Jacob Jaremko, M.D., PhD

Ultrasound in hip dysplasia

Hip dysplasia affects 1-3% of all infants born, and leads to dislocated hips in severe cases and premature osteoarthritis in milder cases if missed. Current screening for hip dysplasia uses conventional 2D ultrasound, which is unreliable because the limited view of the hip it shows depends highly on the skill of the sonographer.

Since 2012 my research team has been performing 3D ultrasound scans of hundreds of infants suspected of having dysplastic hips. 3D ultrasound provides a much more complete view of the hip, which ought to lead to more reliable diagnosis of hip dysplasia. We are developing visual and quantitative ways to make this diagnosis from 3D data, as shown in this video.

In 2015 I co-founded the Collaborative for Ultrasound Deep Learning (CUDL). This is a multidisciplinary, multi-national team of researchers and clinicians who share a vision that advanced machine learning techniques can be used to analyze uploaded ultrasound images (2D or 3D) to help clinicians optimize diagnosis and management of medical problems ranging from hip dysplasia to soft tissue tumors, cardiac and atherosclerotic disease, and other musculoskeletal and solid organ diseases. I describe CUDL, which is partly funded by a grant from the Canadian Medical Association Joule initiative, in this short video.

Ultrasound, especially when acquired using modern 3D technology and analyzed with advanced computer techniques, might ultimately be the 21st century stethoscope!

Arthritis Scoring Systems

Many forms of arthritis, previously thought to be inevitable consequences of ageing and untreatable, are increasingly recognized to be at least partly due to treatable inflammation. To decide in whom a treatment is likely to be successful, to test whether a new therapy is effective, and to understand the natural history of each form of arthritis, it is important to have measures of disease that are more objective than patient-reported pain. MRI allows reliable tracking of disease status and changes over time, especially when a semi-quantitative scoring system is applied by a trained user.

I work with Dr. Walter Maksymowych, a rheumatologist, and Dr. Rob Lambert, a radiologist, on initiatives applying a modern web-based approach to objective semi-quantitative grading of arthritis. We have applied the approach to spondyloarthritis (SpA), osteoarthritis of the hip (see video of HIMRISS) and knee (see video of KIMRISS), and are investigating its use in juvenile inflammatory osteoarthritis (JIA).

Tools and further information are available at www.carearthritis.com.