Carpal involvement in inflammatory (erosive) osteoarthritis

Area of Science:

• Rheumatology
• Orthopedic Surgery
• Radiology

Background:

• Osteoarthritis (OA) classically affects the digits.
• Inflammatory or erosive OA variants can extend beyond digital joints.
• The carpus represents an under-recognized site for these OA types.

Purpose of the Study:

• To describe the characteristic radiographic findings of inflammatory or erosive osteoarthritis in the carpus.
• To highlight the specific joints and features involved in carpal OA.
• To aid in the differential diagnosis of wrist pain and radiographic abnormalities.

Main Methods:

• Review of radiographic findings in patients with suspected or confirmed inflammatory/erosive OA involving the carpus.
• Detailed analysis of joint space, bone texture, osteophyte formation, and joint alignment.
• Comparison with known OA patterns and other arthropathies.

Main Results:

• Carpal involvement is predominantly on the radial aspect of the wrist.
• Characteristic changes include joint space narrowing, subchondral bone eburnation (hardening), osteophytosis (bone spurs), and mild subluxation.
• The first carpometacarpal and trapezio-scaphoid joints are most commonly affected.

Conclusions:

• Inflammatory or erosive osteoarthritis has distinct patterns of carpal involvement.
• Radial-sided carpal joints are the primary sites of characteristic changes.
• Recognition of these findings is crucial for accurate diagnosis and management of wrist OA.