Quantitative microfocal radiographic assessment of progression in osteoarthritis of the hand

Abstract

We studied 32 patients with osteoarthritis who had 5x macroradiographs taken of their wrists and hands at 6-month intervals over an 18-month period. The higher magnification and resolution of microfocal radiography permitted the quantitative detection of progressive changes in 4 different features: subchondral sclerosis, the number and size of osteophytes, juxtaarticular radiolucencies, and joint space narrowing. Compared with normal control subjects, subchondral cortical thickness was greater in all patients at entry and showed a variable degree of change over the study period. Osteophytes and juxtaarticular radiolucencies were present in all patients at study entry; by the end of the study, osteophytes had increased in number and area, and juxtaarticular radiolucencies had increased in area, but not in number. At entry, 44% of the patients had joint space narrowing significantly greater than that in the control subjects; by 18 months, this proportion increased to 65%. No correlation was found between subchondral sclerosis, osteaphytes, juxtaarticular radiolucencies, and joint space narrowing. We conclude that in osteoarthritis of the hand, the bony changes have

Targeting subchondral bone for treating osteoarthritis: what is the evidence?

“…Using quantitative microfocal radiography, Buck-land-Wright et al [19,20] showed that the changes in OA joints also involve thickening of the sub-chondral cortical plate. In the ACL dog model of OA, Brandt et al [6] reported that, at a later stage of the disease, 54 months after OA induction, there was a marked increase in the volume of subchondral bone with active bone formation.…”

Early radiographic features in patients with anterior cruciate ligament rupture

“…These studies have shown that bony features appear before cartilage narrowing and loss measured radiographically as joint space narrowing 1517 18 …”

Techetium 99m methylene diphosphonate bone scanning in osteoarthritic hands

“…1987). In the much smaller joints of the wrist and hand of our patients, no such correspondence was found despite the presence of sclerosis and its change during the study period (Buckland-Wright et al 1990). As the subchondral bone in these joints is narrow, the uptake of bone-seeking isotope would appear to fall below that required for detection by the gamma camera.…”

“…The advantages of high spatial resolution and magnification characteristic of this technique (Buckland-Wright 1989) provided detailed images of structures approximating to that of histology (BucklandWright and Bradshaw 1989). Accurate measurement of the dimensions of X-radiographic features can be obtained (Buckland-Wright et al 1986), giving details of the extent (Buckland-Wright and Walker 1987) and progression , 1990) of a disease process. Measurements from the bone scan images were compared with those of the macroradiographic appearance of the X-radiographic features at both baseline and 1 year later.…”