Those creaky knees, aching hips and stiff fingers may leave little doubt that osteoarthritis has set in. But if you'd known this was coming 20 years ago, you might have worked a little harder to take the steps that would have forestalled or lessened the aches and pains of arthritis -- keep your weight in check, strengthen those surrounding muscles and baby those joints a bit more. Right?
Well, of course you would have; it's just that because no X-rays, MRIs, sonograms and any other scans could peer into your joints' future, you didn't know.
A Stanford University radiologist may strip future arthritis sufferers of the excuse that they didn't see it coming. Using a new imaging technique he developed, Dr. Garry Gold has been able to see the earliest signs of deteriorating cartilage in the joints of young athletes injured on the playing field. Gold is scanning the knees of Stanford athletes who have hurt their anterior cruciate ligament, or ACL -- an injury that puts these athletes at almost the double the risk of osteoarthritis symptoms in the affected joint a decade or two down the road.
Gold is using sodium MRI -- a technique that's been around a long time but would have only been helpful if you were the size of a mouse -- to assess the structural integrity of the cartilage that cushions joints. Existing MRI techniques allow physicians to see the structure of cartilage at a joint. But sodium MRI, which uses a different class of magnets to develop pictures of internal structures, allows them to assess the quality of that cartilage -- sort of like hunting for "dry rot" in a wooden structure that looks just fine, he says.
In the case of the 12 Stanford athletes whose knees he has scanned, sodium MRI revealed significant losses of glycosaminoglycan, a key structural material in cartilage, in the damaged knees -- but not in undamaged ones -- within three years of the injury. That, says Gold, is likely the earliest sign of incipient arthritis -- or a marker for impending disease.
Gold's work was sponsored by the National Institutes of Health, which sees a wave of arthritis sufferers coming with the nation's aging population, and by -- surprise! -- GlaxoSmithKline, makers of the weight-loss drug Alli and proposed new drugs for rheumatoid arthritis and inflammatory pain. Gold's innovation in imaging will likely allow drug makers seeking to prevent ot treat arthritis early to test their medications for effectiveness.
-- Melissa Healy