Imaging modalities in hand osteoarthritis - status and perspectives of conventional radiography, magnetic resonance imaging, and ultrasonography |
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Authors: | Ida K Haugen and Pernille B?yesen |
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Abstract: | Hand osteoarthritis (OA) is very frequent in middle-aged and older women and men in the general population. Currently, owing
to high feasibility and low costs, conventional radiography (CR) is the method of choice for evaluation of hand OA. CR provides
a two-dimensional picture of bony changes, such as osteophytes, erosions, cysts, and sclerosis, and joint space narrowing
as an indirect measure of cartilage loss. There are several standardized scoring methods for evaluation of radiographic hand
OA. The scales have shown similar reliability, validity, and sensitivity to change, and no conclusion about the preferred
instrument has been drawn. Patients with hand OA may experience pain, stiffness, and physical disability, but the associations
between radiographic findings and clinical symptoms are weak to moderate and vary across studies. OA is, indeed, recognized
to involve the whole joint, and modern imaging techniques such as ultrasound (US) and magnetic resonance imaging (MRI) could
be valuable tools for better evaluation of hand OA. Standardized scoring methods have been proposed for both modalities. Several
studies have examined the validity of US features in hand OA, whereas knowledge of the validity of MRI is more limited. However,
both synovitis (detected by either US or MRI) and MRI-defined bone marrow lesions have been associated with pain, indicating
that treatment of inflammation is important for pain management in hand OA. Both US and MRI have shown better sensitivity
than CR in detection of erosions, and this may indicate that erosive hand OA may be more common than previously thought. |
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