Topical Diclofenac Reduces Joint Synovitis in Hand Osteoarthritis: A Pilot Investigation Using Fluorescent Optical...

Area of Science:

• Rheumatology
• Medical Imaging
• Pharmacology

Background:

• Synovitis, characterized by synovial inflammation, is a key feature of hand osteoarthritis (HOA).
• Current assessment methods for synovitis in HOA include Magnetic Resonance Imaging (MRI) and Ultrasonography (US).
• Fluorescent Optical Imaging (FOI) is an emerging modality for evaluating joint inflammation.

Purpose of the Study:

• To assess the efficacy of topical diclofenac in reducing synovitis in patients with hand osteoarthritis (HOA).
• To compare established imaging techniques (MRI, US) with Fluorescent Optical Imaging (FOI) for evaluating treatment response.
• To develop and apply a quantitative approach for synovitis assessment using FOI.

Main Methods:

• A pilot study involving 10 patients with symptomatic HOA treated with topical diclofenac for 14 days.
• Assessment of synovitis using FOI, MRI, and US at baseline, Day 8, and Day 15.
• Development and application of a quantitative pixel analysis method for FOI images.

Main Results:

• Topical diclofenac showed a reduction in synovitis across all imaging modalities, particularly in the most affected joints.
• FOI demonstrated a synovitis reduction of 21.1% (Day 8) and 34.2% (Day 15) in the most affected joints.
• Quantitative FOI analysis revealed a synovitis reduction of 17.8% (Day 8) and 42.4% (Day 15), correlating with decreased subjective pain.

Conclusions:

• Topical diclofenac effectively reduces synovitis and pain in hand osteoarthritis.
• Quantitative analysis of FOI images shows promise for objective assessment of synovitis in HOA.
• Further research is needed to validate the quantitative pixel analysis of FOI for HOA treatment monitoring.