Bone marrow lesions on magnetic resonance imaging in hand osteoarthritis are associated with pain and interact with synovitis

Liu, R.; Damman, W.; Reijnierse, M.; Bloem, Johan L.; Rosendaal, Frits R.; Kloppenburg, Margreet

doi:10.1016/j.joca.2017.02.790

Cited by 28 publications

(36 citation statements)

References 19 publications

(19 reference statements)

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“…[H2] Advances in ultrasonography and MRI In the past 10 years, the use of ultrasonography and MRI for assessing patients with hand OA has increased, providing greater insight into the pathology of the disease and increased evidence that these imaging modalites have a higher sensitivity than radiography in determining the presence of pathological features such as osteophytes, JSN and central erosions 76,77,78,79,80,47 . Using ultrasonography and MRI, researchers have shown that inflammatory changes in the synovium and at the enthesis of the hands are a common finding in hand OA 81,82,83 .…”

Section: [H1] Imagingmentioning

confidence: 99%

Hand osteoarthritis: clinical phenotypes, molecular mechanisms and disease management

et al. 2018

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Osteoarthritis (OA) is a highly prevalent condition and the hand is the most commonly affected site. Patients with hand OA frequently report symptoms of pain, functional limitations, and frustration in undertaking everyday activities. The condition presents clinically with changes to the bone, ligaments, cartilage and synovial tissue, which can be observed using radiography, ultrasonography or MRI. Hand OA is a heterogeneous disorder and is considered to be multifactorial in aetiology. This review provides an overview of the epidemiology, presentation and burden of hand OA, including an update on hand OA imaging (including the development of novel techniques), disease mechanisms and management. In particular, areas for which new evidence has substantially changed the way we understand, consider and treat hand OA are highlighted. For example, genetic studies, clinical trials and careful prospective imaging studies from the past 5 years are beginning to provide insights into the pathogenesis of hand OA that might uncover new therapeutic targets in disease.

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Section: [H1] Imagingmentioning

confidence: 99%

Hand osteoarthritis: clinical phenotypes, molecular mechanisms and disease management

et al. 2018

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“…The mean age for all studies was 64.4 [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32]. Most studies (n = 13) were performed on both genders, although the majority of the subjects in each study were female.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Only two studies [26,32] had female subjects only and one study did not report the gender of the participants [25]. Of these studies, 13 were from observational cohort studies: the Hand OSTeoarthritis in secondary care (HOSTAS) [27,[29][30][31] the Oslo hand OA cohort [18-23, 25, 32] and a clinical trial: the digital osteoarthritis in refractory hand OA (DORA) study [28]. All articles examined BMLs and various subchondral features using MRI.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…All articles examined BMLs and various subchondral features using MRI. The strength of the magnetic field was 1.5 T in four studies [27,29,26,30]. Eight studies used a 1.0 T system [18-23, 25, 32] whereas one study [28] used the 0.2 T system in two patients only.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Interestingly, in thumb base OA, structural damage was more strongly associated with pain than synovitis [30]. In the HOSTAS Evaluating the Relation between Bone Marrow Lesions and Synovitis with Pain and Structural… DOI: http://dx.doi.org/10.5772/intechopen.81786 study, which was a large study of 92 participants with HOA [29], interphalangeal and thumb base joints were evaluated to demonstrate that MRI-identified BMLs in HOA were associated with pain and also interacted with synovitis. Findings in DIP/ PIP and thumb base HOA have also been replicated in erosive hand OA [26].…”

Section: Correlation Of Mri Changes With Plain Radiographymentioning

confidence: 99%

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Evaluating the Relation between Bone Marrow Lesions and Synovitis with Pain and Structural Damage in Hand Osteoarthritis

Sofat¹,

Koushesh²

2019

Osteoarthritis Biomarkers and Treatments

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Osteoarthritis (OA) is the most prevalent arthritis worldwide and is a condition affecting the whole joint. Changes in subchondral bone, cartilage integrity and synovitis are recognised during OA progression. Although advances have been made in our understanding of OA pathophysiology, there are no current treatments that delay or halt the progression of the disease. Treatments are largely based upon physical therapies to improve function, anti-inflammatory agents for pain symptoms and joint replacement surgery for late stage disease in large weight bearing joints. There is an urgent need to better understand the pathophysiology of OA that could translate into improved treatments for this condition. In recent years, more advanced imaging techniques including magnetic resonance imaging (MRI) have led to an improved understanding of changes at the bone-cartilage interface in OA, with recognition that loss of integrity at the cartilage-bone junction and development of bone marrow lesions (BMLs) in the subchondral bone are associated with OA pain in large epidemiological studies. In this book chapter, we review the evidence for the role of BMLs and synovitis, particularly in the pathophysiology of hand OA. Based on a systematic review of the literature, we have identified 15 articles reported on BMLs and synovitis in hand OA, which will be discussed in this chapter.

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Two‐Year Changes in Magnetic Resonance Imaging Features and Pain in Thumb Base Osteoarthritis

Beest

Kroon

Reijnierse

et al. 2021

Arthritis Care & Research

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Objective To investigate the two‐year course of pain and osteoarthritic features on magnetic resonance imaging (MRI) in the thumb base. Methods Patients in the Hand Osteoarthritis in Secondary Care (HOSTAS) cohort who had received radiographic examination, MRI, and clinical examination of the right thumb base at baseline and who had a 2‐year follow‐up period were studied. Pain on palpation of the thumb base was assessed on a 0–3 scale. MRIs were analyzed with the Outcome Measures in Rheumatology (OMERACT) thumb base osteoarthritis MRI scoring system for synovitis, bone marrow lesions (BMLs), subchondral bone defects, cartilage space loss, osteophytes, and subluxation. Radiographs were assessed for osteophytes and joint space narrowing. We studied the associations of changes in synovitis and BMLs with changes in pain using a logistic regression model adjusted for radiographic damage, with values expressed as odds ratios (ORs) and 95% confidence intervals (95% CIs). Results Of 165 patients, 83% were women and the mean age was 60.7 years. At baseline, 65 patients had thumb base pain. At 2‐year follow‐up, pain had decreased in 32 patients and increased in 33 patients. MRI features remained stable in most patients. Structural MRI features generally deteriorated, while synovitis and BMLs improved in some individuals and deteriorated in others. Change in radiographic osteophytes rarely occurred (n = 10). Increased synovitis (odds ratio [OR] 3.4 [95% CI 1.3–9.3]) and increased BMLs (OR 5.1 [95% CI 2.1–12.6]) were associated with increased pain. Decreased BMLs appeared to be associated with decreased pain (OR 2.7 [95% CI 0.8–8.9]), and reductions in synovitis occurred too infrequently to calculate associations. Conclusion Over 2 years, thumb base pain fluctuated, while MRI features changed in a minority of patients with hand osteoarthritis. Changes in synovitis and BMLs were associated with changes in pain on palpation, even after adjustment for radiographic damage.

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Bone marrow lesions on magnetic resonance imaging in hand osteoarthritis are associated with pain and interact with synovitis

Abstract: In hand OA patients severe synovitis is associated with joint pain, which is worsened when BMLs co-occur, suggesting synovitis as primary target of treatment.

Cited by 28 publications

References 19 publications

Hand osteoarthritis: clinical phenotypes, molecular mechanisms and disease management

Hand osteoarthritis: clinical phenotypes, molecular mechanisms and disease management

Evaluating the Relation between Bone Marrow Lesions and Synovitis with Pain and Structural Damage in Hand Osteoarthritis

Two‐Year Changes in Magnetic Resonance Imaging Features and Pain in Thumb Base Osteoarthritis

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