Progression of digital osteoarthritis: a sequential scintigraphic and radiographic study

Abstract

Hand radiographs and scintigraphy were obtained initially and at the 4-year follow-up in 15 patients with symptomatic osteoarthritis (OA) of distal and/or proximal interphalangeal joints. For each joint, a 0-15 score was obtained for the OA radiographic lesions read blind by the same observer. An abnormal isotope retention over a bone reference area was assessed and quantified. The predictive value of scintigraphy for the OA radiographic progression was confirmed and shown to be improved by a second investigation. During the study period, the percentage of radiographic OA joints increased from 66.3 to 76.6%, but joints showing an abnormal scan decreased from 40 to 22.5%. Progression of the OA radiographic score was closely related to scintigraphic changes. The mean difference between the final and initial OA score was -0.08 in joints with two normal scans (N = 115), +0.73 in joints showing a first abnormal and a second normal scan (N = 94) and +1.8 in joints with two abnormal scans (N = 14) or a scan becoming abnormal (N = 47). An abnormal scan appears to represent a transient event, and this event is associated with a period of progression of digital OA. Potentially, anti-OA therapies that suppress joint isotope retention might slow down OA progression. The magnitude of joint isotope retention was positively correlated with the OA radiographic score established at the same time (R = 0.61 and P < 0.001), but showed no predictive value for progression of the latter.

Metric properties of advanced imaging methods in osteoarthritis of the hand: a systematic review

“…In all three studies scintigraphic studies scores decreased over time while the disease progressed and radiographic and pain scores increased 28 32 50. Changes in the radiographic scores were weakly correlated with changes in the scintigraphic scores (r=0.13) 32…”

“…Isotope uptake was correlated with joint pain (τ=0.24),28 and OA on CR (r=0.50–0.61) 32 50. Scintigraphy detected fewer pathological joints than CR.…”

Progression of hand osteoarthritis over 2 years: a clinical and radiological follow-up study

“…Radiological progression of DIPJ, PIPJ and first CMCJ was recorded for osteophytes (38–39% of patients) and for JSN (39–48% of patients). Balblanc et al 29 performed a small study comprising 15 patients with symptomatic osteoarthritis of DIPJ and/or PIPJ. Significant radiographic progression in JSN, osteophytes, sclerosis, cysts and subluxation was seen after 4 years’ follow-up.…”

Clinical and radiographic disease course of hand osteoarthritis and determinants of outcome after 6 years

“…Studies investigating the course of hand OA in patient populations are scarce 5–8. Previously, we reported on the course of hand OA over a period of 2 years, showing that a considerable proportion of patients showed clinical as well as radiographic deterioration over this relatively short period 8.…”