Ultrasound features of nonstructural lesions of the proximal and distal interphalangeal joints of the hands in patients with finger osteoarthritis

The Application of Imaging in Osteoarthritis

“…In order to improve near field resolution, increased sensitivity for detection of blood flow and minimize compression / obliteration of small quantities of effusion or synovial thickening, a lightly held probe with a generous amount of contact jelly reduces contact pressure (Koski, Saarakkala et al 2006). Effusion and PDS do not appear to be specific for cartlage erosion with effusion also found in 'normal' joints and conflicting results found in current studies (Chao, Wu et al 2010;Kortekaas, Kwok et al 2010;Mancarella, Magnani et al 2010;Wittoek, Carron et al 2010;Wittoek, Jans et al 2010;Arrestier, Rosenberg et al 2011). Subclinical inflammation has been reported in some studies with no correlation found with PDS or patients' reported pain levels but may indicate future disease progression (Kuroki, Nakagawa et al 2008;Kortekaas, Kwok et al 2010;Wittoek, Jans et al 2010).…”

“…Using an initial grey-scale setting and by altering the probe frequency both superficial and deeper structures can be viewed in small joints such as in the hand and larger joints such as the hip (Iagnocco 2010;Mancarella, Magnani et al 2010). Power Doppler settings allow the assessment of active inflammation, or at least to vascular hyperaemia in the synovium thus defining both disease state and response to therapy modalities (Iagnocco 2010;Mancarella, Magnani et al 2010;Arrestier, Rosenberg et al 2011). The application of US in the assessment of OA includes definition of the extent of changes in the cartilaginous matrix, changes in intra-articular and peri-articular soft tissues as well as assessment of changes to the bony cortex (Moller, Bong et al 2008).…”

“…Specific US findings related to anatomical location of the joint under investigation have also been defined in the literature, with the majority of studies involving the joints of the hand (Walther, Harms et al 2002;Kuroki, Nakagawa et al 2008;Wittoek, Carron et al 2010;Wittoek, Jans et al 2010;Arrestier, Rosenberg et al 2011). Several studies have also investigated the diagnostic accuracy of US compared to CR, CT and MRI in the hand (Keen, Wakefield et al 2008;Moller, Bonel et al 2009;Mancarella, Magnani et al 2010).…”

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

“…Only one study detected fewer erosions with US (sensitivity=0.73, specificity=1.0) 38. Joint pain, tender joints and swollen joints were used as comparator in four studies and agreed poorly with US greyscale measurements of synovitis, effusion, PD measurements, JSN and osteophytes 31 42 45 46…”

“…Four of 11 US studies compared patients with hand OA with healthy controls and reported significant differences in JSN,42 osteophytes,42 synovitis,31 42 48 power Doppler (PD) signal,31 42 48 and joint effusion,31 37 48 while no significant differences were found for tendon effusion 31. Five studies compared structural US changes with CR, and US generally detected more osteophytes,41 46 51 52 erosions51 52 and JSN 41.…”