"Why aren't we there yet?" Re-examining standard paradigms in imaging of OA Summary of the 2nd annual workshop on imaging based measures of osteoarthritis

Objective: This white paper constitutes an overview of presentations and discussions from the 2nd annual osteoarthritis (OA) imaging workshop. Design: This workshop brought together the communities of basic OA researchers, orthopedists and rheumatologists, imaging scientists, instrument manufacturers, and pharmaceutical and regulatory representatives to try to identify those factors that have limited imaging [focusing mostly on magnetic resonance imaging (MRI)] from making larger inroads into understanding and treating OA ("why aren't we there yet"), and to delineate future directions for success. Results: The meeting was successful in raising awareness and questions about how we may proceed in this process. There was a general consensus that a change in direction is needed for OA imaging research to succeed in yielding a better understanding of OA and development of preventive and therapeutic procedures. Conclusions: Our current paradigms are limiting the potential for MRI, by limiting how trials are designed and interpreted. Many basic questions remain in biology, pathophysiology, pain, and biomechanics; these questions need to be identified and specific imaging protocols need to be developed to address them. The OA research communities need to work alongside the regulatory, pharmaceutical, and MRI industries to support the new ideas and engage in the positive reinforcement of resources to further the new studies. (C) 2009 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.