Imaging and Arthritis; Osteoarthritis; Outcome Measurement
MRI and ultrasound improve the phenotype of arthritis and much of my research involves using these modalities to improve understanding of pathogenesis and therapeutic response in rheumatoid arthritis (RA) and osteoarthritis (OA). One of my PhD fellows (Jane Freeston) is validating and assessing the benefits of novel therapies in RA cohorts, and I recently obtained funding for an extremity MRI machine which will improve study capability.
My major disease focus is OA, particularly the importance of synovial inflammation and subchondral bone. A recently completed large OA study using sensitive MRI techniques demonstrated the (unexpected) extensive nature of synovitis. A PhD fellow (Helen Keen) is studying the relationship of ultrasonographic synovitis to both symptoms and therapy response. Collaboration with Professor McDermott is examining some key synovial inflammatory mediators. A number of OA clinical trials are on-going including a large community- based arc-funded randomised trial. Another PhD fellow (Anne Maree Keenan) has developed a new OA quality of life measure.
Outcome measurement and appropriate development and validation of tools is critical for translational researchers, and I am currently working with Professor Alan Tennant and international groups on novel tool development and in the areas of item banking and computer adaptive testing.
Figure 1 MRI image of the metacarpophalangeal joints in rheumatoid arthritis demonstrating synovitis and adjacent bone marrow inflammation.
Figure 2 MRI image of the knee joint in osteoarthritis demonstrating synovitis and subchondral bone abnormalities.
Conaghan PG, D’Agostino MA, Ravaud P, Baron G, Le Bars M, Grassi W, Martin-Mola E, Wakefield R, Brasseur JL, So A, Backhaus M, Malaise M, Burmester G, Schmidely N, Emery P, Dougados M. EULAR report on the use of ultrasonography in painful knee osteoarthritis. exploring decision rules for clinical utility. Ann Rheum Dis. 2005;64(12):1710-4.
Jarrett SJ, Conaghan PG, Sloan VS, Papanastasiou P, Ortmann CE, O’Connor PJ, Grainger AJ, Emery P. Preliminary evidence for a structural benefit of the new bisphosphonate zoledronic acid in early rheumatoid arthritis. Arthritis Rheum. 2006;54(5):1410-4.
Keenan AM, Tennant A, Fear J, Emery P, Conaghan PG. Impact of multiple joint problems on daily living tasks in people in the community over age fifty-five. Arthritis Rheum 2006;55(5):757-64.