February 26, 2024

Common Arthritis Treatment May Actually Accelerate Disease Progression

Osteoarthritis is a degenerative joint illness that causes the cartilage in the joints to break down, leading to pain, tightness, and difficulty moving. Knee osteoarthritis, which impacts roughly 800,000 individuals each year, is a persistent and progressive condition that can cause pain and difficulty moving. Roughly 10% of people with knee osteoarthritis look for noninvasive treatments and turn to corticosteroid or hyaluronic acid injections to reduce their discomfort.
In the very first research study, scientists at the University of California, San Francisco consisted of 210 Osteoarthritis Initiative individuals, 70 of whom received intraarticular injections, and a control group of 140 who did not receive injections during a two-year period. The MRI scans were assessed utilizing whole-organ magnetic resonance imaging score (WORMS), a grading system for knee osteoarthritis that focuses on the meniscus, bone marrow lesions, cartilage, joint effusion, and ligaments.

Knee joint of a patient showing (A) serious cartilage problems and (B) undamaged knee joint. Credit: RSNA and Upasana Upadhyay Bharadwaj, M.D
. In the very first research study, scientists at the University of California, San Francisco consisted of 210 Osteoarthritis Initiative individuals, 70 of whom got intraarticular injections, and a control group of 140 who did not get injections throughout a two-year period. Of the 70 patients who received injections, 44 were injected with corticosteroids, and 26 were injected with hyaluronic acid. The treatment and control groups were matched by age, sex, body mass index, pain and exercise scores, and seriousness of the disease.
MRI was carried out on all clients at the time of the injection and two years prior to and after. The MRI scans were examined utilizing whole-organ magnetic resonance imaging rating (WORMS), a grading system for knee osteoarthritis that focuses on the meniscus, bone marrow lesions, cartilage, joint effusion, and ligaments. The scientists recognized osteoarthritis development by comparing the imaging scores from the initial scans and two-year follow-up scans.
” This is the very first direct comparison of corticosteroid and hyaluronic acid injections utilizing the semi-quantitative, entire organ assessment of the knee with MRI,” said Upasana Upadhyay Bharadwaj, M.D., a research study fellow in the Department of Radiology at University of California, San Francisco.
Analytical analysis showed that corticosteroid knee injections were significantly associated with the general progression of osteoarthritis in the knee, specifically in the lateral meniscus, lateral cartilage, and medial cartilage.
Hyaluronic acid knee injections were not considerably connected with the development of osteoarthritis in the knee. Compared to the control group, the group who received hyaluronic injections revealed a decreased progression of osteoarthritis, particularly in bone marrow sores.
” While both corticosteroid and hyaluronic acid injections are reported to help with symptomatic pain relief for knee osteoarthritis, our results conclusively reveal that corticosteroids are related to significant progression of knee osteoarthritis as much as two years post-injection and must be administered with caution,” Dr. Upadhyay Bharadwaj stated.
” Hyaluronic acid, on the other hand, may decrease the progression of knee osteoarthritis and ease long-lasting impacts while providing symptomatic relief.”
In the second study, scientists at the Chicago Medical School of Rosalind Franklin University of Medicine and Science carried out a case-control research study comparing the radiographic development of osteoarthritis in clients who received injections of corticosteroids and hyaluronic acid.
” While these injections offer some patients with short-term pain relief, the results of the injections on the development of the illness are unknown,” said researcher and medical student Azad Darbandi.
Darbandis group chose a friend of 150 clients with comparable baseline characteristics from the Osteoarthritis Initiative database, including 50 clients who received corticosteroid injections, 50 who received hyaluronic acid injections, and 50 who were not injected over a 36-month time period. The groups were matched by sex, body mass index, and X-ray findings.
Clients went through X-ray imaging of the knee at standard and 2 years later. The scientists examined the X-ray imaging, consisting of joint area narrowing, formation of bone stimulates, and bone thickening around the knee cartilage.
Compared to patients who received an injection of hyaluronic acid or no treatment at all, clients injected with corticosteroids had considerably more osteoarthritis progression, consisting of medial joint area constricting, a hallmark of the illness.
” Even though imaging findings for all clients were similar at baseline, the imaging trademarks of osteoarthritis were even worse two years later on in patients who received corticosteroid injections compared to patients who received hyaluronic acid injections or no treatment at all,” Darbandi said.
” The results recommend that hyaluronic acid injections need to be further checked out for the management of knee osteoarthritis symptoms and that steroid injections must be used with more care.”
” Knowing the long-term impacts of these injections will assist osteoarthritis patients and clinicians make more educated choices for handling the disease and the pain it causes,” Dr. Upadhyay Bharadwaj included.
Fulfilling: 108th Scientific Assembly and Annual Meeting of the Radiological Society of North America
Dr. Upadhyay Bharadwajs co-authors are Thomas Link, M.D., Ph.D., Zehra Akkaya, Gabby Joseph, John Lynch, Ph.D., and Paula Giesler. Darbandis co-authors are Sean Hormozian, Atefe Pooyan, M.D., Ehsan Alipour, M.D., Firoozeh Shomal Zadeh, M.D., Parham Pezeshk, M.D., and Majid Chalian, M.D.

Osteoarthritis is a degenerative joint illness that triggers the cartilage in the joints to break down, causing discomfort, tightness, and problem moving. It is a typical condition that often impacts the hands, knees, hips, and spine. Risk elements for establishing osteoarthritis consist of aging, weight problems, and a history of joint injuries.
2 current studies have shown that corticosteroid injections, which are commonly utilized to treat the discomfort related to knee osteoarthritis, might really add to the development of the illness. These findings were just recently provided at the annual conference of the Radiological Society of North America (RSNA).
Osteoarthritis is a widespread condition that affects 32.5 million grownups in the United States and is characterized by the degeneration and breakdown of cartilage in the joints. Knee osteoarthritis, which impacts around 800,000 people each year, is a persistent and progressive condition that can trigger discomfort and difficulty moving. Approximately 10% of people with knee osteoarthritis look for noninvasive treatments and rely on corticosteroid or hyaluronic acid injections to minimize their pain.
Scientists in both research studies picked associates from the Osteoarthritis Initiative, a multicenter, longitudinal, observational research study of nearly 5,000 individuals with knee osteoarthritis currently in its 14th year of follow-up.