Can optical spectral transmission assess ultrasound-detected synovitis in hand osteoarthritis?

Abstract

Objective To determine whether optical spectral transmission (OST) can be used to assess synovitis in hand and wrist joints of patients with hand osteoarthritis (OA). Design Hand and wrist joints of 47 primary hand OA patients with at least one clinically inflamed hand or wrist joint were assessed for synovitis by OST and ultrasound (US). Associations between standardized OST and US synovitis were studied in linear mixed effects models, across all joint types together and individually for wrist, proximal interphalangeal (PIP), and distal interphalangeal (DIP) joints, and were adjusted for OA features that showed associations with US synovitis. Diagnostic performance was determined using receiver operator characteristic (ROC) curves analysis, with US as reference standard. Results Altogether, 6.7% of joints showed US synovitis. Statistically significant associations between OST scores and US synovitis were found for all joints combined (Δ0.37SD, p<0.001) and PIP joints (Δ0.81SD, p<0.001), but not for DIP (Δ0.14SD, p = 0.484) or wrist joints (Δ0.37SD, p = 0.178). All associations were independent of other OA features, i.e. osteophytes and dorsal vascularity. Analysis of diagnostic performance of OST, revealed an area under the ROC curve (AUC-ROC) of 0.74 for all joints together (p<0.001), 0.69 for PIP joints (p<0.001), 0.54 for DIP joints (p = 0.486), and 0.61 for wrist joints (p = 0.234). Conclusions OST scores and US synovitis are statistically significantly associated, independent of osteophytes and dorsal vascularity. At this stage, OST performs fair in the assessment of synovitis in PIP joints of hand OA patients.

Evaluation of osteoarthritic features in peripheral joints by ultrasound imaging: A systematic review

“…A total of 159 citations were identified for screening with 32 articles included for final analysis. Thirty articles evaluated US features of hand OA [ 24 , 25 , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] , [47] , [48] , [49] , [50] , [51] , [52] , [53] , [54] , [55] , [56] , [57] , [58] , [59] , [60] , [61] , [62] , [63] , [64] ] and two assessed US OA features in the foot [ 65 , 66 ]. Twenty-seven hand OA studies assessed the proximal and distal interphalangeal joints [ 24 , 25 , 37 , 38 , [41] , [42] , [43] , [44] , [45] , [46] , [47] , [48] , [49] , [50] , [51] , [52] , [53] , [54] , [55] , [56] , [57] , [59] , [60] , [61] , [62] , [63] , [64] ], 22 studies assessed the metacarpophalangeal and carpometacarpal joints [ 24 , 25 , [38] , …”

“…The following inflammatory US features were investigated by the included studies: synovitis, synovial hypertrophy, joint effusion, tenosynovitis, and power Doppler (PD) signal. PD signal was the most reported US feature across all studies (n ​= ​24) [ 24 , [37] , [38] , [39] , [40] , [41] , 44 , [46] , [47] , [48] , [49] , [50] , [51] , [53] , [54] , [55] , 57 , 59 , 60 , [62] , [63] , [64] , [65] , [66] ]. There were also inconsistencies between the different entities of synovial pathology, making comparison between studies difficult.…”

“…There were also inconsistencies between the different entities of synovial pathology, making comparison between studies difficult. Of the 32 studies included in the review, 16 assessed synovitis [ 24 , [37] , [38] , [39] , 41 , 42 , 46 , 49 , 54 , 56 , 57 , 59 , 60 , [62] , [63] , [64] ], of which eight studies combined joint effusion and synovial hypertrophy as a single domain, termed “synovitis” [ 24 , 39 , 49 , 52 , 54 , 59 , 62 , 63 ], whereas five studies assessed synovitis and joint effusion as separate entities [ 41 , 49 , 56 , 57 , 64 ]. Furthermore, several studies clearly differentiated between synovial hypertrophy and joint effusion; with 14 studies having assessed joint effusion [ 40 , 41 , [47] , [48] , [49] , [50] , [51] , 53 , [55] , [56] , [57] , 65 , 66 ] and 12 studies assessed synovial hypertrophy [ 40 , 41 , 44 , [47] , [48] , [49] , [50] , [51] , 53 , 55 , [64] , [65] , [66] ] as separate entities (US features).…”

Associations between fluorescence optical imaging and magnetic resonance imaging and symptoms in hand osteoarthritis

“…Nevertheless, a Dutch study found moderate results with MRI as reference, while a Danish study concluded that the sensitivity of OST was not superior to clinical examination (195,196). The diagnostic performance of OST has also been investigated in hand OA, with fair performance in the PIP joints and poor performance in the DIP joints (197).…”

Optical imaging compared to clinical examination in 484 rheumatoid arthritis patients: the Leeuwarden Handscan Registry

“…The Handscan is an optical imaging device, designed for the visualization of hemodynamics related to joint inflammation by optical spectral transmission imaging of hands and wrists before, during and after venous occlusion at the lower arm. [11] It is a safe and fast measurement, which takes only 2 min [12]. By using this technique, the Handscan is supposed to be an objective measurement tool of inflammation.…”