# Assessment of ultrasound features of knee osteoarthritis in a population-based community cohort

> **NIH NIH R01** · UNIV OF NORTH CAROLINA CHAPEL HILL · 2021 · $331,837

## Abstract

Project summary
Our long-term goal is to demonstrate the utility of ultrasound for OA assessment, standardize its acquisition
and scoring, and promote increased uptake of US for use in clinical, research, and trial settings. Knee
osteoarthritis (KOA) is highly prevalent and frequently debilitating. Development of potential treatments has
been hampered by the heterogenous nature of this common chronic condition, which is characterized by a
number of subgroups, or phenotypes, with different underlying pathophysiological mechanisms. Imaging,
genetics, biochemical biomarkers, and other features can be used to characterize phenotypes, but variations in
data types can make it difficult to harmonize definitions. While radiography is widely used in KOA imaging, it is
limited in its ability to assess early disease (when interventions are most likely to succeed) and is insensitive to
change. Ultrasound (US) is a widely accessible, time-efficient and cost-effective imaging modality that can
provide detailed and reliable information about all joint tissues (e.g., cartilage, meniscus, synovium, bone), and
could therefore inform phenotypes in KOA (e.g., by presence of synovitis, effusion, cartilage damage, calcium
crystal deposition, and popliteal cysts). Use of US is currently limited by the lack of systematically performed
studies in well-characterized non-clinical populations. To address this gap and further the use of this
advantageous imaging modality for KOA, we will obtain standardized US and radiography in the population-
based Johnston County Health Study (JoCoHS), the new enrollment phase of the 25+ year Johnston County
OA Project which includes white, African American, and Hispanic men and women aged 35-70, to achieve
three aims. In Aim 1, we will determine the population prevalence (n~3000) of knee US features including
cartilage and meniscal damage, synovitis/effusion, calcium crystal deposition, popliteal cysts and osteophytes
overall and in key subgroups by age, sex, race/ethnicity, and symptom status. Aim 2 will allow quantification of
the associations between these US features and radiographic findings and symptom scores overall and in key
subgroups (e.g., those with and without radiographic KOA, by sex, by race/ethnicity). For Aim 3, we will apply
novel machine learning methodologies (e.g., Direction-projection-permutation [DiProPerm] hypothesis testing,
Joint and Individual Variation [JIVE], and Distance-Weighted Discrimination [DWD]) to a) develop an overall
US score for symptomatic KOA and b) identify the contribution of US variables to phenotypes relevant to KOA
based on general health, physical activity, and functional assessments. This study is a crucial step to establish
the foundation for US as an assessment tool for clinical use, research, and clinical trials in KOA, providing
unique population-based cross-sectional data regarding the utility of US and forming the basis for future
longitudinal work evaluating its value and performanc...

## Key facts

- **NIH application ID:** 10158441
- **Project number:** 5R01AR077060-02
- **Recipient organization:** UNIV OF NORTH CAROLINA CHAPEL HILL
- **Principal Investigator:** Amanda E Nelson
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $331,837
- **Award type:** 5
- **Project period:** 2020-05-05 → 2025-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10158441

## Citation

> US National Institutes of Health, RePORTER application 10158441, Assessment of ultrasound features of knee osteoarthritis in a population-based community cohort (5R01AR077060-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10158441. Licensed CC0.

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