Skip to main content

Advertisement

Log in

High-resolution ultrasonography and 3.0 T magnetic resonance imaging in erosive and nodal hand osteoarthritis: high frequency of erosions in nodal osteoarthritis

  • Original Article
  • Published:
Clinical Rheumatology Aims and scope Submit manuscript

Abstract

Erosive osteoarthritis (EOA) is defined as hand osteoarthritis (OA) with interphalangeal joint erosions on plain radiographs. We sought to find ultrasound (US) and magnetic resonance imaging (MRI) features that could distinguish EOA from nodal hand OA (NOA). Symptomatic consecutive patients with hand OA as defined by the American College of Rheumatology criteria (13 EOA patients as defined by erosion in ≥1 interphalangeal joint and seven nodal OA patients) and five normal individuals were examined by plain radiography, US, and MRI. Patients and controls underwent evaluation of metacarpophalangeal and interphalangeal joints by US, and all fingers from second to fifth digit by MRI. A total of 240 joints in symptomatic patients were examined by both imaging modalities. Synovitis, osteophytes, cartilage loss, and erosions were frequently detected in the joints of patients with EOA and NOA. Six of seven patients with NOA had joint erosions that were seen on MRI or US scan but seen on plain radiographs. The overall concordance between MRI and US findings was substantial for osteophytes (κ = 0.79) and excellent for cysts (κ = 0.85), erosions (κ = 0.84), synovitis (κ = 0.82), and tenosynovitis (κ = 0.83) in both groups. Inflammatory changes, such as effusions and synovitis, and structural changes, such as erosions, were frequently detected by US and MRI in EOA and nodal OA. These findings may support the hypothesis that EOA could not be a separate entity but may represent the severe end of the spectrum of hand OA.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Martel W, Stuck KJ, Dworin AM, Hylland RG (1980) Erosive osteoarthritis and psoriatic arthritis: a radiologic comparison in the hand, wrist, and foot. AJR Am J Roentgenol 134:125–135

    Article  PubMed  CAS  Google Scholar 

  2. Punzi L, Ramonda R, Sfriso P (2004) Erosive osteoarthritis. Best Pract Res Clin Rheumatol 18:739–758

    Article  PubMed  Google Scholar 

  3. Tan AL, Grainger AJ, Tanner SF, Shelley DM, Pease C, Emery P, McGonagle D (2005) High-resolution magnetic resonance imaging for the assessment of hand osteoarthritis. Arthritis Rheum 52:2355–2365

    Article  PubMed  Google Scholar 

  4. Wittoek R, Carron P, Verbruggen G (2010) Structural and inflammatory sonographic findings in erosive and non-erosive osteoarthritis of the interphalangeal finger joints. Ann Rheum Dis 69:2173–2176

    Article  PubMed  Google Scholar 

  5. Haugen IK, Lillegraven S, Slatkowsky-Christensen B, Haavardsholm EA, Sesseng S, Kvien TK, van der Heijde D, Boyesen P (2011) Hand osteoarthritis and MRI: development and first validation step of the proposed Oslo Hand Osteoarthritis MRI score. Ann Rheum Dis 70:1033–1038

    Article  PubMed  Google Scholar 

  6. Vlychou M, Koutroumpas A, Malizos K, Sakkas LI (2009) Ultrasonographic evidence of inflammation is frequent in hands of patients with erosive osteoarthritis. Osteoarthr Cartil 17:1283–1287

    Article  PubMed  CAS  Google Scholar 

  7. Iagnocco A, Filippucci E, Ossandon A, Ciapetti A, Salaffi F, Basili S, Grassi W, Valesini G (2005) High resolution ultrasonography in detection of bone erosions in patients with hand osteoarthritis. J Rheumatol 32:2381–2383

    PubMed  Google Scholar 

  8. Koutroumpas AC, Alexiou IS, Vlychou M, Sakkas LI (2010) Comparison between clinical and ultrasonographic assessment in patients with erosive osteoarthritis of the hands. Clin Rheumatol 29:511–516

    Article  PubMed  Google Scholar 

  9. Felson DT, Gale DR, Elon Gale M, Niu J, Hunter DJ, Goggins J, Lavalley MP (2005) Osteophytes and progression of knee osteoarthritis. Rheumatology (Oxford) 44:100–104

    Article  CAS  Google Scholar 

  10. Altman R, Alarcon G, Appelrouth D, Bloch D, Borenstein D, Brandt K, Brown C, Cooke TD, Daniel W, Gray R et al (1990) The American College of Rheumatology criteria for the classification and reporting of osteoarthritis of the hand. Arthritis Rheum 33:1601–1610

    Article  PubMed  CAS  Google Scholar 

  11. McNally EG (2008) Ultrasound of the small joints of the hands and feet: current status. Skeletal Radiol 37:99–113

    Article  PubMed  CAS  Google Scholar 

  12. Zhang W, Doherty M, Leeb BF, Alekseeva L, Arden NK, Bijlsma JW, Dincer F, Dziedzic K, Hauselmann HJ, Kaklamanis P, Kloppenburg M, Lohmander LS, Maheu E, Martin-Mola E, Pavelka K, Punzi L, Reiter S, Smolen J, Verbruggen G, Watt I, Zimmermann-Gorska I (2009) EULAR evidence-based recommendations for the diagnosis of hand osteoarthritis: report of a task force of ESCISIT. Ann Rheum Dis 68:8–17

    Article  PubMed  CAS  Google Scholar 

  13. Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33:159–174

    Article  PubMed  CAS  Google Scholar 

  14. Schraml C, Schwenzer NF, Martirosian P, Koetter I, Henes JC, Geiger K, Claussen CD, Horger M (2011) Assessment of synovitis in erosive osteoarthritis of the hand using DCE-MRI and comparison with that in its major mimic, the psoriatic arthritis. Acad Radiol 18:804–809

    Article  PubMed  Google Scholar 

  15. Grainger AJ, Farrant JM, O'Connor PJ, Tan AL, Tanner S, Emery P, McGonagle D (2007) MR imaging of erosions in interphalangeal joint osteoarthritis: is all osteoarthritis erosive? Skeletal Radiol 36:737–745

    Article  PubMed  CAS  Google Scholar 

  16. Kwok WY, Kloppenburg M, Rosendaal FR, van Meurs JB, Hofman A, Bierma-Zeinstra SM (2011) Erosive hand osteoarthritis: its prevalence and clinical impact in the general population and symptomatic hand osteoarthritis. Ann Rheum Dis 70:1238–1242

    Article  PubMed  CAS  Google Scholar 

  17. Haugen IK, Boyesen P, Slatkowsky-Christensen B, Sesseng S, Bijsterbosch J, van der Heijde D, Kvien TK (2012) Comparison of features by MRI and radiographs of the interphalangeal finger joints in patients with hand osteoarthritis. Ann Rheum Dis 71:345–350

    Article  PubMed  Google Scholar 

  18. Haugen IK, Boyesen P (2011) Imaging modalities in hand osteoarthritis—status and perspectives of conventional radiography, magnetic resonance imaging, and ultrasonography. Arthritis Res Ther 13:248

    Article  PubMed  Google Scholar 

  19. Keen HI, Wakefield RJ, Grainger AJ, Hensor EM, Emery P, Conaghan PG (2008) An ultrasonographic study of osteoarthritis of the hand: synovitis and its relationship to structural pathology and symptoms. Arthritis Rheum 59:1756–1763

    Article  PubMed  Google Scholar 

  20. Crema MD, Roemer FW, Zhu Y, Marra MD, Niu J, Zhang Y, Lynch JA, Javaid MK, Lewis CE, El-Khoury GY, Felson DT, Guermazi A (2010) Subchondral cystlike lesions develop longitudinally in areas of bone marrow edema-like lesions in patients with or at risk for knee osteoarthritis: detection with MR imaging—the MOST study. Radiology 256:855–862

    Article  PubMed  Google Scholar 

  21. Tehranzadeh J, Ashikyan O, Anavim A, Shin J (2008) Detailed analysis of contrast-enhanced MRI of hands and wrists in patients with psoriatic arthritis. Skeletal Radiol 37:433–442

    Article  PubMed  Google Scholar 

  22. Walther M, Harms H, Krenn V, Radke S, Kirschner S, Gohlke F (2002) Synovial tissue of the hip at power Doppler US: correlation between vascularity and power Doppler US signal. Radiology 225:225–231

    Article  PubMed  Google Scholar 

  23. McCune WJ, Dedrick DK, Aisen AM, MacGuire A (1990) Sonographic evaluation of osteoarthritic femoral condylar cartilage. Correlation with operative findings. Clin Orthop Relat Res, (254):230–235

  24. Walther M, Harms H, Krenn V, Radke S, Faehndrich TP, Gohlke F (2001) Correlation of power Doppler sonography with vascularity of the synovial tissue of the knee joint in patients with osteoarthritis and rheumatoid arthritis. Arthritis Rheum 44:331–338

    Article  PubMed  CAS  Google Scholar 

  25. Keen HI, Wakefield RJ, Grainger AJ, Hensor EM, Emery P, Conaghan PG (2008) Can ultrasonography improve on radiographic assessment in osteoarthritis of the hands? A comparison between radiographic and ultrasonographic detected pathology. Ann Rheum Dis 67:1116–1120

    Article  PubMed  CAS  Google Scholar 

  26. Loeuille D, Sauliere N, Champigneulle J, Rat AC, Blum A, Chary-Valckenaere I (2011) Comparing non-enhanced and enhanced sequences in the assessment of effusion and synovitis in knee OA: associations with clinical, macroscopic and microscopic features. Osteoarthr Cartil 19:1433–1439

    Article  PubMed  CAS  Google Scholar 

  27. Saadat E, Jobke B, Chu B, Lu Y, Cheng J, Li X, Ries MD, Majumdar S, Link TM (2008) Diagnostic performance of in vivo 3-T MRI for articular cartilage abnormalities in human osteoarthritic knees using histology as standard of reference. Eur Radiol 18:2292–2302

    Article  PubMed  Google Scholar 

  28. Zanetti M, Bruder E, Romero J, Hodler J (2000) Bone marrow edema pattern in osteoarthritic knees: correlation between MR imaging and histologic findings. Radiology 215:835–840

    PubMed  CAS  Google Scholar 

  29. Leydet-Quilici H, Le Corroller T, Bouvier C, Giorgi R, Argenson JN, Champsaur P, Pham T, de Paula AM, Lafforgue P (2010) Advanced hip osteoarthritis: magnetic resonance imaging aspects and histopathology correlations. Osteoarthr Cartil 18:1429–1435

    Article  PubMed  CAS  Google Scholar 

  30. Haugen IK, Boyesen P, Slatkowsky-Christensen B, Sesseng S, van der Heijde D, Kvien TK (2012) Associations between MRI-defined synovitis, bone marrow lesions and structural features and measures of pain and physical function in hand osteoarthritis. Ann Rheum Dis 71:899–904

    Article  PubMed  Google Scholar 

Download references

Disclosures

None.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Lazaros I. Sakkas.

Additional information

MV and AK contributed equally to this work.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Vlychou, M., Koutroumpas, A., Alexiou, I. et al. High-resolution ultrasonography and 3.0 T magnetic resonance imaging in erosive and nodal hand osteoarthritis: high frequency of erosions in nodal osteoarthritis. Clin Rheumatol 32, 755–762 (2013). https://doi.org/10.1007/s10067-013-2166-x

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10067-013-2166-x

Keywords

Navigation