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Quantitative microfocal radiographic assessment of progression in osteoarthritis of the hand
J C Buckland-Wright1, D G Macfarlane, J A Lynch
1Anatomy Department, United Medical School of Guy's Hospital, London, United Kingdom.
Abstract:
We studied 32 patients with osteoarthritis who had 5x macroradiographs taken of their wrists and hands at 6-month intervals over an 18-month period. The higher magnification and resolution of microfocal radiography permitted the quantitative detection of progressive changes in 4 different features: subchondral sclerosis, the number and size of osteophytes, juxtaarticular radiolucencies, and joint space narrowing. Compared with normal control subjects, subchondral cortical thickness was greater in all patients at entry and showed a variable degree of change over the study period. Osteophytes and juxtaarticular radiolucencies were present in all patients at study entry; by the end of the study, osteophytes had increased in number and area, and juxtaarticular radiolucencies had increased in area, but not in number. At entry, 44% of the patients had joint space narrowing significantly greater than that in the control subjects; by 18 months, this proportion increased to 65%. No correlation was found between subchondral sclerosis, osteophytes, juxtaarticular radiolucencies, and joint space narrowing. We conclude that in osteoarthritis of the hand, the bony changes have progressed significantly before the occurrence of radiographically evident joint space narrowing indicative of cartilage thinning.
Insights
Osteoarthritis (OA) hand bone changes like osteophytes and sclerosis progress before joint space narrowing is evident. Microfocal radiography reveals these early bony changes in OA patients.
Area of Science:
- Orthopedics
- Radiology
- Rheumatology
Background:
- Osteoarthritis (OA) is a degenerative joint disease.
- Early detection of OA progression is crucial for management.
- Radiographic assessment is key in evaluating OA.
Purpose of the Study:
- To quantitatively assess progressive bony changes in hand osteoarthritis using high-resolution radiography.
- To investigate the temporal relationship between various radiographic features of OA.
Main Methods:
- 32 patients with hand OA underwent macroradiography (5x magnification) at 6-month intervals over 18 months.
- Microfocal radiography allowed quantitative detection of subchondral sclerosis, osteophytes, juxtaarticular radiolucencies, and joint space narrowing.
- Comparison with normal control subjects was performed.
Main Results:
- Subchondral sclerosis was greater in OA patients at baseline and showed variable changes.
- Osteophytes and juxtaarticular radiolucencies increased in number/area and area, respectively, over 18 months.
- Joint space narrowing increased significantly from 44% at entry to 65% at 18 months; no correlation found between bony changes and joint space narrowing.
Conclusions:
- Hand OA involves significant progression of bony changes prior to evident joint space narrowing.
- Microfocal radiography is effective in detecting early and progressive bony alterations in hand OA.
- Radiographic evidence of cartilage thinning (joint space narrowing) may lag behind other bony manifestations of OA.