Imaging of osteoarthritis (OA): What is new?

Mathiessen, Alexander; Cimmino, Marco A.; Hammer, Hilde Berner; Haugen, Ida K.; Iagnocco, Annamaria; Conaghan, Philip G.

doi:10.1016/j.berh.2016.09.007

Cited by 33 publications

(35 citation statements)

References 96 publications

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“…Several studies have shown US to be reliable and valid for the evaluation of cartilage pathology in OA, and especially for large joints such as the knee ( 26 – 29 ), and US has demonstrated strong criterion validity with cartilage histology ( 25 ). The knee's hyaline cartilage has a normal thickness of 2 mm, and superficial regions can easily be evaluated by US ( 26 , 27 ).…”

Section: Discussionmentioning

confidence: 99%

Performance of Ultrasonography Compared to Conventional Radiography for the Diagnosis of Osteoarthritis in Patients With Knee Pain

et al. 2020

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To investigate the performance of ultrasonography (US) for the detection of knee osteoarthritis (OA) in patients suffering from knee pain, compared to conventional radiographs. Methods: Cross-sectional study performed at a university teaching hospital. Consecutive patients complaining of unilateral or bilateral mechanical knee pain who signed an informed consent were included. All patients underwent simultaneously an ultrasonographic and a radiographic evaluation of the knee. Exclusion criteria were age under 18 years, prior diagnosis of knee OA, diagnosis of inflammatory arthritis, history of knee surgery or trauma, severe knee deformities, and corticosteroid injection within the last 2 months. The diagnostic properties of US for the detection of knee OA were evaluated using radiological data as the reference method. Evaluated test properties were sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and the positive and negative likelihood ratio (LR+ and LR-). Results: Three-hundred twenty-two knees (281 patients) were included. Radiographic degenerative changes were present in 56.8% (183) of the evaluated knees. Regarding the diagnostic properties of the US, the presence of either osteophytes or the compromise of the femoral hyaline cartilage had the best sensitivity to detect OA (95%), with a NPV of 92% and a LR-of 0,07, while the combined identification of osteophytes and compromise of the femoral hyaline cartilage had the best specificity (94%), with 94% PPV and a LR+ of 13. Conclusion: US demonstrated an excellent sensitivity with an adequate specificity for the detection of radiographic knee OA.

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Section: Discussionmentioning

confidence: 99%

Performance of Ultrasonography Compared to Conventional Radiography for the Diagnosis of Osteoarthritis in Patients With Knee Pain

et al. 2020

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“…Still much is unknown about the pathophysiology and disease course of the different subsets. In order to improve research and performance of clinical trials in hand OA sensitive outcome measures are needed for each of these subsets 8 .…”

Section: Introductionmentioning

confidence: 99%

Assessment of osteoarthritic features in the thumb base with the newly developed OMERACT magnetic resonance imaging scoring system is a valid addition to standard radiography

Beest

Kroon

et al. 2019

Osteoarthritis and Cartilage

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Objective: To investigate the construct validity of the new thumb base OA magnetic resonance imaging (MRI) scoring system (TOMS) by comparing TOMS scores with radiographic scores in patients with primary hand OA. Design: In 200 patients (83.5% women, mean (SD) age 61.0 (8.4) years), postero-anterior radiographs and MR scans (1.5 T) of the right first carpometacarpal (CMC-1) and scaphotrapeziotrapezoid (STT) joints, were scored using the OARSI atlas and TOMS, respectively. The distributions of the TOMS scores (specified in results section) were stratified for the OARSI scores of corresponding radiographic features and investigated using boxplots and non-parametric tests. Furthermore, Spearman's rank or Phi correlation coefficients (r/4) were calculated. Results: For all features, especially for erosions and osteophytes, the prevalence found with MRI was higher than with radiography. TOMS osteophyte and cartilage loss scores differed statistically significant between corresponding OARSI scores in CMC-1 (0 vs 1; 1 vs 2). TOMS scores were positively correlated with radiographic scores in CMC-1 for osteophytes (coefficient [95% confidence interval], r ¼ 0.75 [0.69; 0.81]), cartilage loss/joint space narrowing (r ¼ 0.70 [0.62; 0.76]), subchondral bone defects (SBDs)/ erosion-cyst (r ¼ 0.41 [0.29; 0.52]), bone marrow lesions (BMLs)/subchondral sclerosis (r ¼ 0.65 [0.56; 0.73]) and subluxation (4 ¼ 0.65 [0.57; 0.73]); and in STT for osteophytes (r ¼ 0.30 [0.17; 0.42]) and cartilage loss/joint space narrowing (r ¼ 0.53 [0.42; 0.62]). Conclusions: In patients with hand OA, TOMS scores positively correlated with radiographic scores, indicating good construct validity. However, the prevalence of features on MR images was higher compared to radiographs, suggesting that TOMS might be more sensitive than radiography. The clinical meaning of these extra MR detected cases is currently still unknown.

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“… 2 3 Conventional radiography remains the cornerstone in obtaining an image-based OA diagnosis. 4 However, previous studies on knee OA have shown that cartilage degradation is well established and often substantial by the time radiographic changes are identified. 5 6 Hence, we need instruments to identify OA at an earlier stage.…”

Section: Introductionmentioning

confidence: 99%

Ultrasound-detected osteophytes predict the development of radiographic and clinical features of hand osteoarthritis in the same finger joints 5 years later

Mathiessen

Slatkowsky-Christensen

Kvien

et al. 2017

RMD Open

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BackgroundStructural pathology may be present in joints without radiographic evidence of osteoarthritis (OA). Ultrasound is a sensitive tool for early detection of osteophytes. Our aim was to explore whether ultrasound-detected osteophytes (in radiographically and clinically normal finger joints) predicted the development of radiographic and clinical hand OA 5 years later.MethodsWe included finger joints without radiographic OA (Kellgren-Lawrence grade (KLG)=0; n=301) or no clinical bony enlargements (n=717) at baseline and examined whether ultrasound-detected osteophytes predicted incident radiographic OA (KLG ≥1, osteophytes or joint space narrowing (JSN)) or incident clinical bony enlargement (dependent variables) in the same joints 5 years later. We applied logistic regression with generalised estimating equations adjusted for age, sex, body mass index and follow-up time.ResultsUltrasound demonstrated osteophytes in 86/301 (28.6%) joints without radiographic OA and 392/717 (54.7%) joints without clinical bony enlargement. These osteophytes were confirmed in the majority of joints where MRI assessment was available. Significant associations were found between ultrasound-detected osteophytes and development of both radiographic OA (OR=4.1, 95% CI 2.0 to 8.1) and clinical bony enlargement (OR=3.5, 95% CI 2.4 to 5.1) and also incident radiographic osteophytes (OR=4.2, 95% CI 2.1 to 8.5) and JSN (OR=5.3, 95% CI 2.1 to 13.4).ConclusionUltrasound-detected osteophytes predicted incident radiographic and clinical hand OA 5 years later. These results support the use of ultrasound for early detection of OA.

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Imaging of osteoarthritis (OA): What is new?

Cited by 33 publications

References 96 publications

Performance of Ultrasonography Compared to Conventional Radiography for the Diagnosis of Osteoarthritis in Patients With Knee Pain

Performance of Ultrasonography Compared to Conventional Radiography for the Diagnosis of Osteoarthritis in Patients With Knee Pain

Assessment of osteoarthritic features in the thumb base with the newly developed OMERACT magnetic resonance imaging scoring system is a valid addition to standard radiography

Ultrasound-detected osteophytes predict the development of radiographic and clinical features of hand osteoarthritis in the same finger joints 5 years later

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