Emerging Role of inflammatory biomarker monitoring in the Diagnosis of osteoarthritis
DOI:
https://doi.org/10.5281/zenodo.22814116Keywords:
osteoarthritis, inflammatory biomarkers, C-reactive protein, interleukin-6, cartilage turnoverAbstract
Background: Osteoarthritis has traditionally been framed as a mechanical, cartilage-wear disease, but accumulating evidence over the past two decades has established that low-grade synovial and systemic inflammation contribute meaningfully to disease onset, structural progression, and symptom burden.
Objective: This review synthesizes the published evidence on circulating and synovial inflammatory biomarkers, including C-reactive protein, interleukin-6, tumor necrosis factor-alpha, cartilage oligomeric matrix protein, matrix metalloproteinases, and emerging synovial fluid panels, as tools for diagnosing osteoarthritis, stratifying phenotypes, and monitoring progression.
Methods: We synthesized cohort studies, biomarker validation studies, and consensus statements addressing inflammatory biomarker performance in knee, hip, and hand osteoarthritis, drawing on established osteoarthritis biomarker frameworks.
Findings: High-sensitivity C-reactive protein and interleukin-6 are consistently associated with radiographic progression and pain severity, cartilage oligomeric matrix protein and matrix metalloproteinase-3 track cartilage turnover with moderate specificity, and composite panels combined with imaging outperform any single marker for identifying an inflammatory phenotype likely to progress rapidly.
Conclusions: Inflammatory biomarker monitoring is not yet ready to replace radiography or clinical criteria for osteoarthritis diagnosis, but it adds meaningful value for phenotyping, prognostication, and trial enrichment, and a layered strategy combining core biomarkers with imaging is the most defensible current approach.
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