Page 20 - Imaging of Osteoarthritis and Rheumatoid Arthritis in Hand Joints

Chapter 1
Figure 5. Sagital image of an MCP joint in a patient with arthritis, and an explanation below. The blue dotted lines represent the bones, on the left side the proximal phalanx, and on the right the metacarpal bone. There is hypertrophy of the synovium (red marked area)in the joint.
Thesis outline
Current role of imaging in OA
According to the 2006 EULAR recommendations for diagnosing hand OA, a confident clinical diagnosis can be made when typical features are present in patients aged over 40.14 When complaints are not typical, imaging might be beneficial to confirm the diagnosis of HOA, or to exclude other diagnosis. According to these EULAR recommendations conventional radiographs are the gold standard for morphological assessment of hand OA, and the additive information of other imaging modalities is not well-researched and rarely yield additional diagnostic information.
Since these recommendations were created, multiple studies have investigated the use of ultrasound and MRI in hand OA yielding promising results. In chapter 2 we therefore systematically reviewed the literature on imaging methods other than conventional radiology on their ability to detect features of HOA. Articles on validity, reliability and responsiveness of MRI, CT, ultrasound, and bone scintigraphy were reviewed.
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