News August 2005 Issue

In the News: 08/05

New MRI May Help You Avoid Knee Surgery
The scanning accuracy of 3-Tesla Magnetic Resonance Imaging (MRI) may help you avoid knee surgery. A newer version of the standard MRI, the 3-Tesla MRI  allows the physician to see the knee from all planes and angles and then reconstruct it three-dimensionally on a computer screen. Although its accuracy is no greater than a standard MRI, it reportedly allows for faster imaging of potential damage with less patient movement.

Comparing the 3-Tesla MRI procedure—called isotopic imaging—to arthroscopy, researchers found that the 3-Tesla MRI had an accuracy rate of 96 percent in detecting meniscal tears, identifying 108 of 112 tears that were found through arthroscopic surgery. They also found three cases in which the new MRI identified a tear not discovered through arthroscopy.

The study, presented  during a recent meeting of the American Roentgen Ray Society, suggests that isotopic imaging also shows promise in detecting ACL and other knee injuries. Although isotopic imaging has not replaced standard knee MRI, researchers say the procedure will enable patients with meniscal tears to determine if they’re in need of immediate surgery or if they might benefit from rehabilitation first to see if their knee injury heals.

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Bone-Builders Could Also Be Pain-Builders
Reports of severe bone, joint, and muscle pain associated with the bone-strengthening drugs alendronate (Fosamax) and risedronate (Actonel) have surfaced in a letter written by the U.S. Food and Drug Administration (FDA). The FDA, whose findings were published in a recent issue of the Archives of Internal Medicine, claims it had received reports of severe bone, joint, or muscle pain in 124 patients who had been taking the drugs. Most reports were associated with alendronate (118 vs. six for risedronate), and 95 percent of those taking the drug were women whose age averaged 67 years; most patients (74 percent) took 10mg/day. The average time of pain onset was 14 days, and 66 percent of the patients reported the pain had stopped once alendronate was discontinued. Patients reported that pain was experienced throughout the body and, in some cases, it began at one site and then migrated.

FDA officials claim they had earlier reviewed clinical-trial findings on both drugs and found no significant differences between the drugs and a placebo in producing adverse events, concluding that differences are often later discovered as the drugs enter the marketplace.

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Spinal Arthritis: NSAIDs To The Rescue
Nonsteroidal anti-inflammatory drugs (NSAIDs) have long been used to ease the pain of ankylosing spondylitis (AS), or arthritis of the spine, a condition which develops as a result of swelling and irritation of the spinal joints (vertebrae). But the results of a trial recently conducted in the Netherlands showedthat NSAIDs might well alter the course of the disease. Specifically, researchers found AS progression was slowed when celecoxib (Celebrex) was taken continuously, but not when the drug was taken only when symptoms were severe. (The U.S. Food and Drug Administration has ordered a black-box label for Celebrex warning of the drug’s cardiovascular risks.) The study included 215 AS patients who took celecoxib either continuously or as needed and were followed for two years. Though the study did not include data on the use of other NSAIDs, the authors claim that the results, at least as treatment for AS, are a strong indication that NSAIDs generally may have disease-controlling properties.

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More Muscle, Less Arthritis?
An Australian study of 86 middle-aged men and women reveals that people with greater muscle mass have thicker cartilage in their knees, and thicker cartilage may prevent the onset of osteoarthritis. Subjects underwent magnetic resonance imaging (MRI) at the outset of the study and then two years later to assess change in cartilage volume at the top of the tibia. Body composition was similarly recorded via X-ray absorptiometry. Investigators concluded that further studies were needed to determine if programs to increase muscle mass will protect against OA. The study was published in Arthritis & Rheumatism.