"Medical Imaging and Osteoarthritis of the Knee" is a great example of a paper on the musculoskeletal system. The article is a timely reminder of the expectation of osteoarthritis and related bone disorders’ as the primary diseases needing attention in the future, with iconoclastic financial implications (Shagam, 2011). Citing the presence of the baby-boomer generation’ living in the United States currently, the author has served a warning note for the medical fraternity in the United States to be prepared to face this particular scenario in the immediate future. For the reader, this article is an enlightening and thought-provoking treatise on the intricacies of joint disorders and the diagnostic modalities available at present to differentiate various types of joint disorders.
The author has described in detail the various etiological factors behind the high incidence of osteoarthritis and related syndromes. Beginning with the pathological conditions responsible for osteoarthritis, the author has highlighted the role of congenital predisposition in some individuals’ along with the lifestyle and dietary factors responsible for its high incidence. The author has explained in meticulous detail how to differentiate between normal osteoarthritis, rheumatoid arthritis, and gout, the three conditions responsible for bone joint dysfunctions.
Although all joints can be affected depending upon the intensity of their use, the knee joint, in particular, has been shortlisted as the primary area of focus by the author. The article is interspersed with pertinent photographs, radiographs, and MRI (Magnetic Resonance Imaging) scans which enlighten the reader about the anatomical details of the knee and how underlying pathologies’ of various disorders damage the knee. The diagnostic modalities available to the present generation of orthopedicians’ and radiologists’ have been well explained with a thorough explanation of the diagnostic criteria, their finer nuances, and how to ascertain the diagnosis with the modern MRI, PET scans, and noninvasive biological tests.
The author has touched on other issues like treatment modalities, their efficacy, precautions, and contraindications as well as suitability in various categories of patients, based upon their sex, age, and comorbid conditions. Complications arising out of medication use have been discussed and well explained. Nonpharmacological approaches such as arthroscopy, injection of a lubricating substance, and alternative therapies have been discussed with the only effective alternative therapy being identified as acupuncture.
However, the author has not touched on all aspects of therapy as certain popular therapeutic agents such as glucosamine and its combination with chondroitin have been omitted (McAlindon, 2000). However, the author has identified the issue that treatment of osteoarthritis involves numerous modalities which have to be individualized for each patient. The author in her concluding pages has explained the latest research findings and the hope being generated by the cooperative efforts of engineers’ , material scientists’ biologists’ , radiologists, and physicians’ in working out future therapeutic approaches, the most interesting one being the methodologies being developed to rebuild damaged cartilages by injecting stem cells into the lesion. Conclusion The article is well structured, easy to follow, and leaves no facet of the osteoarthritic disorders untouched.
On reading it, one can easily update one’ s knowledge about the etiological factors, preventive measures, and the currently available diagnostic and therapeutic modalities. The author has stressed preventive measures as the better alternative to treatment, as the available therapeutic modalities are rife with controversies with no single treatment comprehensively effective.
Shagam, J. Y. (2011). Medical Imaging and Osteoarthritis of the Knee, Radiologic Technology, Vol. 83 (1), pp. 37-56
McAlindon, T.E., LaValley, M.P., Gulin, J.P. & Felson, D.T. (2000). Glucosamine and Chondroitin for Treatment of Osteoarthritis, JAMA, Vol. 283(11), pp. 1469-1475