic and patient relevant outcomes. Ann Rheum Dis 2004; 63 (3) 269-273
    CrossrefPubMedGoogle Scholar
  • 35 Øiestad BE, Engebretsen L, Storheim K, Risberg MA. Knee osteoarthritis after anterior cruciate ligament injury: a systematic review. Am J Sports Med 2009; 37 (7) 1434-1443
    CrossrefPubMedGoogle Scholar
  • 36 Kessler MA, Behrend H, Henz S, Stutz G, Rukavina A, Kuster MS. Function, osteoarthritis and activity after ACL-rupture: 11 years follow-up results of conservative versus reconstructive treatment. Knee Surg Sports Traumatol Arthrosc 2008; 16 (5) 442-448
    CrossrefPubMedGoogle Scholar
  • 37 Neuman P, Englund M, Kostogiannis I, Fridén T, Roos H, Dahlberg LE. Prevalence of tibiofemoral osteoarthritis 15 years after nonoperative treatment of anterior cruciate ligament injury: a prospective cohort study. Am J Sports Med 2008; 36 (9) 1717-1725
    Google Scholar
  • 38 Linko E, Harilainen A, Malmivaara A, Seitsalo S. Surgical versus conservative interventions for anterior cruciate ligament ruptures in adults. Cochrane Database Syst Rev 2005; 2 (2) CD001356
    PubMedGoogle Scholar
  • 39 Myklebust G, Maehlum S, Holm I, Bahr R. A prospective cohort study of anterior cruciate ligament injuries in elite Norwegian team handball. Scand J Med Sci Sports 1998; 8 (3) 149-153
    PubMedGoogle Scholar
  • 40 Amin S, Guermazi A, Lavalley MP , et al. Complete anterior cruciate ligament tear and the risk for cartilage loss and progression of symptoms in men and women with knee osteoarthritis. Osteoarthritis Cartilage 2008; 16 (8) 897-902
    CrossrefPubMedGoogle Scholar
  • 41 Stein V, Li L, Lo G , et al. Pattern of joint damage in persons with knee osteoarthritis and concomitant ACL tears. Rheumatol Int 2012; 32 (5) 1197-1208
    CrossrefPubMedGoogle Scholar
  • 42 Englund M, Lohmander LS. Risk factors for symptomatic knee osteoarthritis fifteen to twenty-two years after meniscectomy. Arthritis Rheum 2004; 50 (9) 2811-2819
    CrossrefPubMedGoogle Scholar
  • 43 Tandogan RN, Taşer O, Kayaalp A , et al. Analysis of meniscal and chondral lesions accompanying anterior cruciate ligament tears: relationship with age, time from injury, and level of sport. Knee Surg Sports Traumatol Arthrosc 2004; 12 (4) 262-270
    Google Scholar
  • 44 Englund M, Guermazi A, Gale D , et al. Incidental meniscal findings on knee MRI in middle-aged and elderly persons. N Engl J Med 2008; 359 (11) 1108-1115
    CrossrefPubMedGoogle Scholar
  • 45 Bhattacharyya T, Gale D, Dewire P , et al. The clinical importance of meniscal tears demonstrated by magnetic resonance imaging in osteoarthritis of the knee. J Bone Joint Surg Am 2003; 85-A (1) 4-9
    PubMedGoogle Scholar
  • 46 Hodler J, Haghighi P, Pathria MN, Trudell D, Resnick D. Meniscal changes in the elderly: correlation of MR imaging and histologic findings. Radiology 1992; 184 (1) 221-225
    PubMedGoogle Scholar
  • 47 Englund M, Guermazi A, Lohmander LS. The meniscus in knee osteoarthritis. Rheum Dis Clin North Am 2009; 35 (3) 579-590
    CrossrefPubMedGoogle Scholar
  • 48 Englund M, Guermazi A, Roemer FW , et al. Meniscal tear in knees without surgery and the development of radiographic osteoarthritis among middle-aged and elderly persons: The Multicenter Osteoarthritis Study. Arthritis Rheum 2009; 60 (3) 831-839
    CrossrefPubMedGoogle Scholar
  • 49 Hunter DJ, Zhang YQ, Niu JB , et al. The association of meniscal pathologic changes with cartilage loss in symptomatic knee osteoarthritis. Arthritis Rheum 2006; 54 (3) 795-801
    CrossrefPubMedGoogle Scholar
  • 50 Roos H, Adalberth T, Dahlberg L, Lohmander LS. Osteoarthritis of the knee after injury to the anterior cruciate ligament or meniscus: the influence of time and age. Osteoarthritis Cartilage 1995; 3 (4) 261-267
    CrossrefPubMedGoogle Scholar
  • 51 Loeser RF. Age-related changes in the musculoskeletal system and the development of osteoarthritis. Clin Geriatr Med 2010; 26 (3) 371-386
    CrossrefPubMedGoogle Scholar
  • 52 Goldring MB, Goldring SR. Articular cartilage and subchondral bone in the pathogenesis of osteoarthritis. Ann N Y Acad Sci 2010; 1192: 230-237
    CrossrefPubMedGoogle Scholar
  • 53 Brandt KD, Dieppe P, Radin EL. Etiopathogenesis of osteoarthritis. Rheum Dis Clin North Am 2008; 34 (3) 531-559
    CrossrefPubMedGoogle Scholar
  • 54 Hunter DJ, Niu JB, Zhang Y , et al. Premorbid knee osteoarthritis is not characterised by diffuse thinness: the Framingham Osteoarthritis Study. Ann Rheum Dis 2008; 67 (11) 1545-1549
    CrossrefPubMedGoogle Scholar
  • 55 Ding C, Cicuttini F, Jones G. Tibial subchondral bone size and knee cartilage defects: relevance to knee osteoarthritis. Osteoarthritis Cartilage 2007; 15 (5) 479-486
    CrossrefPubMedGoogle Scholar
  • 56 Hunter DJ. Insights from imaging on the epidemiology and pathophysiology of osteoarthritis. Radiol Clin North Am 2009; 47 (4) 539-551
    CrossrefPubMedGoogle Scholar
  • 57 Davies-Tuck ML, Wluka AE, Wang Y, English DR, Giles GG, Cicuttini F. The natural history of bone marrow lesions in community-based adults with no clinical knee osteoarthritis. Ann Rheum Dis 2009; 68 (6) 904-908
    CrossrefPubMedGoogle Scholar
  • 58 Davies-Tuck ML, Wluka AE, Forbes A , et al. Development of bone marrow lesions is associated with adverse effects on knee cartilage while resolution is associated with improvement—a potential target for prevention of knee osteoarthritis: a longitudinal study. Arthritis Res Ther 2010; 12 (1) R10
    CrossrefPubMedGoogle Scholar
  • 59 Myers SL, Brandt KD, Ehlich JW , et al. Synovial inflammation in patients with early osteoarthritis of the knee. J Rheumatol 1990; 17 (12) 1662-1669
    PubMedGoogle Scholar
  • 60 Roemer FW, Zhang Y, Niu J , et al; Multicenter Osteoarthritis Study Investigators. Tibiofemoral joint osteoarthritis: risk factors for MR-depicted fast cartilage loss over a 30-month period in the multicenter osteoarthritis study. Radiology 2009; 252 (3) 772-780
    CrossrefPubMedGoogle Scholar
  • 61 Slemenda C, Brandt KD, Heilman DK , et al. Quadriceps weakness and osteoarthritis of the knee. Ann Intern Med 1997; 127 (2) 97-104
    CrossrefPubMedGoogle Scholar
  • 62 Baker KR, Xu L, Zhang Y , et al. Quadriceps weakness and its relationship to tibiofemoral and patellofemoral knee osteoarthritis in Chinese: the Beijing osteoarthritis study. Arthritis Rheum 2004; 50 (6) 1815-1821
    CrossrefPubMedGoogle Scholar
  • 63 Cerejo R, Dunlop DD, Cahue S, Channin D, Song J, Sharma L. The influence of alignment on risk of knee osteoarthritis progression according to baseline stage of disease. Arthritis Rheum 2002; 46 (10) 2632-2636
    CrossrefPubMedGoogle Scholar
  • 64 Felson DT, McLaughlin S, Goggins J , et al. Bone marrow edema and its relation to progression of knee osteoarthritis. Ann Intern Med 2003; 139 (5 Pt 1) 330-336
    CrossrefPubMedGoogle Scholar
  • 65 Brouwer GM, van Tol AW, Bergink AP , et al. Association between valgus and varus alignment and the development and progression of radiographic osteoarthritis of the knee. Arthritis Rheum 2007; 56 (4) 1204-1211
    CrossrefPubMedGoogle Scholar
  • 66 Hunter DJ, Niu J, Felson DT , et al. Knee alignment does not predict incident osteoarthritis: the Framingham osteoarthritis study. Arthritis Rheum 2007; 56 (4) 1212-1218
    CrossrefPubMedGoogle Scholar
  • 67 Zhang Y, Xu L, Nevitt MC , et al. Comparison of the prevalence of knee osteoarthritis between the elderly Chinese population in Beijing and whites in the United States: the Beijing Osteoarthritis Study. Arthritis Rheum 2001; 44 (9) 2065-2071
    CrossrefPubMedGoogle Scholar
  • 68 Sharma L, Song J, Felson DT, Cahue S, Shamiyeh E, Dunlop DD. The role of knee alignment in disease progression and functional decline in knee osteoarthritis. JAMA 2001; 286 (2) 188-195
    CrossrefPubMedGoogle Scholar