Osteoarthritis of the shoulder is a growing problem among older adults. It is gradual, painful and leads to a loss of motion over the months and years.

Essentially, cartilage tissues wear down, leading to the joint surface degenerating, which causes the bone to lose its shape and the joint capsule to thicken, which further erodes shoulder rotation and causes pain.

Dr. Nikolas KnowlesDr. Nikolas Knowles, a researcher in Kinesiology and Health Sciences, is studying a new imaging technology to assess shoulder osteoarthritis. Called dual-energy computed tomography (DECT), it can detect changes in multiple tissues, not just cartilage, which has the potential to change how medical imaging is used to quickly and cost-effectively diagnose early osteoarthritis and assess treatment options.

DECT uses recent technological advancements in scanners to scan patients at two x-ray energies with scan times and radiation doses similar to current single energy scans,” Knowles says. “The images from these scans allow for changes to be detected in multiple tissues, which not possible with single energy scans alone.”

Knowles’ research project was one of only 10 to receive a recent Arthritis Society Canada Ignite Research Grant, representing $1 million investment into developing and testing high-potential, but high-risk, ideas that challenge our understanding of arthritis. 

Knowles says the high-risk aspect of his project is that DECT in musculoskeletal applications has primarily been used to only assess acute injuries and not whole-joint changes associated with degenerative joint disease, such as osteoarthritis.

“It is therefore unknown if this modality is capable of detecting deleterious tissue changes over time. However, if DECT can capture changes in the early-stages post-injury, this provides high-potential for this now-clinically available imaging modality.

“It could become the new standard of care in early joint imaging and monitoring of osteoarthritis. It may allow for preventative strategies to be implemented early to slow or even stop progression.”

The Arthritis Society Canada grant allows Knowles to explore DECT imaging in participants who have sustained an acute shoulder injury. It will include a baseline scan shortly after injury and a second scan six months post-injury.

“Comparing the two time points will allow us to determine if deleterious joint changes in multiple joint tissues improve or persist,” Knowles says. “The funding will support graduate students and costs associated with imaging resources to complete the study.”

Dr. Sian Bevan, chief science officer at Arthritis Society Canada, notes in a press release that “arthritis is a devastating, chronic condition and six million Canadians are aching for a cure. Ignite Research Grants enable paradigm-shifting ideas to be explored.”