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Magnetic resonance imaging (MRI) is increasingly used in the classification and evaluation of osteoarthritis (OA). Many studies have focused on knee OA, investigating the association between MRI-detected knee structural abnormalities and knee pain. Hip OA differs from knee OA in many aspects, but little is known about the role of hip structural abnormalities in hip pain. This study aimed to systematically evaluate the association of hip abnormalities on MRI, such as cartilage defects, bone marrow lesions (BMLs), osteophytes, paralabral cysts, effusion-synovitis, and subchondral cysts, with hip pain. We searched electronic databases from inception to February 2024, to identify publications that reported data on the association between MRI features in the hip joint and hip pain. The quality of the included studies was scored using the Newcastle-Ottawa Scale (NOS). The levels of evidence were evaluated according to the Cochrane Back Review Group Method Guidelines and classified into five levels: strong, moderate, limited, conflicting, and no evidence. A total of nine studies were included, comprising five cohort studies, three cross-sectional studies, and one case-control study. Moderate level of evidence suggested a positive association of the presence and change of BMLs with the severity and progress of hip pain, and evidence for the associations between other MRI features and hip pain were limited or even conflicting. Only a few studies with small to modest sample sizes evaluated the association between hip structural changes on MRI and hip pain. BMLs may contribute to the severity and progression of hip pain. Further studies are warranted to uncover the role of hip MRI abnormalities in hip pain. The protocol for the systematic review was registered with PROSPERO (https://www.crd.york.ac.uk/PROSPERO/, CRD42023401233). [ABSTRACT FROM AUTHOR]

A 65-year-old man with a history of seronegative rheumatoid arthritis presented with pain and swelling in his knees and wrists. Despite previous treatments, his symptoms did not improve. Laboratory tests showed low potassium levels, high ESR, and high CRP. X-rays revealed osteoarthritic changes. The differential diagnosis includes various forms of arthritis, such as seronegative rheumatoid arthritis, peripheral spondyloarthritis, osteoarthritis, infectious arthritis, crystalline arthritis, and paraneoplastic arthritis. Further evaluation is needed to determine the correct diagnosis. In this case, the patient was diagnosed with chronic calcium pyrophosphate crystal inflammatory arthritis due to hypomagnesemia caused by proton pump inhibitor use. Checking for hypomagnesemia in patients with CPPD disease is important, and PPI use should be considered as a potential cause. [Extracted from the article]

Background: Bibrachial amyotrophy associated with an extradural CSF collection and infratentorial superficial siderosis (SS) are rare conditions that may occasionally mimic ALS. Both disorders are assumed to be due to dural tears. Case presentation: A 53-year-old man presented with a 7-year history of slowly progressive asymmetric bibrachial amyotrophy. Initially, a diagnosis of atypical motor neuron disease (MND) was made. At re-evaluation 11 years later, upper limb wasting and weakness had further progressed and were accompanied by sensorineural hearing loss. MRI of the brain and spine demonstrated extensive supra- and infratentorial SS (including the surface of the whole spinal cord) as well as a ventral longitudinal intraspinal fluid collection (VLISFC) extending along almost the entire thoracic spine. Osteodegenerative changes were observed at C5-C7 level, with osteophytes protruding posteriorly. The bony spurs at C6-C7 level were hypothesized to have lesioned the dura, causing a CSF leak and thus a VLISFC. Review of the MRI acquired at first evaluation showed that the VLISFC was already present at that time (actually beginning at C7 level), whereas the SS was not. 19 years after the onset of upper limb weakness, the patient additionally developed parkinsonism. Response to levodopa, brain scintigraphy with 123I-ioflupane and brain MRI with nigrosome 1 evaluation were consistent with idiopathic Parkinson's disease (PD). On the latest follow-up 21 years after symptom onset, the VLISFC was unchanged, as were upper arm weakness and wasting. Conclusions: Based on the long-term follow-up, we could establish that, while the evidence of the VLISFC was concomitant with the clinical presentation of upper limb amyotrophy and weakness, the radiological signs of SS appeared later. This suggests that SS was not per se the cause of the ALS-like clinical picture, but rather a long-term sequela of a dural leak. The latter was instead the causative lesion, giving rise to a VLISFC which compressed the cervical motor roots. Dural tears can actually cause several symptoms, and further studies are needed to elucidate the pathophysiological correlates of "duropathies". Finally, as iron metabolism has been implicated in PD, the co-occurrence of PD with SS deserves further investigation. [ABSTRACT FROM AUTHOR]

Study Design: Technical Report Objective: Cerebrospinal fluid (CSF) leak secondary to anterior osteophytes at the cervico-thoracic junction is a rare cause of intracranial hypotension. In this article we describe a technique for anterior repair of spontaneous ventral cerebrospinal fluid leaks in the upper thoracic spine. Methods: In this technical report and operative video, we describe a 23-year-old male who presented with positional headaches and bilateral subdural hematoma. Dynamic CT myelography demonstrated a high flow ventral cerebrospinal fluid leak associated with a ventral osteophyte at the level of the T1-T2 disc space. Targeted blood patch provided only temporary improvement in symptoms. An anterior approach was chosen to remove the offending spur and micro-surgically repair the dural defect. Results: The patient had complete resolution of his preoperative symptoms after primary repair. Conclusions: In select cases, an anterior approach to the upper thoracic spine is effective to repair Type 1 cerebrospinal fluid leaks. [ABSTRACT FROM AUTHOR]

Introduction: Magnetic resonance imaging (MRI) scans are increasingly used for knee osteoarthritis evaluation and preoperative planning before unicompartmental knee arthroplasty (UKA), and often patients already have MRI scans before their initial surgeon consultation. This highlights the need for surgeons to understand anteromedial osteoarthritis (AMOA) patterns on MRI. Hence, we aim to describe MRI findings in patients with AMOA meeting current indications for medial UKA. Materials and methods: We analysed MRI scans from 100 knees evaluated for UKA between 2006 and 2013. Inclusion criteria comprised full-thickness medial compartment loss and intact lateral compartment joint space on preoperative radiographs. Assessment included cartilage lesions, osteophytes, meniscal damage, and anterior-cruciate ligament (ACL) status on tibial and femoral surfaces. Final decision to proceed with UKA relied on intraoperative findings, independent of MRI. Results: Complete anteromedial tibial and femoral cartilage loss preserved posterior cartilage rims was evident in all cases. Cartilage thinning occurred in the lateral compartment in 34% of cases. While 62% displayed lateral osteophytes, only 6 exhibited small areas of full-thickness cartilage loss. ACL abnormalities varied: 27% normal, 3% ruptured, and 70% had intrasubstance high signal. Larger osteophytes in the medial (p = 0.012) and lateral (p = 0.002) intercondylar notch correlated significantly with ACL damage. All underwent medial UKA, with no evidence of areas with full lateral compartment cartilage loss intraoperatively. Conclusions: The MRI findings confirmed the radiographic diagnosis of bone-on-bone medial disease but highlights a range of findings in the ACL, lateral compartment, and patellofemoral joint compartment for patients who met the current x-ray and intraoperative indication for UKA. Further research is required to understand if these MRI changes will affect long-term outcomes. [ABSTRACT FROM AUTHOR]

Objective: To compare the degenerative features of cartilaginous endplate with bony endplate in association with intervertebral degeneration in local population at radiographic, macroscopic and microscopic level in human motion segments. Methods: This cross-sectional descriptive study examined 59 lumbar spine motion segments from adult male cadavers at the Department of Anatomy, University of Health Sciences, Lahore, between May and September, 2022. Radiographic assessment observed bony endplate (BEP) for the presence of sclerosis & osteophytes and degeneration scores from 1-8 were assigned. Macroscopic assessment was done to evaluate BEP, cartilaginous endplate (CEP) and IVD, and scores ranged from 1to 28 for BEP, 1-4 for CEP and 1-64 for IVD were assigned. Microscopic assessment revealed degeneration scores of CEP ranged from 1-42 and 1-30 for IVD. Segments with BEP defects were also identified on radiographs & macroscopy. Results: Significant correlations were observed between the total degeneration scores of BEP with IVD and CEP scores (r=0.88 and r=0.909, respectively, p<0.001). Similarly, the total degeneration scores of the CEP is also significantly correlated with total IVD (r=0.86, p<0.001). Additionally, the samples with BEP defects were having higher IVD degeneration scores (p<0.001). Conclusion: This study, for the first time identifies that there exists a critical association of bony and cartilaginous endplate with intervertebral disc degeneration individually in the same tissue sections using multi-dimension assessment methods. Degeneration in any of the components of VEP is consonantly associated with IVD degeneration. The BEP & CEP, though, they are unique structures but are interlinked with each other structurally and functionally. [ABSTRACT FROM AUTHOR]

Zebrafish are considered as model organisms in biological and medical research because of their high degree of homology with human genes. Automatic behavioral analysis of multiple zebrafish based on visual tracking is expected to improve research efficiency. However, vision-based multi-object tracking algorithms often suffer from data loss owing to mutual occlusion. In addition, simply tracking zebrafish as points is not sufficient-more detailed information, which is required for research on zebrafish behavior. In this paper, we propose Zebrafishtracker3D, which utilizes a skeleton stability strategy to reduce detection error caused by frequent overlapping of multiple zebrafish effectively and estimates zebrafish skeletons using head coordinates in the top view. Further, we transform the front- and top-view matching task into an optimization problem and propose a particle-matching method to perform 3D tracking. The robustness of the algorithm with respect to occlusion is estimated on the dataset comprising two and three zebrafish. Experimental results demonstrate that the proposed algorithm exhibits a multiple object tracking accuracy (MOTA) exceeding 90% in the top view and a 3D tracking matching accuracy exceeding 90% in the complex videos with frequent overlapping. It is noteworthy that each instance in the trace saves its skeleton. In addition, Zebrafishtracker3D is applied in the zebrafish courtship experiment, establishes the stability of the method in applications of life science, and proves that the data can be used for behavioral analysis. Zebrafishtracker3D is the first algorithm that realizes 3D skeleton tracking of multiple zebrafish simultaneously. • The first 3D multi-object zebrafish skeleton-level tracking method is proposed. • It can effectively solve the problem of data loss caused by cross occlusion. • A general method of bone spur removal based on morphology is proposed. • The algorithm has been successfully applied to life science experiments. [ABSTRACT FROM AUTHOR]

In this study, we investigated the discriminative capacity of knee morphology in automatic detection of osteophytes defined by the Osteoarthritis Research Society International atlas, using X‐ray and magnetic resonance imaging (MRI) data. For the X‐ray analysis, we developed a deep learning (DL) based model to segment femur and tibia. In case of MRIs, we utilized previously validated segmentations of femur, tibia, corresponding cartilage tissues, and menisci. Osteophyte detection was performed using DL models in four compartments: medial femur (FM), lateral femur (FL), medial tibia (TM), and lateral tibia (TL). To analyze the confounding effects of soft tissues, we investigated their morphology in combination with bones, including bones+cartilage, bones+menisci, and all the tissues. From X‐ray‐based 2D morphology, the models yielded balanced accuracy of 0.73, 0.69, 0.74, and 0.74 for FM, FL, TM, TL, respectively. Using 3D bone morphology from MRI, balanced accuracy was 0.80, 0.77, 0.71, and 0.76, respectively. The performance was higher than in 2D for all the compartments except for TM, with significant improvements observed for femoral compartments. Adding menisci or cartilage morphology consistently improved balanced accuracy in TM, with the greatest improvement seen for small osteophyte. Otherwise, the models performed similarly to bones‐only. Our experiments demonstrated that MRI‐based models show higher detection capability than X‐ray based models for identifying knee osteophytes. This study highlighted the feasibility of automated osteophyte detection from X‐ray and MRI data and suggested further need for development of osteophyte assessment criteria in addition to OARSI, particularly, for early osteophytic changes. [ABSTRACT FROM AUTHOR]

Background Extracellular vesicles derived from mesenchymal stem cells (MSCs) show great promise in treating osteoarthritis (OA). However, studies from the perspective of clinical feasibility that consider an accessible cell source and a scalable preparationmethod forMSC-extracellular vesicles are lacking. Questions/purposes (1) Does an infrapatellar fat pad obtained from patients undergoing TKA provide a suitable source to provide MSC-extracellular vesicles purified by anion exchange chromatography? Using an in vivo mouse model for OA in the knee, (2) how does injection of the infrapatellar fat pad-derived MSC-extracellular vesicles alter gait, cartilage structure and composition, protein expression (Type II collagen, MMP13, and ADAMTS5), subchondral bone remodeling and osteophytes, and synovial inflammation? Methods The infrapatellar fat pad was collected from three patients (all female; 62, 74, 77 years) during TKA for infrapatellar fat pad-derived MSC culturing. Patients with infection, rheumatic arthritis, and age > 80 years were excluded. MSC-extracellular vesicles were purified by anion exchange chromatography. For the animal study, we used 30 male C57BL/6 mice aged 10 weeks, divided into six groups. MSC-extracellular vesicles were injected weekly into the joint of an OA mouse model during ACL transection (ACLT). To answer our first research question, we characterized MSCs based on their proliferative potential, differentiation capacity, and surface antigen expression, and we characterized MSC-extracellular vesicles by size, morphology, protein marker expression, and miRNA profile. To answer our second research question, we evaluated the effects of MSC-extracellular vesicles in the OA mouse model with quantitative gait analysis (mean pressure, footprint area, stride length, and propulsion time), histology (Osteoarthritis Research Society International Score based on histologic analysis [0 = normal to 24 = very severe degeneration]), immunohistochemistry staining of joint sections (protein expression of Type II collagen, MMP13, and ADAMTS5), and micro-CT of subchondral bone (BV/TV and Tb.Pf) and osteophyte formation. We also examined the mechanism of action of MSCextracellular vesicles by immunofluorescent staining of the synovium membrane (number of M1 and M2 macrophage cells) and by analyzing their influence on the expression of inflammatory factors (relative mRNA level and protein expression of IL-1β, IL-6, and TNF-α) in lipopolysaccharide-induced macrophages. Results Infrapatellar fat pads obtained from patients undergoing TKA provide a suitable cell source for producing MSC-extracellular vesicles, and anion exchange chromatography is applicable for isolating MSC-extracellular vesicles. Cultured MSCs were spindle-shaped, proliferative at Passage 4 (doubling time of 42.75 ± 1.35 hours), had trilineage differentiation capacity, positively expressed stem cell surface markers (CD44, CD73, CD90, and CD105), and negatively expressed hematopoietic markers (CD34 and CD45). MSC-extracellular vesicles purified by anion exchange chromatography had diameters between 30 and 200 nm and a typical cup shape, positively expressed exosomal marker proteins (CD63, CD81, CD9, Alix, and TSG101), and carried plentiful miRNA. Compared with the ACLT group, the ACLT + extracellular vesicle group showed alleviation of pain 8 weeks after the injection, indicated by increased area (0.67 ± 0.15 cm² versus 0.20 ± 0.03 cm², -0.05 [95% confidence interval -0.09 to -0.01]; p = 0.01) and stride length (5.08 60.53 cm versus 6.20 ± 0.33 cm, -1.12 [95% CI -1.86 to -0.37]; p = 0.005) and decreased propulsion time (0.2260.06 s versus 0.1160.04 s, 0.11 [95% CI 0.03 to 0.19]; p = 0.007) in the affected hindlimb. Compared with the ACLT group, the ACLT + extracellular vesicles group had lower Osteoarthritis Research Society International scores after 4 weeks (8.80 ± 2.28 versus 4.80 ± 2.28, 4.00 [95% CI 0.68 to 7.32]; p = 0.02) and 8 weeks (16.00 ± 3.16 versus 9.6062.51, 6.40 [95% CI 2.14 to 10.66]; p = 0.005). In the ACLT + extracellular vesicles group, there was moresevere OA at 8 weeks than at 4 weeks (9.60 ± 2.51 versus 4.80 ± 2.28, 4.80 [95% CI 0.82 to 8.78]; p = 0.02), indicating MSC-extracellular vesicles could only delay but not fully suppress OA progression. Compared with the ACLT group, the injection of MSC-extracellular vesicles increased Type II collagen expression, decreased MMP13 expression, and decreased ADAMTS5 expression at 4 and 8 weeks. Compared with the ACLT group, MSCextracellular vesicle injection alleviated osteophyte formation at 8 weeks and inhibited bone loss at 4 weeks. MSC-extracellular vesicle injection suppressed inflammation; the ACLT + extracellular vesicles group had fewer M1 type macrophages than the ACLT group. Compared with lipopolysaccharide-treated cells, MSCextracellular vesicles reduced mRNA expression and inhibited IL-1β, IL-6, and TNF-α in cells. Conclusion Using an OA mouse model, we found that infrapatellar fat pad-derived MSC-extracellular vesicles could delay OA progression via alleviating pain and suppressing cartilage degeneration, osteophyte formation, and synovial inflammation. The autologous origin of extracellular vesicles and scalable purification method make our strategy potentially viable for clinical translation. Clinical Relevance Infrapatellar fat pad-derived MSCextracellular vesicles isolated by anion exchange chromatography can suppress OA progression in a mouse model. Further studies with large-animal models, larger animal groups, and subsequent clinical trials are necessary to confirm the feasibility of this technique for clinical OA treatment. [ABSTRACT FROM AUTHOR]

Background The distribution of subchondral bone density in a joint represents stress that is applied to the joint. Knowing this information is important for understanding the pathophysiology of osteoarthritis (OA). In the elbow, however, this has not been studied before. Questions/purposes (1) Is advanced-stage elbow OA associated with more radially distributed subchondral bone density than earlier stages? (2) What demographic (age and sex) and radiographic (osteophyte location and carrying angle) factors are associated with increased radial shift in subchondral bone density? Methods Between March 2001 and December 2021, we treated 301 patients for elbow OA. We considered patients with plain radiographs and conventional CT scans as potentially eligible. Thus, 68% (206 patients) were eligible; a further 27%(80 patients)were excluded because of a history of any injury or surgery or known inflammatory joint disease, leaving 42% (126 patients) for analysis here. Their mean 6 standard deviation age was 60 6 10 years. Early OA with minimal joint space narrowing and osteophyte formation was found in 33% (42 of 126) of patients, and advanced OA was found in the remaining 67% (84 of 126). Three-dimensional distal humerus subchondral bonemodels were derived from CT images, and in the central intraarticulating portion, we measured the subchondral bone density in two different sites: where it articulates with the radius (SBDrad) and with the ulna (SBDulna). We further defined the SBDratio as the percent ratio of SBDrad to SBDulna. We also evaluated osteophyte severity based on its size at the radiocapitellar and ulnotrochlear joints, and alignment through measuring the carrying angle on radiographs. To assess interobserver reliability, two orthopaedic surgeons took measurements independently from each other. All measurements had excellent intraoberver and interobserver reliabilities. Then, we compared the subchondral bone parameters between early and advanced OA and performed a multivariable analysis of the factors associated with subchondral bone parameters, including age, sex, osteophyte location, and carrying angle. Results Radial versus ulna subchondral bone density (SBDratio) was modestly higher in patients with advanced OA (118% 617%) than in patients with early OA (109%6 17%, mean difference 9% [95% CI 2.3% to 15.3%]; p = 0.01). With increasing radial deviation in subchondral bone density, cubitus valgus had amodest association (b = 0.466 0.23; p = 0.04) and severe osteophytes at the radiocapitellar joint had a large association (± = 9.51 6 3.06; p = 0.002). Conclusion According to subchondral bone density distribution, stress concentration was more radially deviated in patients with the advanced stages of elbow OA than in those with the early stages. We also found that an increase in carrying angle is associated with radial deviation of stress. Afuture study that examines longitudinal changes in the subchondral bone density might be required to confirm changes in stress concentration with OA progression. Clinical Relevance This study gives us insight into the potential pathophysiology of elbow OA in relation to elbow alignment. Although debridement of osteophytes in the ulnotrochlear joint is the most frequently performed procedure in patients with advanced elbow OA, our finding suggests that some patients with an increased carrying angle might benefit from management of the radiocapitellar joint as well, or from being informed of the future development of OA in the radiocapitellar joint, because stress at this site can be increased with the advancement of OA. [ABSTRACT FROM AUTHOR]

Foot disorders are responsible for up to 5% of confinement losses. Identifying the cause of lameness and applying the correct treatment are crucial measures. The possibility of determining the probable origins of digital lesions, their extension, and assistance in cases in which it was not possible to reach a definitive clinical diagnosis demonstrates that the radiographic evaluation provides information of great importance on cattle digits. Thus, this study aimed to investigate possible radiographic changes in the hoof, bone structures, and soft tissues of the digits of Nelore bulls at the end of the confinement period. Regarding the main signs, 100% (n = 24) showed proliferation of enthesophytes and osteophytes and irregular contours, 62.5% (n = 15) enlargement of vascular channels, 37.5% (n = 9) osteolysis, 33.4% (n = 8) gas content in the white line region, 20.84% (n = 5) gas content in the dorsal lamina region, and 4.16% (n = 1) presented palisade periosteal reaction. Ten (41.7%) out of 24 (100%) animals evaluated at the end of the confinement presented lameness, three animals of score three, four animals of score two, and three animals of score one. The higher the score indicating the severity of the signs observed in the visual assessment of the radiographs, the higher the internal angle values (moderate correlation of 0.5 and p < 0.05). A higher prevalence of osteo‐proliferative radiographic changes was identified at the end of the 114‐day confinement period in the third phalanx of Nellore cattle even in animals that had no lameness. [ABSTRACT FROM AUTHOR]

Osteoarthritis (OA) is the most common form of arthritis, characterized by osteophyte formation, cartilage degradation, and structural and cellular alterations of the synovial membrane. Activated fibroblast-like synoviocytes (FLS) of the synovial membrane have been identified as key drivers, secreting humoral mediators that maintain inflammatory processes, proteases that cause cartilage and bone destruction, and factors that drive fibrotic processes. In normal tissue repair, fibrotic processes are terminated after the damage has been repaired. In fibrosis, tissue remodeling and wound healing are exaggerated and prolonged. Various stressors, including aging, joint instability, and inflammation, lead to structural damage of the joint and micro lesions within the synovial tissue. One result is the reduced production of synovial fluid (lubricants), which reduces the lubricity of the cartilage areas, leading to cartilage damage. In the synovial tissue, a wound-healing cascade is initiated by activating macrophages, Th2 cells, and FLS. The latter can be divided into two major populations. The destructive thymocyte differentiation antigen (THY)1- phenotype is restricted to the synovial lining layer. In contrast, the THY1+ phenotype of the sublining layer is classified as an invasive one with immune effector function driving synovitis. The exact mechanisms involved in the transition of fibroblasts into a myofibroblast-like phenotype that drives fibrosis remain unclear. The review provides an overview of the phenotypes and spatial distribution of FLS in the synovial membrane of OA, describes the mechanisms of fibroblast into myofibroblast activation, and the metabolic alterations of myofibroblast-like cells. [ABSTRACT FROM AUTHOR]

Objective: The most common causes of plantar and heel pain are plantar fasciitis and calcaneal spurs, and they often co‐exist. Surgery is a recognized treatment for refractory plantar fasciitis. However, few studies have proposed treatment options for patients with metatarsophalangeal fasciitis with bone spurs. Accordingly, this study's purpose was to propose a four‐step surgical regimen, and to improve the surgical outcome of plantar fasciitis with osteophytes and to establish a procedure for surgical treatment. Methods: Retrospective analysis of 45 patients suffering from plantar fasciitis with bone spurs from 2020 to 2023. All patients underwent a four‐step procedure, including plantar fascia release, calcaneal spur grinding, inflammatory tissue removal, and calcaneal burr decompression. The imaging parameters and functional scores were recorded before and after the operation. The objective evaluation included the measurement of calcaneal spur length on radiographs. Clinical evaluation included the American Orthopaedic Foot and Ankle Society (AOFAS), the Visual Analog Scale (VAS), and the Foot and Ankle Outcome Scale (FAOS). Measurement data that conformed to normal distribution were expressed as (x2 ± s), and pre‐and postoperative AOFAS, FAOS, and VAS scores were compared using repeated‐measures ANOVA, and preoperative and postoperative spur lengths were compared using paired t‐tests. Results: The 45 patients were followed up for 3 to 30 months, (17.72 ± 8.53) months, at final follow‐up, the patient's AOFAS score improved from preoperative (74.93 ± 5.56) to (94.78 ± 3.98), FAOS score increased from preoperative (76.42 ± 3.37) to (96.16 ± 2.74), the VAS score decreased from (3.18 ± 0.54) to (1.07 ± 1.20) (p < 0.05), the length of spur decreased from (0.72 ± 1.81) cm to (0.23 ± 1.19) cm, and there were significant differences before and after operation (p < 0.05). Conclusion: The four‐step surgical regimen is an appropriate and effective surgical procedure to treat plantar fasciitis with bone spurs. [ABSTRACT FROM AUTHOR]

Purpose: Knee osteoarthritis (KOA) is a very common cartilage disorder affecting millions of people globally and is characterized by pain, stiffness, swelling, loss of articular cartilage, and osteophyte formation, resulting in disability. The presently available treatments for KOA are palliative. Hence, there is a need to explore a non-surgical treatment portfolio. Bone marrow aspirate concentrate (BMAC) is one of the predominant attention-drawing managements/treatments for KOA in recent times due to its potential advantages of disease-modifying and regeneration capacities. Principle: This study aimed to evaluate the role of single-injection autologous BMAC as a therapeutic option in the treatment of KOA and evaluate the functional and clinical outcomes of KOA patients. In this study, 132 patients with KOA (Kellgren and Lawrence (KL) grade II and III) were included as per the inclusion criteria. Autologous bone marrow was aspirated and separated, and concentrated bone marrow aspirate was administered into the knee joint of the affected individual. Results: At the end of the 12th month (end of the follow-up period), 95% of patients showed complete pain relief and improvement in joint function, which shows that the results were promising and encouraging. Unpaired t-test results also indicated that the two-tailed p-value is less than 0.0001, and the difference is extremely statistically significant. No adverse effects were observed in the study patients. Conclusions: BMAC therapy has potential, with satisfactory, efficient, and durable results in KL grades II and III in KOA patients. This can be a safe alternative therapy in the treatment of KOA, especially in the early grades of OA. In summary, to the best of our knowledge, this is the first study from India that evaluated BMAC efficacy both subjectively and objectively in KOA (KL-II and KL-III) patients. [ABSTRACT FROM AUTHOR]

Purpose: Digital mucoid cysts are frequently found at the distal interphalangeal (DIP) joint in patients with degenerative osteoarthritis. In complicated cases, surgical treatment with mucoid cyst resection is considered, and soft tissue is covered with one of various local flap techniques. Among these, bilobed flaps are reliable and aesthetically favorable, with primary healing of the donor site. In this study, we investigated a case series of bilobed flaps for digital mucoid cysts. Methods: We retrospectively reviewed our electronic medical records and found 26 digital mucoid cysts treated with bilobed flaps at our facility between July 2022 and February 2024. We extracted data from the records of these patients on sex; age; time to surgery; clinical findings including nail ridging, the presence of osteophytes, cyst size and location, and additional procedures (arthrodesis); and follow-up data including the occurrence of complications, such as delayed wound healing, infection, stiffness, and recurrence. Results: Among the 26 patients in our sample, 19 were female and seven were male. The average age was 62.2 years, and the average time to surgery was 10.8 months. Preoperatively, the average cyst measured 6.9×8.3 mm. Nail ridging was found in 19 patients (73.1%) and osteophytes in 22 patients (84.6%). The most commonly affected digit was the middle finger, which accounted for 10 cases (38.5%). All the flaps totally survived, without major complications. Conclusion: Based on our series, a bilobed flap for soft tissue coverage after mucoid cyst excision can achieve high-quality surgical results. [ABSTRACT FROM AUTHOR]

This article discusses the natural course of degenerative changes in the spine in patients with axial spondyloarthritis (axSpA) over a 10-year period. The study used radiographs and magnetic resonance imaging (MRI) to assess structural lesions in the spine. The results showed a high prevalence of degenerative changes in the spine, with the number of changes increasing over the 10-year period. The most frequent degenerative changes observed were loss of disk height, osteophytes, facet joint osteoarthritis, disk degeneration, high-intensity zone, Schmorl's node without edema, and disk protrusion. This study provides valuable insights into the progression of degenerative changes in the spine in axSpA patients. [Extracted from the article]

Study Design. Prospective, case series. Objective. To identify and characterize any differences in specific patient factors, MRI findings, features of spontaneous disc resorption, and outcomes between patients with single-level and multilevel LDH. Background. Lumbar disc herniation (LDH) is one of the most common spinal pathologies worldwide. Though many cases of LDH resolve by spontaneous resorption, the mechanism underlying this "self-healing" phenomenon remains poorly understood, particularly in the context of multilevel herniations. Methods. A one-year prospective study was conducted of patients presenting with acute symptomatic LDH between 2017 and 2019. Baseline demographics, herniation characteristics, and MRI phenotypes were recorded before treatment, which consisted of gabapentin, acupuncture, and the avoidance of inflammatorymodulating medications. MRIs were performed approximately every three months after the initial evaluation to determine any differences between patients with single-level and multilevel LDH. Results. Ninety patients were included, 17 demonstrated multilevel LDH. Body mass index was higher among patients with multilevel LDH (P<0.001). Patients with multilevel LDH were more likely to exhibit L3/L4 inferior endplate defects (P=0.001), L4/L5 superior endplate defects (P=0.012), and L4/L5 inferior endplate defects (P= 0.020) on MRI. No other differences in MRI phenotypes (e.g. Modic changes, osteophytes, etc.) existed between groups. Resorption rate and time to resolution did not differ between those with single-level and multilevel LDH. Conclusions. Resorption rates were similar between single-level and multilevel LDH at various time points throughout one prospective assessment, providing insights that disc healing may have unique programmed signatures. Compared with those with singlelevel LDH, patients with multilevel herniations were more likely to have a higher BMI, lesser initial axial and sagittal disc measurements, and endplate defects at specific lumbar levels. In addition, our findings support the use of conservative management in patients with LDH, regardless of the number of levels affected. [ABSTRACT FROM AUTHOR]

Osteoartritis (OA) is a debilitating disease affecting both humans and animals. In the early stages, OA is characterized by damage to the extracellular matrix (ECM) and apoptosis and depletion of chondrocytes. OA progression is characterized by hyaline cartilage loss, chondrophyte and osteophyte formation, thickening of the joint capsule and function loss in the later stages. As the regenerative potential of cartilage is very limited and osteoarthritic changes are irreversible, prevention of OA, modulation of existing osteoarthritic joint inflammation, reducing joint pain and supporting joint function are the only options. Progression of OA and pain may necessitate surgical intervention with joint replacement or arthrodesis as end-stage procedures. In human medicine, the role of adipokines in the development and progression of OA has received increasing interest. At present, the known adipokines include leptin, adiponectin, visfatin, resistin, progranulin, chemerin, lipocalin-2, vaspin, omentin-1 and nesfatin. Adipokines have been demonstrated to play a pivotal role in joint homeostasis by modulating anabolic and catabolic balance, autophagy, apoptosis and inflammatory responses. In small animals, in terms of dogs and cats, naturally occurring OA has been clearly demonstrated as a clinical problem. Similar to humans, the etiology of OA is multifactorial and has not been fully elucidated. Humans, dogs and cats share many joint related degenerative diseases leading to OA. In this review, joint homeostasis, OA, adipokines and the most common joint diseases in small animals leading to naturally occurring OA and their relation with adipokines are discussed. The purpose of this review is highlighting the translational potential of OA and adipokines research in small animal patients. [ABSTRACT FROM AUTHOR]

Spontaneous spinal arthrodesis (SSA) is a phenomenon of spontaneous fusion, and SSA is not rare in posttraumatic thoracolumbar kyphosis (PTK). However, few reports have focused on SSA in patients with PTK. The objective of this study was to investigate the prevalence, features, and predictive factors of SSA in patients with PTK. In this retrospective study, 70 patients with PTK were included. Data on the clinical and radiologic parameters were obtained and evaluated. According to whether there was SSA or not, patients were divided into an SSA group (n = 45) or a non-SSA group (n = 25). A binary logistic regression analysis was used to identify the predictive factors for SSA. The incidence of SSA in PTK was 64%. Among 45 patients with PTK with SSA, SSA was present as a solid bridging anterior osteophyte along the vertebral bodies in 11 patients, posterior contiguous bony growth through the facet joints bilaterally in 13 patients, bony formation in both anterior and posterior elements in 18 patients, and direct contiguous bony formation from the injured vertebral body to the adjacent one in 3 patients. Patients with longer disease duration, larger local Cobb angle, and anterior wall height loss (AWHL) ratio of injured vertebral body, and less kyphosis flexibility index were significantly more likely to develop SSA. The parameter of AWHL remained significant in binary logistic regression analysis. SSA in PTK was common, and the SSA sign presented in various patterns, which might have implications for surgical decisions. AWHL was the independent predictor for SSA. [ABSTRACT FROM AUTHOR]

The paper presents research on identifying a biomechanical parameter from a theoretical model of changes during osteoarthritis. In vitro experiments were carried out on quasi-3D chondrocyte cultures seeded on corn-starch hydrogel materials and subjected to mechanical stress on a designed and constructed stand. The results were adapted to a mathematical model and calculated on a simplified two-dimensional specimen. Numerical simulations have been performed to illustrate the growth of bone spurs. The observed changes of variables which determine osteophytes are qualitative and more correlated to the real-life observations. [ABSTRACT FROM AUTHOR]

Study Design. Retrospective cohort study. Objective. (1) To develop a reliable grading system to assess the severity of posterior intervertebral osteophytes and (2) to investigate the impact of posterior intervertebral osteophytes on clinical outcomes after L5-S1 decompression and fusion through anterior lumbar interbody fusion (ALIF) and minimally-invasive transforaminal lumbar interbody fusion (MIS-TLIF). Background. There is limited evidence regarding the clinical implications of posterior lumbar vertebral body osteophytes for ALIF and MIS-TLIF surgeries and there are no established grading systems that define the severity of these posterior lumbar intervertebral osteophytes. Patients and Methods. A retrospective analysis of patients undergoing L5-S1 ALIF or MIS-TLIF was performed. Preoperative and postoperative patient-reported outcome measures of the Oswestry Disability Index (ODI) and leg Visual Analog Scale (VAS) at 2-week, 6-week, 12-week, and 6-month follow-up time points were assessed. Minimal clinically important difference (MCID) for ODI of 14.9 and VAS leg of 2.8 were utilized. Osteophyte grade was based on the ratio of osteophyte length to foraminal width. “High-grade” osteophytes were defined as a maximal osteophyte length >50% of the total foraminal width. Results. A total of 70 consecutive patients (32 ALIF and 38 MISTLIF) were included in the study. There were no significant differences between the two cohorts in patient-reported outcome measures or achievement of MCID for Leg VAS or ODI preoperatively or at any follow-ups. On multivariate analysis, neither the surgical approach nor the presence of high-grade foraminal osteophytes was associated with leg VAS or ODI scores at any follow-up time point. In addition, neither the surgical approach nor the presence of high-grade foraminal osteophytes was associated with the achievement of MCID for leg VAS or ODI at 6 months. Conclusion. ALIF and MIS-TLIF are both valid options for treating degenerative spine conditions and lumbar radiculopathy, even in the presence of high-grade osteophytes that significantly occupy the intervertebral foramen. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the reliability of magnetic resonance imaging (MRI) in detecting disc perforations in the temporomandibular joint (TMJ), and to establish diagnostic criteria for this purpose. The retrospective analysis included patients who had undergone preoperative MRI and TMJ arthroscopy at the same hospital. Direct and indirect signs of disc abnormalities on MRI were compared with arthroscopic findings of disc perforation. Out of 355 joints evaluated in 185 patients, arthroscopy confirmed disc perforations in 14.7% of cases. Several MRI findings were significantly associated with disc perforation, including anterior disc displacement without reduction (ADDwoR), signal alterations in the mid-disc area, disc deformity (SAMD), retrocondylar disc fragments, osteophytes, condylar bone marrow degeneration (CBMD), and joint effusion in both joint spaces (ESJS-EIJS). Regression analysis revealed that SAMD, osteophytes, and CBDM were strongly associated with disc perforation. The ROC curve showed that MRI had an AUC = 0.791, with a sensitivity of 88.5% and a specificity of 61.5%. Two diagnostic methods, one based on three findings (osteophytes, ADDwoR, and SAMD) and one based on two direct signs (ADDwoR and SAMD), yielded high sensitivity and specificity values of 80.4% and 69.8%, and 84.3% and 62.5%, respectively. In conclusion, MRI demonstrated acceptable accuracy in the detection of TMJ disc perforations, with specific diagnostic criteria offering high sensitivity and specificity. Significant MRI indicators of disc perforation included SAMD, osteophytes, and CBDM. This study provides valuable information on the use of MRI as a diagnostic tool for TMJ disc perforations. [ABSTRACT FROM AUTHOR]

Endoscopic surgery is a minimally invasive option for effectively addressing lumbar degenerative diseases. This study aimed to describe the specific technology of percutaneous transforaminal endoscopic lumbar foraminotomy (PTELF) as a therapeutic intervention for managing radicular leg pain (RLP) resulting from stable degenerative lumbar isthmic spondylolisthesis (DLIS) and to present the associated clinical results. Methods: From March 2022 and April 2023, 25 patients were diagnosed with single-level stable DLIS with RLP and underwent PTELF. Clinical assessments utilized the visual analog scale (VAS), Oswestry Disability Index (ODI), and modified MacNab criteria. All endoscopic surgery videos were reviewed to interpret the pathology associated with DLIS. Results: The mean age of the cohort was 65.3 ± 11.0 years. The mean preoperative ODI score, VAS score for low back, and VAS score of the leg were 64.1 ± 8.2, 7.0 ± 0.7, and 7.3 ± 0.8, respectively. These scores significantly improved to 16.3 ± 10.4, 2.0 ± 0.6, and 1.7 ± 1.0 at the final follow-up, respectively (P< 0.01). The modified MacNab criteria indicated "good" or "excellent" outcomes in 92.0% of cases. Analysis of 23 surgical videos revealed 15 patients with disc herniation, nine with lower vertebral endplate involvement, consistent presence of uneven bone spurs (at the proximal lamina stump and around the foramen), and accumulated scars. Two patients experienced postoperative dysesthesia, and one encountered a recurrence of RLP. Conclusion: PTELF emerges as a potentially safe and effective procedure for alleviating RLP in patients with stable DLIS. However, additional evidence and extended follow-up periods are imperative to evaluate the feasibility and potential risks associated with PTELF. [ABSTRACT FROM AUTHOR]

This document is a list of references for three articles related to hip arthroscopy and osteoarthritis. The articles explore the use of hip arthroscopy in patients with osteoarthritis, the reliability of the Tonnis classification in early hip arthritis, and whether hip arthroscopy can delay the need for hip arthroplasty. The document also includes a copyright notice prohibiting unauthorized reproduction of the articles. [Extracted from the article]

Copyright of Current Research in Dental Sciences is the property of Ataturk University Coordinatorship of Scientific Journals and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: This retrospective study aims to assess the clinical and radiological outcomes of cheilectomy in patients diagnosed with Grade 3-4 Hallux Rigidus. Materials and Methods: Nineteen patients (21 feet) who underwent cheilectomy between January 2016 and September 2018 were retrospectively analyzed. Clinical evaluation included a range of motion (ROM), Visual Analog Scale (VAS), and American Orthopedic Foot and Ankle Society (AOFAS) scoring. Radiological assessment involved examining osteophyte recurrence and arthrosis progression through both anteroposterior (AP) and lateral X-ray images. Results: The average patient age was 52 years, with a mean follow-up of 26.2 months. Following cheilectomy, significant improvements in dorsiflexion and total joint ROM were observed compared to preoperative levels (p=0.001). VAS scores significantly decreased at the last follow-up compared to preoperative values (p=0.018). Based on AOFAS scoring, 19 out of 21 feet achieved good to excellent results, while 2 patients showed poor outcomes. Radiologically, no osteophyte recurrence was noted. One patient required arthroplasty revision. Conclusion: Cheilectomy may offer favorable outcomes in well-selected patients with high-grade Hallux Rigidus, particularly when joint mobility preservation is desired over arthrodesis. [ABSTRACT FROM AUTHOR]

Background: Surgeons have limited knowledge of the lumbar intervertebral foramina. This study aimed to classify osteophytes in the lumbar intervertebral foramen and to determine their pathoanatomical characteristics, discuss their potential biomechanical effects, and contribute to developing surgical methods. Methods: We conducted a retrospective, non-randomized, single-center study involving 1224 patients. The gender, age, and anatomical location of the osteophytes in the lumbar intervertebral foramina of the patients were recorded. Results: Two hundred and forty-nine (20.34%) patients had one or more osteophytes in their lumbar 4 and 5 foramina. Of the 4896 foramina, 337 (6.88%) contained different types of osteophytes. Moreover, four anatomical types of osteophytes were found: mixed osteophytes in 181 (3.69%) foramina, osteophytes from the lower endplate of the superior vertebrae in 91 (1.85%) foramina, osteophytes from the junction of the pedicle and lamina of the upper vertebrae in 39 foramina (0.79%), and osteophytes from the upper endplate of the lower vertebrae in 26 (0.53%) foramina. The L4 foramen contained a significantly higher number of osteophytes than the L5 foramen. Osteophyte development increased significantly with age, with no difference between males and females. Conclusions: The findings show that osteophytic extrusions, which alter the natural anatomical structure of the lumbar intervertebral foramina, are common and can narrow the foramen. [ABSTRACT FROM AUTHOR]

Background: An experimental study was performed to improve the anterior approach model of intervertebral disc degeneration (IVDD). Objective: The aims of this study were to investigate the anterior approach model of IVDD for the cause of death, phenotypes, and underlying mechanisms of low back pain in mice. Method: In this study, we conducted an anterior puncture procedure on a cohort of 300 C57BL/6J mice that were 8 weeks old. Our investigation focused on exploring the causes of death in the study population (n = 300) and assessing the time‐course changes in various parameters, including radiographical, histological, immunofluorescence, and immunohistochemistry analyses (n = 10). Additionally, we conducted behavioral assessments on a subset of the animals (n = 30). Results: Transverse vertebral artery rupture is a major factor in surgical death. Radiographical analyses showed that the hydration of the nucleus pulposus began to decrease at 2 weeks after puncture and obviously disappeared over 4 weeks. 3D‐CT showed that disc height was significantly decreased at 4 weeks. Osteophyte at the anterior vertebral rims was observed at 2 weeks after the puncture. As the time course increased, histological analyses showed progressive disruption of the destruction of the extracellular matrix and increased secretion of inflammatory cytokines and apoptosis. Behavioral signs of low back pain were increased between the puncture and sham groups at 4 weeks. Conclusion: The improvement of anterior intervertebral disc approach model in mice will be useful to investigate underlying mechanisms and potential therapeutic strategies for behavior and phenotypes. Furthermore, the application of vibrational pre‐treatment can be used to increase the sensitivity of axial back pain in the model, thereby providing researchers with a reliable method for measuring this critical phenotype. [ABSTRACT FROM AUTHOR]

The objective of this study was to determine the long-term outcomes of microendoscopic foraminotomy in treating lumbar foraminal stenosis and identify the optimal extent of decompression that yields improved results and fewer complications. A retrospective cohort study reviewed the medical records of 95 consecutive patients who underwent microendoscopic foraminotomy for lumbar foraminal stenosis. Clinical outcomes were assessed using the Japanese Orthopaedic Association scoring system and visual analog scale for low back and leg pain. Surgical success was determined by meeting significant improvement thresholds for back and leg pain at 2 years postoperatively. Multiple regression analysis identified factors associated with improved pain scores. Receiver operating characteristic curve analysis determined the cut-off values for successful surgeries. Significant improvements were observed in Japanese Orthopaedic Association and visual analog scale scores for back and leg pain 2 years postoperatively compared with preoperative scores (P < 0.0001) and sustained over a ≥5-year follow-up period. Reoperation rates were low and did not significantly increase over time. Multiple regression analysis identified occupancy of the vertebral osteophytes and bulging intervertebral discs (O/D complex) as surgical success predictors. A 45.0% O/D complex occupancy cutoff value was determined, displaying high sensitivity and specificity for predicting surgical success. This study provides evidence supporting the long-term efficacy of microendoscopic foraminotomy for lumbar foraminal stenosis and predicting surgical success. The 45.0% O/D complex occupancy cut-off value can guide patient selection and outcome prediction. These insights contribute to informed surgical decision-making and underscore the importance of evaluating the O/D complex in preoperative planning and predicting outcomes. [ABSTRACT FROM AUTHOR]

Anterior cervical osteophytes (ACOs) are commonly found in the general population, especially in older individuals. While they are typically asymptomatic, they can cause symptoms in some patients due to compression of the aerodigestive tract. In rare cases, ACOs can result in unilateral vocal cord palsy (UVCP), leading to symptoms such as dysphonia, dyspnea, and dysphagia. This article presents a case study of a 59-year-old male with progressive symptoms of UVCP caused by a large ACO. The patient underwent surgery to remove the osteophyte, resulting in significant improvement in symptoms. The use of laryngeal electromyography (LEMG) was also discussed as a diagnostic tool for UVCP caused by ACOs. Overall, this case highlights the rare occurrence of UVCP due to ACOs and the potential for recovery after osteophytectomy. [Extracted from the article]

In this study, we present a novel surgical method that utilizes the ultrasonic bone scalpel (UBS) for the removal of large retrovertebral osteophytes in anterior cervical discectomy and fusion (ACDF) and evaluate its safety and efficacy in comparison to the traditional approach of using high-speed drill (HSD). A total of 56 patients who underwent ACDF for retrovertebral osteophytes were selected. We recorded patients' baseline information, operation time, intraoperative blood loss, complications, JOA and VAS scores, and other relevant data. The mean operation time and the mean intraoperative blood loss in the UBS group were less than those in the HSD group (P < 0.05). Although both groups exhibited considerable improvements in JOA and VAS scores following surgery, there was no statistically significant difference between the two groups (P > 0.05). Additionally, no significant disparities were found in bone graft fusion between the two groups at 6- and 12-months postsurgery. Notably, neither group exhibited complications such as dura tear or spinal cord injury. Our study found that the use of UBS reduced operative time, minimized surgical bleeding, and led to clinical outcomes comparable to HSD in ACDF. This technique offers an effective and safe method of removing large retrovertebral osteophytes. [ABSTRACT FROM AUTHOR]

This document contains abstracts from a rheumatology conference, providing information on various topics related to rheumatic and musculoskeletal diseases. The first abstract emphasizes the need for adequate healthcare services for patients in the Asia-Pacific region. The second abstract highlights the increasing diagnosis of gout in women and discusses the differences in risk factors and clinical features between men and women. The third abstract provides an update on treatment options for osteoarthritis, including disease-modifying drugs, stem cell therapies, and drug delivery scaffolds. The fourth abstract explores the role of imaging techniques in diagnosing and evaluating osteoarthritis. The final abstract focuses on interstitial lung disease in patients with polymyositis/dermatomyositis and discusses the use of immunosuppressive therapy and serological markers to predict progression and prognosis. The document also provides information on the causes and risk factors of gout, emphasizing the need for improved knowledge and management of gout-related metabolic complications. [Extracted from the article]

The objective of this study is to estimate the prevalence of US findings indicative of calcium pyrophosphate deposition (CPPD) in patients with knee pain. Consecutive patients with knee pain, equally distributed among males and females in seven different age-decades (21–90 years), were enrolled in a cross-sectional study. The presence of US OMERACT-defined CPPD (medial and lateral menisci and femoral hyaline cartilage) and osteophytes (medial and lateral compartments of the tibiofemoral joint) was scored as presence/absence in both knees. Four hundred twenty participants were enrolled (210 men/210 women). Fibrocartilage and hyaline cartilage CPPDs were detected by US in 94/420 (22.4%) and 41/420 (9.8%) participants, respectively. No significant sex differences were noted. The prevalence and the extent of CPPD increased with age. Fibrocartilage and hyaline cartilage CPPDs were identified in 0/60 participants in the third decade, and in 28/60 (46.7%) and 14/60 (23.3%) participants in the ninth decade, respectively (p for trend < 0.01). While fibrocartilage and hyaline cartilage CPPD is virtually absent in subjects younger than 40 and 50 years old, their prevalence steeply increases above from these age groups. Age (aIRR, 1.03; 95% CI, 1.02–1.05), osteophyte score (aIRR, 1.40; 95% CI, 1.22–1.60), and hyaline cartilage CPPD score (aIRR, 2.68; 95% CI, 2.06–3.49) were associated with fibrocartilage CPPD score, whereas age (aIRR, 1.02; 95% CI, 1.01–1.05) and fibrocartilage CPPD score (aIRR, 2.92; 95% CI, 2.29–3.72) were associated with hyaline cartilage CPPD score in multivariable negative binomial regression analyses. In conclusion, we report the US prevalence of CPPD in patients with knee pain. Fibrocartilage CPPD occurs at a younger age and is more prevalent than hyaline cartilage CPPD. Key points • Fibrocartilage CPPD occurs at a younger age and is more prevalent than hyaline cartilage CPPD. • Fibrocartilage and hyaline cartilage CPPDs are virtually absent in subjects younger than 40 and 50 years old. • In subjects older than 80 years, fibrocartilage and hyaline cartilage CPPD prevalence rises up to 46.7% and 23.3%, respectively. [ABSTRACT FROM AUTHOR]

It is unclear whether osteochondral lesions of the talus (OLTs) without chronic lateral ankle instability (CLAI) progress to osteoarthritis, which affects the therapeutic strategy. Especially, the efficacy of conservative treatment for OLT remains controversial. Since various anatomical abnormalities have been reported, there may be abnormal movement of the talus in the mortise, causing ankle instability. We hypothesized that OLTs have frequent osteoarthritic changes even without CLAI. This study aimed to evaluate the incidence of osteoarthritic changes and stress distribution on the talus in OLT. Fifty-eight ankles with medial OLT without CLAI were retrospectively reviewed. Osteophytes and joint space narrowing on radiographs were scored using Kraus's classification and compared to ankles without OLTs. OA scores were compared between over 18 years and less than 17 years in OLTs. On computed tomography images, the area of OLTs was measured. Besides, Hounsfield Units (HU) of the talus in patients with and without OLTs were measured and compared. Osteoarthritic changes were observed in 54 of the 58 ankles (94.8%) in the OLT patients. Osteophytes were frequently observed at the medial gutter and anterior tibial plafond. The OA score in patients aged over 18 years was significantly higher than that in patients aged less than 17 years (P < 0.05). HU values in the talus were significantly higher than those in non-OLT patients. OLTs more than 100 mm2 had a significantly higher osteoarthritic score than those less than 100 mm2. Medial OLT without CLAI has frequently osteoarthritic changes, especially large lesions. Osteoarthritic changes in OLTs will progress over time, which needs to be considered when deciding whether to perform the surgical or non-surgical treatment. [ABSTRACT FROM AUTHOR]

Temporomandibular joint disorders (TMDs) are usually accompanied by changes in the bone structure of the TMJ brought on by degenerative processes. Osteophytes, erosion, flattening, subchondral sclerosis, pseudocysts, TMJ remodeling, articular cartilage abrasion, bone degradation, and synovial inflammation are among the characteristics of degenerative joint disease. Synovial chondromatosis (SC) is one of the degenerative joint conditions, which is defined by the growth of cartilaginous nodules, which are typically loose in the joint space of the synovial membrane. Its appearance in the TMJ, however, is more uncommon than in other large joints such as the knee and hip and is accompanied by preauricular pain, swelling, and restricted mouth opening. However, we recently encountered cases of degenerative joint disorder, i.e., of SC of TMJ, which showed the typical histopathological findings along with the typical imaging findings on Panoramic radiography (PAN) TMJ and cone-beam computed tomography images. [ABSTRACT FROM AUTHOR]

Introduction: Due to the silent manifestation of temporomandibular joint (TMJ), dentists and rheumatologists may neglect treatment for this joint. Aims: The aim of this study was to investigate the TMJ components in patients with various rheumatic diseases and to compare them with a control group based on cone beam computed tomography (CBCT) images. Materials and Methods: This study comprised an assessment of the CBCT images of 65 patients (130 temporomandibular joints) with various rheumatic diseases (mostly rheumatoid arthritis) affecting the TMJ. Moreover, 65 patients (130 temporomandibular joints) with a similar age and gender distribution were examined as the control group. Pathologies were classified into a total of 12 types for the presence of any osseous changes in the condylar head or articular fossa or for joint space narrowing. Statistical analysis of all data was performed with SPSS version 18. The conformity of continuous variables to a normal distribution was examined by the Kolmogorov–Smirnov test. The Mann–Whitney U test was used to compare the means of two independent groups. The Pearson Chi-square test, Yates correction and Fisher's exact test were used in the analysis of categorical variables. Results: The mean age of the patient and control groups was 50 ± 13 and 48 ± 16, respectively, and no statistically significant difference was found between the patient and control groups in terms of age distribution (p = 0.123). Condylar erosion, condylar flattening, subcondylar sclerosis, osteophytes, subcortical cysts, articular eminence resorption and articular eminence flattening rates were found to be statistically significantly higher in the patient group than in the control group (p < 0.05). Conclusions: Dentomaxillofacial radiologists should examine the bony components of the TMJ in patients with rheumatic diseases, and a multidisciplinary approach involving a dental specialist and rheumatologist is required. [ABSTRACT FROM AUTHOR]

Aim: To examine the prevalence of adjacent segment degeneration associated with the use of cages and disc prostheses in patients who underwent cervical disc surgery via an anterior cervical approach. Methods: We retrospectively reviewed the medical records of 60 patients who underwent cervical disc surgery via an anterior cervical approach at our clinic between 2018 and 2023. The patients were divided into two groups based on the type of implant used: those with a cervical cage (Group 1) and those with a cervical disc prosthesis (Group 2). Patients' demographic and clinical details, including age, gender, smoking habits, followup durations, and any additional comorbid diseases, were recorded. Radiological evaluations focused on degeneration rates in the segments adjacent to where either the cage or disc prosthesis was implanted. Results: In the study comparing two groups, participants' average ages were 48.9 in Group 1 and 48.1 in Group 2 (p=0.720). Group 1 had a higher proportion of smokers (p=0.052) and more discopathy (p=0.196). In terms of disc degenerations, variations existed but were not statistically significant (p=0.259). Utilizing the Pfirrmann grading, Group 1 had more Grade III degeneration (p=0.088) and a significantly higher presence of ossification or osteophytes (p=0.038). Both groups showed high rates of adjacent segment degeneration, yet Group 1 had notably more proximal degeneration (p=0.012). Stenosis and facet hypertrophy differences were not significant (p=0.417, p=0.071). Follow-up duration averaged around 38 months for both groups (p=0.929). Conclusions: No substantial difference in the overall incidence of adjacent segment degeneration between the two procedures. Nevertheless, further large-scale and long-term studies are essential to draw comprehensive conclusions regarding the optimal surgical intervention for cervical disc ailments. [ABSTRACT FROM AUTHOR]

Background Bow Hunter's syndrome is vertebral basilar artery insufficiency caused by mechanical occlusion of the vertebral artery during head rotation. This is often due to the formation of osteophytes, herniated discs, cervical spondylosis, or tumours. However, whether the contralateral vessel is organically stenotic is not well known. Case summary A 79-year-old man was referred to our department for a close examination of syncope because the transient loss of consciousness occurring when he was made to turn his head to the left was reproducibly induced and recovered when his face was returned to the normal position. The carotid massage did not induce significant bradycardia or hypotension bilaterally, and Holter electrocardiography, echocardiography, head-up tilt test, coronary angiography, and an acetylcholine stress test showed no obvious abnormalities. A 3D CT angiography was performed to investigate the possibility of vertebrobasilar artery insufficiency, as C3/4 cervical spondylosis, and the left vertebral artery was compressed by the C4 superior process osteophyte, indicating hypoplasia of the contralateral vertebral artery. Vertebral artery angiography and intravascular ultrasound (IVUS) showed moderate stenosis of the left vertebral artery, and IVUS showed a half-circumferential calcified lesion. Compared to the midline position, the stenosis worsened at the site of compression and drainage when the patient turned left downward, and a diagnosis of Bow Hunter's syndrome was made. Discussion Bow Hunter's syndrome is characterized by vertebrobasilar insufficiency. Intravascular ultrasound clearly showed that the lesion was not only stenotic due to compression but also had plaque growth due to continuous mechanical stimulation. [ABSTRACT FROM AUTHOR]

Clinical symptoms of cervical radiculopathy include radiating pain and paresthesia along the distribution of a nerve root, often associated with sensory loss and motor dysfunction. Radiculopathy often affects the cervical nerve root segments 4 to 8, resulting in well-recognized clinical syndromes. Patient were divided into two groups as surgeon choice, first group includes 15 patients who had been managed with anterior cervical plate with titanium cage. The second group included 15 patients who had been managed with locking standalone cage. The anterior cervical approach was used. The cartilaginous end plates of the upper and lower end plates were removed after inter body distraction under microscopic view. The removal of the posterior osteophytes was associated with the incision of the posterior longitudinal ligament. The test results demonstrated the mean Visual analogue scores at different time intervals for both the implant groups i.e. locking standalone cage and anterior cervical plate with disc cage groups, the mean VAS scores at pre-op period was 8.12 ± 0.99 for the LSC group and 7.53±0.74 for the APC group. In the post-operative period it was 4.47 ± 1.18 in the LSC group and 4.07±0.26 in the APC group. At 3 months post op, the mean VAS score was 3.47 ± 1.19 in the LSC group and 4.0±0.38 in the APC group, at 6 Months was 3.20±1.21 in the LSC group and 3.47±0.52 in the APC group and at 1 year post op period, it was 2.87 ± 1.06 in the LSC group and 2.87±0.52 in the APC group. [ABSTRACT FROM AUTHOR]

This article discusses the condition known as kissing spines, or Baastrup disease, which occurs when spinous processes in the spine become hypertrophic and contact each other. The article examines the presence of kissing spines in various individuals, including a Neanderthal and individuals from Byzantine Carthage. The study suggests that kissing spines may be associated with lumbar rigidity and joint misalignment, but the exact cause is difficult to determine. The article also explores possible causes of kissing spines, such as activity-related factors and other diseases. The Carthage collection reveals a high frequency of kissing spines, which may be related to heavy labor and horseback riding. Overall, the article highlights the complexity of this condition and its potential links to various factors. [Extracted from the article]

The aim of this study was to evaluate the effect on pain and functional results, and potential complications, of arthrodesis applied to the carpometacarpal (CMC) joint of the thumb because of osteoarthritis. This single-centre, retrospective study included patients who presented at the polyclinic between 2003 and 2018 with complaints of pain and/or deformity at the base of the thumb, clinically and radiographically consistent with osteoarthritis of the CMC joint of the thumb. Before treatment and at the final examination, pain at rest and during activity (daily living activities) was evaluated with a visual analog scale (VAS), and the functional results were evaluated with the patient-reported DASH and PRWE scores. The study included 26 patients with a mean age of 55.4 years and mean follow-up period of 8.3 ± 4.1 years. Surgery was performed on the dominant hand in 73.1% of the patients. A significant improvement was determined postoperatively with mean VAS score of 3.5 (IQR: 2 - 5), mean DASH score of 26.1 (IQR: 20.5-37.0), and mean PRWE score of 22.5 (IQR: 15.1-29.6). In the cases with surgery applied to the nondominant hand, no significant correlation was determined postoperatively between the PRWE function score and VAS (p=0.053). In one patient applied with revision surgery with autograft because of pseudarthrosis during follow-up, there were complaints of pain because of the development of osteophytes. Patients applied with arthrodesis for osteoarthritis of the thumb CMC joint, showed a high level of satisfaction in the long-term follow up measured with DASH and PRWE. In the light of these results, arthrodesis for osteoarthritis of the thumb CMC joint can be evaluated as a reliable and effective treatment method. [ABSTRACT FROM AUTHOR]

Objective: To compare sacroiliac joint (SIJ) lesions on MRI in women with versus without axial spondyloarthritis (ax-SpA) and establish an algorithm to determine whether such lesions are due to ax-SpA. Methods: This retrospective comparative study assessed bone marrow edema (BME), sclerosis, erosions, osteophytes, and ankylosis at the SIJ in two groups of women, one with and another without ax-SpA. Sensitivity and specificity were calculated for combinations/characteristics of lesions, using rheumatologists' assessment with assessment of spondyloarthritis international society (ASAS) criteria as the gold standard for diagnosis of ax-SpA. Results: Compared to women without ax-SpA, women with ax-SpA had more BME (61% vs 17%, p < 0.001), sclerosis (40% vs 22%, p < 0.001), erosions (35% vs 5%, p < 0.001), and ankylosis (2% vs 0%, p = 0.007), but less osteophytes (5% vs 33%, p < 0.001). The ASAS MRI criteria yielded 59% sensitivity and 88% specificity, while a new algorithm achieved 56% sensitivity and 95% specificity using the following criteria: no osteophytes at the SIJ and either (i) BME at the SIJ with at least one dimension ≥ 8 mm or (ii) at least one erosion at the SIJ. Conclusions: We recommend the following pragmatic algorithm for MRI diagnosis of ax-SpA in women: no osteophytes at the SIJ and either (i) BME at the SIJ with at least one dimension ≥ 8 mm or (ii) at least one erosion at the SIJ. The false positive rate when using the new algorithm (3.3%) is less than half than when using the ASAS MRI criteria (7.7%); thus, its application in clinical practice could reduce overdiagnosis and prevent overtreatment of ax-SpA. Clinical relevance statement: The developed algorithm has a false-positive rate that is less than half than when using the ASAS MRI criteria (3.3% vs 7.7%), thus its application in clinical practice could reduce overdiagnosis and prevent overtreatment of axial spondyloarthritis. Key Points: • Compared to women without axial spondyloarthritis (ax-SpA), women with ax-SpA had a significantly higher prevalence of bone marrow edema (BME), sclerosis, erosions, and ankylosis, but a significantly lower prevalence of osteophytes. • A new algorithm for positive ax-SpA based on sacroiliac joint MRI was developed: no osteophytes at the sacroiliac joint (SIJ) and either (i) BME at the SIJ with at least one dimension ≥ 8 mm or (ii) at least one erosion at the SIJ. • We recommend this new algorithm for diagnosis of ax-SpA in women, as it has a significantly better specificity than the assessment of spondyloarthritis international society (ASAS) MRI criteria and less than half the false positive rate; thus, its application in clinical practice could reduce overdiagnosis and prevent overtreatment of ax-SpA. [ABSTRACT FROM AUTHOR]

Background:: Osteoarthritis (OA) is a disease with progressive loss of articular cartilage, which is due to a variety of genetic and environmental risk factors and pathophysiological processes. The main cause of trauma and discomfort in joint mobility leading to disability in osteoarthritis is simultaneous new bone generation and synovial growth. Disruption of articular cartilage, osteophyte generation, subchondral sclerosis, meniscal disintegration, bone marrow lesions, and synovial proliferation are the typical characteristics of osteoarthritis (OA) (1) The progression and morbidity due to arthritis can be reduced significantly with the help of early diagnosis of OA knee joint with detailed clinical history with the help of a simple questionnaire, X-ray evaluation, and baseline biochemical tests can help to initiate early intervention in the form of analgesics and physiotherapy with follow-up. Early structural changes in the disease may also be captured with the help of imaging studies and this can help in the initiation of therapy at an earlier stage and good outcome of the disease Detection of those subjects with co-morbidities and with early knee, OA may offer an opportunity to successfully intervene in the disease and reduce the burden on patients and the community. Aim: To evaluate the effectiveness of an integrated approach to clinical assessment and management in the whole sample population. Methods: According to the sample size calculation, a total of 70 patients were selected after screening and exclusion. Baseline characteristics and clinical scores of 70 patients were recorded. The patients were followed up after 3 months and 6 months for clinical scores. Informed written consent in a language understood by the patient was taken. Personal data, clinical findings, radiological findings, biochemical reports, and related medical records of all patients were obtained. A pre-tested semi-structured questionnaire was administered to all patients. The second part was comprised of the possible risk factors for developing OA of the knee such as age, gender, body mass index, occupation, family history of OA, physical activity, history of injury to the knee, etc. X-ray, weight, and height measurements along with all necessary investigations according to the standard protocol were done. Results: An almost equal number of elderly (above the age of 60) and non-elderly were involved in the study. Hence it could be concluded that early changes in knee OA may not necessarily be age dependent. After analyzing a total of 70 patients in the study, it was observed that there was almost an equal distribution of males and females in the study. On the evaluation of BMI of the individual patients, it was noticed that the majority of the patients belonged to either the overweight or obese class. The majority of the patients were found to be vitamin D deficient and patients were anemic. Those patients were given supplementation accordingly. Conclusion: All patients of early knee OA are presently getting benefitted from an integrated approach where clinical examination, imaging techniques, and laboratory investigations are used systematically and routinely for clinical assessment while simultaneously exercise, lifestyle modifications, and medication is used for the management of knee OA. Each risk factor associated with knee OA is studied individually as a subset and thus can be of great future research potential. [ABSTRACT FROM AUTHOR]

Purpose: Ankle impingement is generally characterised by limited range of motion and pain due to pathological contact between structures. Anterior ankle impingement is usually diagnosed by clinical examination and radiographic evidence of tibiotalar osteophytes. In addition to osteophytes, radiographs may show a correlation between the tibia and talus, which may further aid in the diagnosis of anterior ankle impingement. The purpose of this study is to investigate the relationship between the tibia and talus in anterior ankle impingement. Methods: In this retrospective cohort study, the tibial coverage of 22 patients with anterior ankle impingement was compared with that of 67 healthy subjects. Results: The percentage of tibial coverage was 0.674 ± 0.043 in the anterior ankle impingement group and 0.580 ± 0.032 in the control group. The difference between groups was statistically significant (P < 0.05). Conclusions: In addition to existing criteria, the percentage of tibial coverage may provide valuable information for the diagnosis of anterior ankle impingement. [ABSTRACT FROM AUTHOR]

Introduction: The outcomes of total knee arthroplasty (TKA) remain controversial, and we do not know which factors are important for successful outcomes. This study aimed to compare the mid-term outcomes of different conceptual designs by evaluating the radiological and clinical outcomes. Materials and methods: A total of 478 total knee arthroplasties (TKAs) were enrolled and allocated into groups I [posterior stabilizing (PS) with anterior referencing (AR)], II [PS with posterior referencing (PR), and III [ultra-congruent (UC) TKA)]. Preoperative findings, last follow-up clinical outcomes, and final follow-up radiological and indirect assessments of the femoral rollback were compared between the groups. Results: The mean follow-up period was 72.6 ± 12.9 months. The tourniquet was used samely applied to every group. Flexion contracture was significantly larger in group III than in groups I and II (3.3 ± 2.7, p < 0.001), and further flexion was significantly smaller in group III (130.0° ± 2.7°, p < 0.001). Among the radiological parameters, posterior osteophyte formation was the most common in group III (67.8%). The rollback distance was significantly smaller in group III than in groups I and II (p < 0.001). The active deep flexion angle was affected by the posterior condylar offset (PCO) ratio, and the contact point changed the distance (p < 0.05). Conclusion: PS TKAs showed better ROMs than UC TKAs; however, no differences were noted in the clinical outcome scales. The flexion angle was affected by the PCOR and rollback at both PS and UC TKAs. However, rollback negatively affected the flexion angle during UC TKAs. An inappropriate femoral rollback was identified, and femoral osteophyte formation was determined to be the most prominent in UC TKAs. Level of evidence Level III comparative study. [ABSTRACT FROM AUTHOR]

Objective: Diffuse idiopathic skeletal hyperostosis (DISH) is characterized by osteophytes in the anterior vertebrae, and the presence of aorta may have an impact on their formation. However, the anatomical positional relationship between the aorta and osteophytes in patients with DISH remains controversial. This study aimed to evaluate the position of osteophytes in relation to aorta in DISH, and the influence of aortic pulsation on the formation of osteophytes from the perspective of morphology. Methods: We conducted a retrospective review of 101 patients diagnosed with DISH and symptomatic lumbar spinal stenosis between June 2018 and December 2021. A total of 637 segments with heterotopic ossification in DISH were used for quantitative measurements on CT scans. The Cartesian coordinate system was built up on the axial CT scans to reflect the relative position between aorta and osteophytes. Osteophytes were divided into adjacent aorta group (AD group) and non‐adjacent aorta group (N‐AD group). In terms of the morphology, osteophytes in the AD group were further divided into convex, flat, and concave types. The relative position between aorta and osteophytes, and the aorta‐osteophyte distance and morphology of osteophytes were compared. Univariate analysis of variance was performed for multiple groups, and two independent‐samples t‐tests were used for two groups. Results: From T5 to L4, aorta gradually descended from left side to middle of vertebrae, and osteophytes gradually shifted from right side of vertebrae (T5‐T10) to bilateral sides (T11‐L4). Of 637 osteophytes in DISH, 60.1% (383/637) were in AD group, including convex type 0.6% (4/637), flat type 34.7% (221/637), and concave type 24.8% (158/637). The N‐AD group accounted for 39.9% (254/637). Flat osteophytes were concentrated in T5‐T12, while concave osteophytes in T11‐L4. Overall, the aorta‐osteophyte distance of concave type was significantly smaller than that of flat type. Conclusion: Osteophytes are not always located on the right side of vertebrae, but move with the position of the descending aorta. Furthermore, the morphology of osteophytes varies by vertebral segment in DISH, which is related to aorta descending anteriorly in the spine. [ABSTRACT FROM AUTHOR]

A joint contains many different tissues that can exhibit pathological changes, providing many potential targets for treatment. Researchers are increasingly suggesting that osteoarthritis (OA) comprises several phenotypes or subpopulations. Consequently, a treatment for OA that targets only one pathophysiologic abnormality is unlikely to be similarly efficacious in preventing or delaying the progression of all the different phenotypes of structural OA. Five structural phenotypes have been proposed, namely the inflammatory, meniscus-cartilage, subchondral bone, and atrophic and hypertrophic phenotypes. The inflammatory phenotype is characterized by marked synovitis and/or joint effusion, while the meniscus-cartilage phenotype exhibits severe meniscal and cartilage damage. Large bone marrow lesions characterize the subchondral bone phenotype. The hypertrophic and atrophic OA phenotype are defined based on the presence large osteophytes or absence of any osteophytes, respectively, in the presence of concomitant cartilage damage. Limitations of the concept of structural phenotyping are that they are not mutually exclusive and that more than one phenotype may be present. It must be acknowledged that a wide range of views exist on how best to operationalize the concept of structural OA phenotypes and that the concept of structural phenotypic characterization is still in its infancy. Structural phenotypic stratification, however, may result in more targeted trial populations with successful outcomes and practitioners need to be aware of the heterogeneity of the disease to personalize their treatment recommendations for an individual patient. Radiologists should be able to define a joint at risk for progression based on the predominant phenotype present at different disease stages. [ABSTRACT FROM AUTHOR]

Purpose: Radiological degenerative phenotypes provide insight into a patient's overall extent of disease and can be predictive for future pathological developments as well as surgical outcomes and complications. The objective of this study was to develop a reliable method for automatically classifying sagittal MRI image stacks of cervical spinal segments with respect to these degenerative phenotypes. Methods: We manually evaluated sagittal image data of the cervical spine of 873 patients (5182 motion segments) with respect to 5 radiological phenotypes. We then used this data set as ground truth for training a range of multi-class multi-label deep learning-based models to classify each motion segment automatically, on which we then performed hyper-parameter optimization. Results: The ground truth evaluations turned out to be relatively balanced for the labels disc displacement posterior, osteophyte anterior superior, osteophyte posterior superior, and osteophyte posterior inferior. Although we could not identify a single model that worked equally well across all the labels, the 3D-convolutional approach turned out to be preferable for classifying all labels. Conclusions: Class imbalance in the training data and label noise made it difficult to achieve high predictive power for underrepresented classes. This shortcoming will be mitigated in the future versions by extending the training data set accordingly. Nevertheless, the classification performance rivals and in some cases surpasses that of human raters, while speeding up the evaluation process to only require a few seconds. [ABSTRACT FROM AUTHOR]

Study Design. Retrospective cohort study. Objective. To clarify whether outcomes of anterior cervical discectomy and fusion (ACDF) differ according to the presence of posterior cord compression from the ligamentum flavum (CCLF) Summary of Background Data. Although ACDF effectively addresses anterior cord compression from disc material and bone spurs, it cannot address posterior compression. Whether ACDF could result in favorable outcomes when CCLF is present remains unclear. Patients and Methods. A total of 195 consecutive patients who underwent ACDF and were followed up for >2 years were included. CCLF was graded based on magnetic resonance imaging findings. Patients with CCLF grade 2 were classified as such, whereas patients with CCLF grades 0 to 1 were classified as the no- CCLF group. Patient characteristics, cervical sagittal parameters, neck pain visual analog scale, arm pain visual analog scale, and Japanese Orthopedic Association (JOA) score were assessed. Categorical variables were analyzed using a χ² test, whereas continuous variables were analyzed using the Student t test. Multivariable logistic regression analysis was performed to elucidate factors associated with JOA recovery rates of > 50%. Results. One hundred sixty-seven patients (85.6%) were included in the no-CCLF group, whereas the remaining 28 patients (14.4%) were included in the CCLF group. Among patients in the CCLF group, 14 patients (50.0%) achieved clinical improvement. JOA score significantly improved in the no-CCLF group after the operation (P < 0.001), whereas improvement was not appreciated in the CCLF group (P = 0.642). JOA scores at 3 months (P = 0.037) and 2 years (P = 0.001) postoperatively were significantly higher in the no-CCLF group. Furthermore, the JOA recovery rate at 2 years after surgery was significantly higher in the no-CCLF group (P = 0.042). Logistic regression demonstrated that CCLF was significantly associated with a JOA recovery rate of >50% at 2 years after surgery (odds ratio: 2.719; 95% CI: 1.12, 6.60). Conclusion. ACDF performed for patients with CCLF grade 2 showed inferior JOA score improvement compared with those with CCLF grade 0 or 1. ACDF cannot remove posterior compressive structures, which limits its utility when ligamentum flavum significantly contributes to cord compression. [ABSTRACT FROM AUTHOR]

This study was performed to compare the diagnostic accuracy of cone beam computed tomography (CBCT) alone and magnetic resonance imaging (MRI) alone in patients with clinical symptoms of temporomandibular joint osteoarthritis (TMJ-OA). Fifty-two patients (83 joints) with clinical signs of TMJ-OA were included in the study. Two examiners evaluated CBCT and MRI images. McNemar and kappa tests and Spearman's correlation analysis were applied. Radiological findings of TMJ-OA were detected in all 83 joints on CBCT or MRI. Seventy-four joints (89.2%) were positive for degenerative osseous changes on CBCT. MRI findings were positive in 50 joints (60.2%). Osseous changes were found in 22 joints, joint effusion in 30 joints, and disc perforation/degeneration in 11 joints on MRI. CBCT was more sensitive than MRI in detecting condylar erosion (P = 0.001), osteophyte (P = 0.001), and flattening (P = 0.002) and flattening of the articular eminence (P = 0.013). Poor agreement (κ = −0.21) and weak correlations were found between CBCT and MRI. The study findings suggest that CBCT is superior to MRI in evaluating osseous changes of TMJ-OA, and that CBCT is more sensitive than MRI in detecting condylar erosion, condylar osteophyte, and flattening of the condyle and articular eminence. [ABSTRACT FROM AUTHOR]