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Kim SK, Jung UH, Kim JW, Choe JY. Ultrasound Findings were Associated With Radiographic Changes, But Not Clinical and Functional Outcomes in Hand Osteoarthritis. JOURNAL OF RHEUMATIC DISEASES 2021; 28:17-24. [PMID: 37476391 PMCID: PMC10324955 DOI: 10.4078/jrd.2021.28.1.17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 09/18/2020] [Accepted: 09/18/2020] [Indexed: 07/22/2023]
Abstract
Objective There is a debate over the relevance of ultrasound abnormalities to the pain, functional impairment, and radiologic severity in hand osteoarthritis (OA) This study aims to determine the association between ultrasound abnormalities and clinical, functional, and radiographic measures in hand OA. Methods A total of 66 patients was consecutively enrolled All patients with gray-scale synovitis, joint effusion, and osteophytes were examined by ultrasound for 20 hand joints Radiographic changes in both hands were evaluated by the Kellgren-Lawrence (K-L) grading system and were described as total radiographic severity score and number of affected joints Other measures were also assessed, including each patient's visual analogue scale for pain, the Functional Index for Hand Osteoarthritis for functional disability, and grip and pinch strength for hand muscle strength. Results In total, 10 patients with gray-scale synovitis, 35 with joint effusion, and 66 with osteophytes were detected in hand OA scans on ultrasound Osteophytes on ultrasound were significantly associated with total radiographic severity score and number of affected joint (r=0293, p=0003 and r=0336, p<0001, respectively) In addition, there were weak associations of synovitis and joint effusion with radiographic changes Patients with higher total radiographic severity score showed larger number of ultrasound-detected abnormalities, such as synovitis, joint effusion, and osteophytes (p=0011, p=0002, and p<0001, respectively). Conclusion This study shows that ultrasound findings, especially osteophytes, were associated with radiographic changes based on K-L grade, but not clinical and functional status in hand OA.
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Affiliation(s)
- Seong-Kyu Kim
- Division of Rheumatology, Department of Internal Medicine, Daegu Catholic University School of Medicine, Daegu, Korea
| | - Ui Hong Jung
- Division of Rheumatology, Department of Internal Medicine, Daegu Catholic University School of Medicine, Daegu, Korea
| | - Ji-Won Kim
- Division of Rheumatology, Department of Internal Medicine, Daegu Catholic University School of Medicine, Daegu, Korea
| | - Jung-Yoon Choe
- Division of Rheumatology, Department of Internal Medicine, Daegu Catholic University School of Medicine, Daegu, Korea
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Shapiro LM, McQuillan TJ, Kerkhof FD, Ladd A. Radiographic Progression of Thumb CMC Osteoarthritis: A Systematic Review. JOURNAL OF HAND SURGERY GLOBAL ONLINE 2020; 2:343-348. [PMID: 35415524 PMCID: PMC8991744 DOI: 10.1016/j.jhsg.2020.09.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 09/02/2020] [Indexed: 11/19/2022] Open
Affiliation(s)
- Lauren M. Shapiro
- Department of Orthopaedic Surgery, Stanford University, Redwood City, CA
- Corresponding author: Lauren M. Shapiro, MD, Department of Orthopaedic Surgery, Stanford University, 450 Broadway Street, Redwood City, CA 94603.
| | | | - Faes D. Kerkhof
- Department of Orthopaedic Surgery, Stanford University, Redwood City, CA
| | - Amy Ladd
- Department of Orthopaedic Surgery, Stanford University, Redwood City, CA
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Oo WM, Deveza LA, Duong V, Fu K, Linklater JM, Riordan EA, Robbins SR, Hunter DJ. Musculoskeletal ultrasound in symptomatic thumb-base osteoarthritis: clinical, functional, radiological and muscle strength associations. BMC Musculoskelet Disord 2019; 20:220. [PMID: 31096953 PMCID: PMC6524278 DOI: 10.1186/s12891-019-2610-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Accepted: 05/02/2019] [Indexed: 11/13/2022] Open
Abstract
Background Thumb-base osteoarthritis (OA) is a common cause of pain and disability This study aimed to investigate the associations of musculoskeletal ultrasound OA pathologies with the extent of pain, function, radiographic scores, and muscle strength in symptomatic thumb-base osteoarthritis. Methods This is a cross-sectional study of an ongoing clinical trial with eligibility criteria including thumb-base pain on Visual Analogue Scale (VAS) ≥40 (0 to 100 mm), Functional Index for Hand OA (FIHOA) ≥ 6 (0 to 30) and Kellgren Lawrence (KL) grade ≥ 2. The most symptomatic side was scanned to measure synovitis and osteophyte severity using a 0–3 semi-quantitative score, power Doppler and erosion in binary score. A linear regression model was used for associations of ultrasound findings with VAS pain, FIHOA and hand grip and pinch strength tests after adjusting for age, gender, body mass index, disease duration and KL grade as appropriate. For correlation of ultrasound features with KL grade, OARSI ((Osteoarthritis Research Society International) osteophyte and JSN scores, Eaton grades, Spearman coefficients were calculated, and a significant test defined as a p-value less than 0.05. Results The study included 93 participants (mean age of 67.04 years, 78.5% females). Presence of power Doppler has a significant association with VAS pain [adjusted β coefficient = 11.29, P = 0.02] while other ultrasound pathologies revealed no significant associations with all clinical outcomes. In comparison to radiograph, ultrasonographic osteophyte score was significantly associated with KL grade [rs = 0.44 (P < 0.001)], OARSI osteophyte grade [rs = 0.35 (P = 0.001)], OARSI JSN grade [rs = 0.43 (P < 0.001)] and Eaton grade [rs = 0.30 (P < 0.01)]. Ultrasonographic erosion was significantly related with radiographic erosion [rs = − 0.49 (P = 0.001)]. Conclusion From a clinical perspective the significant relationship of power Doppler with pain severity in thumb base OA suggests this might be a useful tool in understanding pain aetiology. It is important to recognise that power Doppler activity was only detected in 14% of the study so this might be an important subgroup of persons to monitor more closely. Trial registration Registered at Australian New Zealand Clinical Trials Registry (ANZCTR), http://www.anzctr.org.au/, ACTRN12616000353493.
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Affiliation(s)
- Win Min Oo
- Rheumatology Department, Royal North Shore Hospital and Institute of Bone and Joint Research, Kolling Institute, University of Sydney, Sydney, Australia.
| | - Leticia A Deveza
- Rheumatology Department, Royal North Shore Hospital and Institute of Bone and Joint Research, Kolling Institute, University of Sydney, Sydney, Australia
| | - Vicky Duong
- Rheumatology Department, Royal North Shore Hospital and Institute of Bone and Joint Research, Kolling Institute, University of Sydney, Sydney, Australia
| | - Kai Fu
- Rheumatology Department, Royal North Shore Hospital and Institute of Bone and Joint Research, Kolling Institute, University of Sydney, Sydney, Australia
| | - James M Linklater
- Department of Musculoskeletal Imaging, Castlereagh Sports Imaging Center, St. Leonards, Sydney, Australia
| | - Edward A Riordan
- Rheumatology Department, Royal North Shore Hospital and Institute of Bone and Joint Research, Kolling Institute, University of Sydney, Sydney, Australia
| | - Sarah R Robbins
- Rheumatology Department, Royal North Shore Hospital and Institute of Bone and Joint Research, Kolling Institute, University of Sydney, Sydney, Australia
| | - David J Hunter
- Rheumatology Department, Royal North Shore Hospital and Institute of Bone and Joint Research, Kolling Institute, University of Sydney, Sydney, Australia
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Oo WM, Linklater JM, Daniel M, Saarakkala S, Samuels J, Conaghan PG, Keen HI, Deveza LA, Hunter DJ. Clinimetrics of ultrasound pathologies in osteoarthritis: systematic literature review and meta-analysis. Osteoarthritis Cartilage 2018; 26:601-611. [PMID: 29426009 DOI: 10.1016/j.joca.2018.01.021] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 01/24/2018] [Accepted: 01/30/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The aims of this study were to systematically review clinimetrics of commonly assessed ultrasound pathologies in knee, hip and hand osteoarthritis (OA), and to conduct a meta-analysis for each clinimetric. METHODS Medline, Embase, and Cochrane Library databases were searched from their inceptions to September 2016. According to the Outcome Measures in Rheumatology (OMERACT) Instrument Selection Algorithm, data extraction focused on ultrasound technical features and performance metrics. Methodological quality was assessed with modified 19-item Downs and Black score and 11-item Quality Appraisal of Diagnostic Reliability (QAREL) score. Separate meta-analyses were performed for clinimetrics: (1) inter-rater/intra-rater reliability; (2) construct validity; (3) criteria validity; and (4) internal/external responsiveness. Statistical Package for the Social Sciences (SPSS), Excel and Comprehensive Meta-analysis were used. RESULT Our search identified 1126 records; of these, 100 were eligible, including a total of 8542 patients and 32,373 joints. The average Downs and Black score was 13.01, and average QAREL was 5.93. The stratified meta-analysis was performed only for knee OA, which demonstrated moderate to substantial reliability [minimum kappa > 0.44(0.15,0.74), minimum intraclass correlation coefficient (ICC) > 0.82(0.73-0.89)], weak construct validity against pain (r = 0.12 to 0.27), function (r = 0.15 to 0.23), and blood biomarkers (r = 0.01 to 0.21), but weak to strong correlation with plain radiography (r = 0.13 to 0.60), strong association with Magnetic Resonance Imaging (MRI) [minimum r = 0.60(0.52,0.67)] and strong discrimination against symptomatic patients (OR = 3.08 to 7.46). There was strong criterion validity against cartilage histology [r = 0.66(-0.05,0.93)], and small to moderate internal [standardized mean difference(SMD) = 0.20 to 0.58] and external (r = 0.35 to 0.43) responsiveness to interventions. CONCLUSION Ultrasound demonstrated strong criterion validity with cartilage histology, poor to strong correlation with patient findings and MRI, moderate reliability, and low responsiveness to interventions. PROSPERO REGISTRATION NO CRD42016039954.
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Affiliation(s)
- W M Oo
- Rheumatology Department, Royal North Shore Hospital, Institute of Bone and Joint Research, Kolling Institute, University of Sydney, Sydney, Australia.
| | - J M Linklater
- Department of Musculoskeletal Imaging, Castlereagh Sports Imaging, St. Leonards, Sydney, Australia
| | - M Daniel
- Rheumatology Department, Royal North Shore Hospital, Institute of Bone and Joint Research, Kolling Institute, University of Sydney, Sydney, Australia
| | - S Saarakkala
- Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland; Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
| | - J Samuels
- Division of Rheumatology, Centre for Musculoskeletal Care, NYU Langone Medical Centre, New York, USA
| | - P G Conaghan
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, United Kingdom; NIHR Leeds Biomedical Research Centre, Leeds, United Kingdom
| | - H I Keen
- School of Medicine and Pharmacology, University of Western Australia, Perth, Australia
| | - L A Deveza
- Rheumatology Department, Royal North Shore Hospital, Institute of Bone and Joint Research, Kolling Institute, University of Sydney, Sydney, Australia
| | - D J Hunter
- Rheumatology Department, Royal North Shore Hospital, Institute of Bone and Joint Research, Kolling Institute, University of Sydney, Sydney, Australia
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