A recently developed MRI scoring system for hand osteoarthritis: its application in a clinical setting

Abstract

This study aimed to apply the recently proposed Oslo hand osteoarthritis magnetic resonance imaging (MRI) scoring system to evaluate MRI findings in a cohort of patients affected by long-standing erosive hand osteoarthritis (EHOA). Eleven female EHOA patients (median 59 [interquartile range 62-52] years, disease duration 9.5 [interquartile range 13-3.75] years) underwent MRI (1.5 T) of the dominant hand, and synovitis, bone marrow lesions (BMLs), joint space narrowing, osteophytes, cysts, malalignment, and erosions were scored using the Oslo scoring system. Intra- and inter-reader reliability were assessed. The patients also underwent X-ray examination, and bone features were evaluated using the same scoring system. Pain and tenderness were assessed during a physical examination. Spearman's non-parametric test was used to analyze the correlations between variables. MRI intra- and inter-reader reliability were found between good and moderate for many features. No statistical differences were found between the radiographs and MRI with regard to detection of JSN, malalignment, and bone erosions. Synovitis was detected in 39.8 % of the 80 joints examined (in a mild form in 80 %), erosions were found in 51.1 %, and BMLs were identified in 20.5 and 23.9 % at the distal and the proximal side, respectively. BMLs at both the proximal and distal ends were correlated with tender joints (BML distal p = 0.0013, BML proximal p = 0.012). The presence of synovitis was correlated with tenderness (p = 0.004) and erosions at both the distal and proximal joints (p = 0.004). The presence of erosions correlated with tender joints (p < 0.01) and the mean visual analog scale (VAS) score (distal p = 0.03, proximal p = 0.01). Synovitis and BMLs were correlated with clinical symptoms in our patients affected with long-standing EHOA.

Review of Prospects of Biological Fluid Biomarkers in Osteoarthritis

“…In case of MRI, it enables visualization of various types of damage that occur in joint, for example, cartilage lesions, cartilage thickness loss, bone marrow lesions (BMLs) and meniscal tear. According to a recent study of Ramonda et al, synovitis and BMLs detected by MRI were associated with pain, an early progression feature of erosive hand OA [9]. Even though MRI provides a diagnostic approach aiding early detection of OA, this method cannot become popular due to its high cost.…”

Evaluating the Relation between Bone Marrow Lesions and Synovitis with Pain and Structural Damage in Hand Osteoarthritis

“…The mean age for all studies was 64.4 [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32]. Most studies (n = 13) were performed on both genders, although the majority of the subjects in each study were female.…”

“…Most studies (n = 13) were performed on both genders, although the majority of the subjects in each study were female. Only two studies [26,32] had female subjects only and one study did not report the gender of the participants [25]. Of these studies, 13 were from observational cohort studies: the Hand OSTeoarthritis in secondary care (HOSTAS) [27,[29][30][31] the Oslo hand OA cohort [18-23, 25, 32] and a clinical trial: the digital osteoarthritis in refractory hand OA (DORA) study [28].…”

“…All articles examined BMLs and various subchondral features using MRI. The strength of the magnetic field was 1.5 T in four studies [27,29,26,30]. Eight studies used a 1.0 T system [18-23, 25, 32] whereas one study [28] used the 0.2 T system in two patients only.…”

From art to science: the functional damage due to thumb osteoarthritis finely described by Velazquez 300 years before its clinical description

“…He commented on a continuum from subchondral sclerosis, osteophyte formation, to joint degradation (6). Although nowadays different methods are useful for the diagnosis of the first CMC joint, such as conventional radiology or magnetic resonance imaging (MRI), biomechanical studies on this articulation have shown that forces increase exponentially (up to 1200%) from the tip of the thumb to the CMC joint with grasp and forceful pinch with compressive forces causing pain and functional impotence in daily activities (7)(8)(9). Pain at the base of the thumb during everyday activities can cause substantial impairment in hand function.…”