Publications by authors named "Michel D Crema"

BackgroundMeniscal damage compromises its capacity to resist load transmission. However, little is known about the effects of different meniscal injuries on meniscal extrusion under femorotibial loading conditions.PurposeTo evaluate meniscal extrusion in the medial compartment using ultrasound (US), with and without axial loading, and correlate to individual factors (age, body mass index [BMI], osteoarthritis [OA], and type of meniscal tear with different degrees of extrusion).

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Objective: To investigate the association between intestinal permeability alteration and erosive hand osteoarthritis (EHOA).

Methods: Serum concentrations of four intestinal permeability biomarkers (lipopolysaccharide binding protein (LBP), FABP2, sCD14, Zonulin-related proteins (ZRP) along with calprotectin, and high-sensitivity C-Reactive Protein (hs-CRP) were assessed in 410 patients of the DIGICOD cohort. The study compared patients with EHOA (≥ 2 erosion in Verbruggen score N=140) to those without EHOA (N=270) using the Mann-Whitney U test.

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Objective: Intra-articular (IA) mineralization may contribute to osteoarthritis (OA) structural progression. We studied the association of IA mineralization on knee computed tomography (CT) with cartilage damage worsening on knee magnetic resonance imaging (MRI), with a focus on location- and tissue-specific effects.

Methods: Participants from the Multicenter Osteoarthritis Study with knee CT and MRI scans were included.

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Article Synopsis
  • This perspective outlines the development of semi-quantitative (SQ) magnetic resonance imaging (MRI) techniques over the past 30 years for assessing tissue issues in osteoarthritis (OA).
  • The article reviews key scoring systems, including the Whole-Organ Magnetic Resonance Imaging Score (WORMS) and MRI Osteoarthritis Knee Score (MOAKS), and discusses the reliability and responsiveness of SQ MRI in OA research.
  • It highlights the potential for artificial intelligence (AI) to enhance assessment efficiency, though further validation and regulatory approval are needed for its use in clinical trials.
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Accurate diagnosis of muscle injuries is a challenge in everyday clinical practice and may have profound impact on the recovery and return-to-play decisions of professional athletes particularly in soccer. Imaging techniques such as ultrasound and magnetic resonance imaging (MRI), in addition to the medical history and clinical examination, make a significant contribution to the timely structural assessment of muscle injuries. The severity of a muscle injury determined by imaging findings has a decisive influence on therapy planning and affects prognosis.

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This article describes recent advances in quantitative imaging of musculoskeletal extremity sports injuries, citing the existing literature evidence and what additional evidence is needed to make such techniques applicable to clinical practice. Compositional and functional MRI techniques including T2 mapping, diffusion tensor imaging, and sodium imaging as well as contrast-enhanced US have been applied to quantify pathophysiologic processes and biochemical compositions of muscles, tendons, ligaments, and cartilage. Dual-energy and/or spectral CT has shown potential, particularly for the evaluation of osseous and ligamentous injury (eg, creation of quantitative bone marrow edema maps), which is not possible with standard single-energy CT.

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Nerve growth factor (a-NGF) inhibitors have been developed for pain treatment including symptomatic osteoarthritis (OA) and have proven analgesic efficacy and improvement in functional outcomes in patients with OA. However, despite initial promising data, a-NGF clinical trials focusing on OA treatment had been suspended in 2010. Reasons were based on concerns regarding accelerated OA progression but were resumed in 2015 including detailed safety mitigation based on imaging.

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Despite decades of research efforts and multiple clinical trials aimed at discovering efficacious disease-modifying osteoarthritis (OA) drugs (DMOAD), we still do not have a drug that shows convincing scientific evidence to be approved as an effective DMOAD. It has been suggested these DMOAD clinical trials were in part unsuccessful since eligibility criteria and imaging-based outcome evaluation were solely based on conventional radiography. The OA research community has been aware of the limitations of conventional radiography being used as a primary imaging modality for eligibility and efficacy assessment in DMOAD trials.

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Overuse-related injuries of the knee joint and periarticular soft tissues include a heterogenous group of sports and nonsports-related injuries. These conditions include friction and impingement syndromes, bone stress injuries, bursitis, and tendon-related pathology such as tendinopathy and snapping. Traction apophysitis are also discussed as commonly seen in the pediatric population.

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Objective: Describe the radiograph-based screening program and frequencies of ineligibility in 3 large, international, randomized, double-blind, phase 3 studies of subcutaneous tanezumab in patients with osteoarthritis (OA).

Design: Standardized bilateral shoulder, hip, and knee screening radiographs were obtained by trained imaging technologists and centrally read by 1 of 5 musculoskeletal radiology experts trained using a program-specific imaging atlas. Inter-reader consistency was tracked with test cases blindly inserted into the reader queue.

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Osteoarthritis (OA) is among the most common diseases affecting both axial and appendicular joints and the lead cause of disability worldwide. OA incidence is rising due to extended life expectancy and the increasing obesity epidemic. Several joint interventions are available to manage pain and joint function in patients with OA, most of these treatments being widely applied using intra-articular injections.

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Objective: To evaluate three-dimensional (3D) turbo spin-echo (TSE) magnetic resonance imaging (MRI) for the assessment of acute muscle injuries in elite athletes in comparison with two-dimensional (2D) MRI.

Methods: Elite athletes with clinically suspected acute muscle injury of the thigh who underwent both 2D and 3D MRI protocols on the same day were retrospectively included. Two musculoskeletal radiologists independently assessed 2D and 3D MRIs, with both techniques evaluated separately 1-month apart.

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Objective: Metabolic syndrome is a major health problem worldwide associated with obesity, thus drawing attention to its relation to osteoarthritis (OA). However, it is still uncertain whether metabolic syndrome or body fat distribution is associated with knee OA. The aim of this longitudinal study was to elucidate the association between metabolic obesity and adverse structural changes of knee OA assessed by magnetic resonance imaging (MRI).

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Objective: To determine reliability among four experienced and calibrated readers in cross-sectional and longitudinal semi-quantitative MRI assessments of knee osteoarthritis (OA) in the Multicenter Osteoarthritis (MOST) study.

Design: From all MOST participants with at least one knee with readable 60-month and 84-month paired knee MRIs (1.0 ​T extremity systems), we selected 10 subjects having a spectrum of baseline disease severity of cartilage, bone marrow lesions, and meniscal damage and a spectrum of longitudinal changes in severity at 24 months follow-up.

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Objective: To describe the frequency and severity of magnetic resonance imaging (MRI) based peripheral osteoarthritis (OA) in athletes during the Rio de Janeiro 2016 Olympic Games.

Methods: All MRIs of the peripheral joints in Olympic athletes, performed at the centralized imaging facility, either following acute trauma or for non-traumatic joint pain, were included. All MRIs were retrospectively reviewed for presence and severity of MRI-based OA using an adapted Outerbridge classification for cartilage and adapted classifications for other tissues.

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Objective: To determine the prevalence, distribution, and characteristics associated with radiographic metacarpophalangeal (MCP) joint osteoarthritis (OA).

Methods: This was a cross-sectional study of baseline data from the Digital Cohort Osteoarthritis Design, a French monocentric cohort including patients with symptomatic hand OA. We evaluated the prevalence of radiographic MCP joint OA, defined as ≥2 MCP joints with a Kellgren/Lawrence score of ≥2.

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Objective: To compare the diagnostic performance of two different sets of magnetic resonance imaging (MRI) for the detection of subchondral erosions in the sacroiliac joints regarding the application of fat-water separation techniques when acquiring T1-weighted (T1w) images, using multi-detector computed tomography (MDCT) as the reference standard.

Methods: We retrospectively included 31 consecutive patients having or being suspected for axial spondyloarthritis (SpA) assessed using both MRI and MDCT. Three sets of images were independently assessed for the presence of erosions by two musculoskeletal radiologists (R1, R2): (1) MRI with standard T1w without fat suppression, (2) MRI with both T1w with and without fat suppression, and (3) MDCT.

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Objective: Despite its prevalence, there are few worldwide hand osteoarthritis (HOA) cohorts. The main objective of DIGItal COhort Design (DIGICOD) cohort is to investigate prognostic clinical, biological, genetic and imaging factors of clinical worsening after 6years follow-up.

Methods: DIGICOD is a hospital-based prospective cohort including patients>35years-old with symptomatic HOA fulfilling: (i) ACR criteria for HOA with≥2 symptomatic joints among proximal/distal interphalangeal joints or 1st interphalangeal joint with Kellgren-Lawrence (KL)≥2; or (ii) symptomatic thumb base OA with KL≥2.

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Objective: To describe the occurrence of imaging-depicted sports-related injuries (bone, muscle, tendon, and ligament injuries) during the Rio 2016 Summer Paralympic Games.

Methods: Descriptive data on all imaging examinations by using radiography, ultrasonography (US), and MRI were collected and retrospectively analyzed centrally by five musculoskeletal radiologists according to imaging modality, country of origin of the athletes, type of sport, type of disability, and type and location of injury.

Results: We report 109 injuries in 4378 athletes.

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Objectives: Emerging evidence suggests a potential link between OA and gout; however, the association between serum uric acid (UA) itself and knee OA remains uncertain due to a lack of longitudinal studies. Here, we investigated the association between serum UA and knee OA according to cartilage status in elderly community residents without gout.

Methods: In this longitudinal study, participants without a history of gout were recruited from among the Korean cohort of the Hallym Aging Study (n = 296 for radiography study and n = 223 for MRI study).

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Background: To investigate the frequency of pain among subjects with advanced radiographic knee osteoarthritis (OA) defined as Kellgren-Lawrence (KL) grade 4 and clinical features associated with pain.

Methods: Subjects from the Hallym Aging Study (HAS), the Korean National Health and Nutrition Examination Survey (KNHANES), and the Osteoarthritis Initiative (OAI) were included. Participants were asked knee-specific questions regarding the presence of knee pain.

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Article Synopsis
  • - The study compared two MRI techniques, STIR and T2 SPAIR, to evaluate their image quality and ability to detect active inflammation in the sacroiliac joints (SIJ) of patients suspected to have spondyloarthritis.
  • - Involving 69 patients, the research measured the signal-to-noise ratio (SNR) for each technique and assessed the diagnostic performance of STIR and T2 SPAIR using established criteria, with T1 SPIR Gd+ serving as the reference standard.
  • - Findings showed that while T1 SPIR had a much higher mean SNR than STIR and T2 SPAIR, both STIR and T2 SPAIR techniques had comparable sensitivity and specificity for diagnosing sacro
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Osteoarthritis (OA) is a highly prevalent chronic condition with marked implications for affected individuals and public health care. There are available treatments to manage pain and symptoms but no effective treatment for OA. In the past 10 years, joint imaging, particularly MRI, has evolved rapidly due to technical advances and their application to clinical research, which has led to abundant evidence regarding the natural history of the disease.

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Purpose: To evaluate the distribution and severity of cartilage damage and scapholunate dissociation assessed on multi-detector computer tomography (MDCT) arthrography in a sample of patients with scapholunate interosseous ligament (SLIL) injury, in regard to component-specific tears.

Methods: We retrospectively included 37 patients with SLIL tears and 34 patients without SLIL tears who served as controls, all patients had undergone MDCT arthrography. Morphology of SLIL dorsal and volar components was graded as: normal, partial, or complete tear.

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Objective: To describe the frequency and the distribution of degenerative disc disease (DDD) detected in athletes who underwent spine MRI in the 2016 Summer Olympic Games in Rio de Janeiro.

Methods: Data on spine MRI examinations from the 2016 Summer Olympics were retrospectively analyzed. We assessed the frequency of DDD of the cervical (Cs), thoracic (Ts), and lumbar (Ls) spine using Pfirrmann's classification.

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