Osteoarthritis (OA) is a prevalent and debilitating disease that affects a large population worldwide. With an estimated 240 million individuals suffering from symptomatic OA globally, it is clear that OA represents a significant health concern [1]. In the United States alone, it is estimated that 10% of the population will develop symptomatic knee OA before they reach the age of 60 years [2,3].

Global estimates from the Global Burden of Diseases, Injuries and Risk Factors Study show that knee OA cases have increased by 9.3%, and hip OA cases have increased by 8.2% since 1990, highlighting the need for improved diagnostic and therapeutic strategies [4]. The impact of OA extends beyond the physical symptoms, affecting psychological well-being and work productivity. Additionally, OA has been associated with heightened mortality rates, substantially impacting affected individuals. In the past, OA was considered a “wear and tear” disease of hyaline cartilage. However, it is now widely accepted that OA is a complex whole-organ disorder with a complex pathophysiology [1].

The Osteoarthritis Research Society International (OARSI) defines OA as a molecular derangement, followed by anatomic and physiological derangements that can result in illness. As a result, there is a need to reconsider imaging protocols for OA. Over the past few decades, musculoskeletal imaging has undergone significant advancements, providing new opportunities for improved diagnosis and characterization of OA [5,6]. Modern musculoskeletal imaging can help visualize various tissues and provide pathophysiological information beyond anatomic details.

Traditional OA imaging focuses on radiography, highlighting osteophytes, sclerosis, and joint space narrowing. However, advances in imaging techniques, including ultrasonography (US), computed tomography (CT), magnetic resonance imaging (MRI), and molecular imaging, have expanded the role of imaging in OA assessment [[7], [8], [9], [10], [11], [12]]. Whole-organ assessment of the joint and surrounding soft tissues has become essential in clinical practice and research, highlighting the need for improved diagnostic and therapeutic strategies [13].