pathology & pain in Peripheral Joint

A review 1 published in Arthritis Research & Therapy decided to cover the link between subchondral bone features, pain, and structural pathology during peripheral joint OA (osteoarthritis). The review concluded that the subchondral OA bone does seem to have relevance when it comes to therapeutic measures.

The Context

According to research, OA (or osteoarthritis) is the most common form of arthritis is human beings. It leads to disability and chronic pain. Also, during the process of this review, the market didn’t necessarily have licensed DMOADs (disease-modifying osteoarthritis drugs). Take note; multiple tissues are usually involved in clinical OA. Gaining a better understanding regarding the intricate relationships that exist between these tissues and structural progression (along with the symptoms) might help with identifying potential tissue targets. The subchondral bone is of particular interest because it’s significantly associated with the hyaline cartilage.

The current review was conducted to comprehensively go over the available literature on subchondral bone structure which has been assessed using non-conventional radiographic imaging modalities. The said literature, used in this review, had examined common sites of peripheral OA as well as had described the relationships between joint replacement, structural progression, subchondral bone features, and pain.

The Method

The required original articles were found using Medline, EMBASE, and the Cochrane library databases. The articles reported an association between non-conventional radiographic imaging-assessed subchondral bone pathologies and joint replacement, pain or structural progression in the knee, hip, hand, ankle and foot OA.

A total of 2456 abstracts were screened for this review. Take note; 139 papers were included (70 of which were cross-sectional, 71 were longitudinal analyses).

The Results

The results of this review showed that there was an independent association when it came to the link between BMLs (bone marrow lesions), osteophytes and bone shape with structural progression or joint replacement. Furthermore, there was an independent association between BMLs and bone shape with longitudinal change in pain as well as incident frequent knee pain (respectively).

What was Concluded?

The review concluded that there are independent associations between subchondral bone features and structural progression, pain as well as joint replacement when peripheral OA is concerned; in the hand and hip, however, particularly in the knee. Furthermore, more in-depth research needs to be conducted to collect data about other associations (namely with the ankle and foot). Also, a better understanding of the subchondral OA bone might open doors for better therapeutic strategies.

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