Modern medical imaging techniques allow us to look inside the body to better understand how our bones, cartilage, muscles and tendons work together in health and in disease. In the Musculoskeletal Research Programme, we use a wide range of medical imaging techniques in our work, in collaboration with the Aberdeen Biomedical Imaging Centre.

One of our main priorities is to develop and test imaging biomarkers. We aim to use these to diagnose diseases earlier than currently possible, identify those at the greatest risk of getting a disease in the future, or to measure changes in disease status more sensitively than currently possible. We hope that in the future this will allow us to prevent more osteoporotic fractures and hip and knee replacements for osteoarthritis.

Osteoporosis:

People with osteoporosis have less bone mineral and are therefore more likely to suffer a fracture. Although there are effective treatments for osteoporosis, it causes no pain and has no symptoms, so many people don’t know they have osteoporosis until after they break a bone. It is diagnosed by measuring the bone mineral density (BMD) using a Dual Energy X-ray Absorptiometry (DXA) scanner. BMD measures the amount of mineral in your bones, but we believe that there is more information than this that we can take from DXA scans, or normal x-ray images to try and identify people at greatest risk of fracture.

By measuring the shape of the hip, we have found that those with longer, thinner, steeper femoral necks are at greatest risk of fracture. Using Active Shape Modelling, a statistical measure of shape variation, we have been able to identify characteristic hip shapes associated with an increased fracture risk (Gregory et al., 2005). By adding information about the shape of the hip to BMD measures, we hope to better predict those at greatest risk of fracture and ensure they receive the treatment they need to prevent it.

Osteoarthritis:

Osteoarthritis (OA) is a widespread, painful and debilitating disease. Unfortunately there are currently no effective treatments at the moment, apart from replacement of the damaged joint. Using Active Shape Modelling, we have identified characteristic shapes which identify those at greatest risk of OA progression over 5-6 years (Barr et al., 2012, Gregory et al., 2007).

We are also using new imaging technologies, such as fast field cycling magnetic resonance imaging to measure proteins in healthy and osteoarthritic cartilage and compare this with standard MRI and laboratory measures, such as Raman Spectroscopy (Broche et al., 2012a, 2012b).

References

  • Barr RJ, Gregory JS, Reid DM, Aspden RM, Yoshida K, Hosie G, et al (2012a). Predicting OA progression to total hip replacement: can we do better than risk factors alone using active shape modelling as an imaging biomarker? Rheumatology (Oxford) Mar 51(3):562-70
  • Broche LM, Ashcroft GP, Lurie DJ (2012b). Detection of osteoarthritis in knee and hip joints by fast field-cycling NMR. Magn Reson Med Aug 68(2):358-62
  • Broche LM, Ismail SR, Booth NA, Lurie DJ (2012). Measurement of fibrin concentration by fast field-cycling NMR. Magn Reson Med May 67(5):1453-7.Gregory JS, Testi D, Stewart A, Undrill PE, Reid DM, Aspden RM (2004). A method for assessment of the shape of the proximal femur and its relationship to osteoporotic hip fracture. Osteoporos Int 15(1):5-11
  • Gregory JS, Stewart A, Undrill PE, Reid DM, Aspden RM (2005). Bone shape, structure, and density as determinants of osteoporotic hip fracture - A pilot study investigating the combination of risk factors. Investigative Radiology 40(9):591-7
  • Gregory JS, Waarsing JH, Day J, Pols HA, Reijman M, Weinans H, et al (2007). Early identification of radiographic osteoarthritis of the hip using an active shape model to quantify changes in bone morphometric features - Can hip shape tell us anything about the progression of osteoarthritis? Arthritis and Rheumatism 56:3634-43