Early stages of osteoarthritis: The search for sensitive predictors

Abstract

So to sum up there are now three ways for detecting the early phases of OA. The clinician should be familiar with and alert to symptoms and signs of early OA. Risk factors should be a target for attempted prevention. Imaging is the second method. Standard radiography using valid technology is still the preferred method of identifying OA in populations, and it is interesting that osteophytes are reliable signs of OA in the knee, but not in the hip, where joint space narrowing must also be present. The Mazzuca study emphasises the importance of standardised imaging techniques, but does not exclude the usefulness of studying subjects with asymmetric disease manifestations, as was intended to be done in the Chingford knee study. Use of biomarkers is the third method. The promising results cited above point to the feasibility of this approach, but the search for more sensitive and specific indicators continues. There is a great demand for better and cheaper markers of OA which can be used as tools to identify patients at risk and assess early effects of interventions. There is a market for fresh ideas, which need to be tested in close collaboration between clinicians and laboratory workers.