Precision Medicine

Precision medicine seeks to match diagnosis and treatment to a patient's molecular and clinical profile rather than applying a single approach to everyone [1]. Osteoarthritis is well suited to this framing because it is not one disease but several overlapping phenotypes with distinct clinical, structural and molecular features [1]. Stratifying patients by these phenotypes is increasingly seen as the route to therapies that finally modify the disease rather than only its symptoms [2]. Recognising osteoarthritis as an inflammatory, multi-phenotype disorder of the whole joint is what makes personalised prevention plausible [2].

Realising this vision depends on tools that can assign patients to the right subgroup, and imaging in particular is used to phenotype joints and select participants for disease-modifying drug trials [3]. Better stratification also produces cleaner trial cohorts, improving the chance of detecting a treatment effect [3]. Precision-diagnostic thinking, connecting molecular phenotype to clinical decision, is the discipline Jessica trained in and applies to cartilage disease [1].