Relationship between radiographic joint space narrowing, sonographic cartilage thickness and anatomy in rheumatoid arthritis and control joints

Mandl, Péter; Supp, Gabriela; Radner, Helga; Studenic, Paul; Gyebnar, Janos; Kurucz, Réka; Niedermayer, Dora; Aletaha, Daniel; Bálint, Péter; Smolen, Josef S

doi:10.1136/annrheumdis-2014-205585

Cited by 30 publications

(42 citation statements)

References 20 publications

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“…One of the most intriguing findings of our study was the prominent cartilage damage in patients with HH-A, particularly in the MCP joints. In RA, a reduction in cartilage thickness has been shown to predict disability after 1–2 years, while it did not correlate with health assessment questionnaire (HAQ) scores at baseline [ 29 , 30 ]. We also observed that neither ultrasound scores nor x-ray findings were associated with pain, global assessment and function; however, ultrasound abnormalities correlated strongly with x-ray-verified structural changes.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound verified inflammation and structural damage in patients with hereditary haemochromatosis-related arthropathy

et al. 2017

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BackgroundChronic arthropathy occurs in approximately two thirds of patients with hereditary haemochromatosis (HH). The aim was to study inflammatory and structural lesions in patients with HH with (HH-A) and without arthropathy (HH-WA) using ultrasonography.MethodsThis was a cross-sectional study of 26 patients with HH-A, 24 with HH-WA and 37 with hand osteoarthritis (HOA). Clinical examination was performed in 68 joints, and we retrieved data on hand function, pain and global disease activity (all using a visual analogue scale (VAS)), morning stiffness and ferritin levels. Standard x-ray and ultrasound were conducted in 36 joints (hands, hips, knees and ankles), and we graded grey scale synovitis (GSS), power Doppler ultrasound (PD), osteophytes, erosions, tenosynovitis and cartilage damage semi-quantitatively in accordance with prior publications.ResultsUltrasound revealed a high proportion of inflammatory changes in HH-A; GSS was found in 96.2% and PD signals in 80.8% of patients (median GSS score 9, PD score 2.5). The frequency of these findings was similar in HOA. Inflammation was also common in HH-WA, yielding GSS in 83.3% and PD signals in 50.0% of patients. Cartilage damage was most prominent in HH-A as compared to HH-WA and HOA (median scores 11.0, 2.5 and 2.0, respectively). The prevalence and extent of erosions and osteophytes were similar in all groups. None of the ultrasound scores was associated with pain or function; GSS, PD, osteophyte and cartilage scores correlated with x-ray-verified structural damage.ConclusionA high prevalence of ultrasound-verified inflammation and cartilage damage was found in HH-A, and to a lesser extent in HH-WA. These findings were associated with x-ray-verified damage but not with clinical scores of pain and function.

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Section: Discussionmentioning

confidence: 99%

Ultrasound verified inflammation and structural damage in patients with hereditary haemochromatosis-related arthropathy

et al. 2017

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“…Among the 17 patients (65%) who completed the 10-year MRI, cartilage thickness appeared to be preserved. Measurements of cartilage thickness represent radiographic joints space width or joint space narrowing [3,12], which is considered the reference standard for assessment of progression of hip OA. Jacobsen et al [10] reported that joint space width less than 2 mm is associated with patient-reported pain in or around the hip, which is in line with the acceptable pain scores of the 17 patients who did not experience thinning of the cartilage during the 10-year period after PAO.…”

Section: Discussionmentioning

confidence: 99%

Cartilage Thickness and Cyst Volume Are Unchanged 10 Years After Periacetabular Osteotomy in Patients Without Hip Symptoms

Mechlenburg

Nyengaard

Gelineck

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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Background Periacetabular osteotomy (PAO) may affect cartilage thickness and cyst volume in patients with hip dysplasia. However, as no studies randomizing patients to either PAO or conservative treatment have been performed, to our knowledge, it is unknown if PAO directly affects the development or progression of osteoarthritis in patients with hip dysplasia. Questions/purposes We investigated (1) changes of cartilage thickness in the hip after PAO; (2) how many patients had subchondral bone cysts in the acetabulum or femoral head; (3) changes in cyst volume; and (4) patients' hip function and pain after PAO. Patients and Methods In this prospective study, 26 patients (22 women and four men) with hip dysplasia were enrolled with the goal of having MRI of the hip before undergoing PAO and again at 1, 2 1 .2, and 10 years after PAO. Of the 26 patients, 17 (65%) underwent complete followup 10 years after PAO, whereas nine could not be included. Of those nine, three had undergone THA, three had substantial hip symptoms, and three were lost to followup. Thickness of acetabular and femoral cartilage and volume of subchondral bone cysts were estimated in the remaining 17 patients. Ten years postoperatively, the patients' Hip disability and Osteoarthritis Outcome Scores (HOOS) were collected. Results Preoperatively, the mean thickness of the acetabular cartilage was 1.38 ± 0.14 mm compared with 1.43 ± 0.07 mm 10 years postoperatively (p = 0.73). The mean thickness of the femoral cartilage preoperatively was 1.37 ± 0.20 mm compared with 1.30 ± 0.07 mm 10 years postoperatively (p = 0.24). Seven patients had an increase in cyst volume, six had a decrease, and four had no cysts to start with and remained without cysts. Preoperatively, the median total cyst volume per patient was 6.0 cm 3 (range, 1.6-188.3 cm 3 ) compared with 2.9 cm 3 (range, 0.7-8.2 cm 3 ) (p = 0.18) at 10 years followup. At 10 years, the mean subscores for the HOOS were: pain, 79 ± 16;

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“…Abnormally hypoechoic (loss of normal fibrillar architecture) and/or thickened tendon or ligament at its bony attachment (may occasionally contain hyperechoic foci consistent with calcification), seen in 2 perpendicular planes that may exhibit Doppler signal and/or bony changes including enthesophytes, erosions, or irregularity et al 26 conducted a study aimed at validating US for measuring cartilage thickness at the metacarpophalangeal (MCP) joint level comparing the findings with anatomical measurement using cadaver specimens; moreover, a correlation with radiography in the assessment of joint space narrowing was performed. Both good agreement between US and cartilage thickness and positive correlation with joint space narrowing (P < 0.001) were found.…”

Section: Us Finding Definitionmentioning

confidence: 98%

“…These results encourage consideration of the US as a valid tool for measuring cartilage thickness in RA patients. 26 Ultrasound may be considered the "criterion standard" imaging tool for the assessment of tendons. 27,28 Its spectrum of application is wide and includes the detection of tenosynovitis and anatomical damage represented by the loss of the normal fibrillar echotexture and loss of definition of the tendon margins (Fig.…”

Section: Us Finding Definitionmentioning

confidence: 99%

General Applications of Ultrasound in Rheumatology

Ruta¹,

Pineda²,

Gutiérrez³

2015

JCR Journal of Clinical Rheumatology

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Ultrasound (US) is a noninvasive imaging technique that continues to gain interest among rheumatologists because of its undoubted utility for the assessment of a wide range of abnormalities in rheumatic diseases. It also has a great potential to be used at the time of consultation as an extension of the clinical examination.Current data demonstrate that the standard clinical approach could result in an insensitive assessment of some the different aspects of the various rheumatic diseases for which US has become a feasible and effective imaging modality that allows early detection of anatomical changes, careful guidance for the aspiration and/or local treatment, and short- and long-term therapy monitoring at the joint, tendon, enthesis, nail, and skin levels. The spectrum of pathological conditions for which US plays a crucial role continues to increase over time and includes rheumatoid arthritis, spondyloarthropathies, osteoarthritis, crystal-related arthropathies, connective tissue disorders, and vasculitis.It is expected that the inclusion of more longitudinal studies with a larger number of patients and more rigorous methodological approach will undoubtedly provide a better understanding of the significance of the abnormal US findings detected in order to provide the proper diagnostic and/or therapeutic approaches. In this article, we analyze the current potential applications of US in rheumatology and discuss the evidence supporting its use in the daily rheumatologic practice.

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Relationship between radiographic joint space narrowing, sonographic cartilage thickness and anatomy in rheumatoid arthritis and control joints

Cited by 30 publications

References 20 publications

Ultrasound verified inflammation and structural damage in patients with hereditary haemochromatosis-related arthropathy

Ultrasound verified inflammation and structural damage in patients with hereditary haemochromatosis-related arthropathy

Cartilage Thickness and Cyst Volume Are Unchanged 10 Years After Periacetabular Osteotomy in Patients Without Hip Symptoms

General Applications of Ultrasound in Rheumatology

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