Radiology in public focus

Knee Arthritis Made Worse with Steroid Injections 

A study in Radiology revealed that corticosteroid injections for knee osteoarthritis pain are associated with higher progression of the disease.  

Study author Upasana Upadhyay Bharadwaj, MD, who was a research fellow in the Department of Radiology at University of California, San Francisco, at the time of the research, and colleagues used patient data from Osteoarthritis Initiative to compare the effects of corticosteroid and hyaluronic acid injections.  

Of the 70 patients who received injections, 44 were injected with corticosteroids and 26 were injected with hyaluronic acid. Compared to the control group and those who received hyaluronic injections, corticosteroid injections led to more knee joint damage over a two-year period. Hyaluronic acid was associated with less progression of joint damage and even appeared to slow down the damage.  

“Our study directly challenges a common clinical practice: the use of corticosteroid injections for knee osteoarthritis symptom relief,” Dr. Bharadwaj said. “It presents robust evidence that corticosteroids accelerate structural knee degeneration, even after a single injection.”  

Read the related RSNA News story. 

Routine Breast Cancer Screening Brings Better Outcomes for Patients 

In a new study published in Radiology: Imaging Cancer, researchers found that breast cancers detected from regular screening, not from symptoms, had improved clinical outcomes.  

Jean M. Seely, MD, FRCPC, a professor in the Department of Radiology at the University of Ottawa and head of the breast imaging section at Ottawa Hospital in Ontario, Canada, and colleagues conducted a retrospective observational analysis on patients aged 40 and older who were diagnosed with breast cancer in 2016.  

Screening-detected breast cancer patients had significantly lower odds of having an advanced stage of breast cancer, lower odds of undergoing a mastectomy and a lower hazard ratio of death.  

Symptom-detected breast cancers were more common in women aged 40 to 49 years and over 75 years of age.  

“The results of this study will likely support the move to reduce the breast cancer screening age to 40 in the U.S. and Canada,” Dr. Seely said. “We have lowered the screening age in many provincial and territorial screening programs in Canada and are aiming to establish a single national policy for screening.” 

Read the related RSNA News story. 

Carotid Plaque May Pose Danger Over Time 

Using patient data from the Rotterdam Study in the Netherlands, researchers found that carotid artery plaques can undergo potentially dangerous changes over time, according to a study published in Radiology.    

Daniel Bos, MD, PhD, an associate professor in clinical epidemiology and neurovascular imaging at Erasmus MC, University Medical Center Rotterdam in the Netherlands, and colleagues followed 802 patients embedded in the study.  

The patients were 45 years and older with subclinical carotid artery atherosclerosis. After six years, plaques that already had calcification were twice as likely to develop internal bleeding. A simulated 30-year evolution beyond the six years also showed that more than half of the patients with plaques containing a single component would develop into multicomponent plaques by the age of 70.  

“One of the key findings of our work is that calcified plaques may not be as harmless as once thought, since these plaques were found to be at risk of intraplaque bleeding, which in itself is the most important cause of plaque rupture and subsequent stroke,” Dr. Bos said.  

Read the related RSNA News story.