Page 86 - Imaging of Osteoarthritis and Rheumatoid Arthritis in Hand Joints
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                                Chapter 5
We included 50 patients with hand OA, of whom 19 had previously participated in the Rotterdam Early Arthritis Cohort (REACH) 12 and an additional 31 new patients from our rheumatology outpatient clinic. A flowchart is provided in Fig 1. All patients were clinically diagnosed with hand OA by a rheumatologist and were excluded if they had a clinical suspicion or diagnosis of any other rheumatic disease. To establish this diagnosis, all patients underwent at least a clinical examination and multidirectional radiographs of both hands. Patients with isolated thumb base OA without signs of OA in MCP, PIP or DIP joints were also excluded. Additionally, 20 healthy female volunteers between the age of 18 and 35 were invited. Healthy volunteers were excluded if they had any symptoms of pain, swelling or stiffness in the hand joints or if they had a previous history of hand surgery or trauma. They did not undergo clinical examination or radiography.
Patients and healthy controls were excluded from participation if they had a contraindication for MRI (e.g., pacemaker, metallic fragments in orbita), or for gadolinium contrast. Recruitment started in January 2011 and lasted until December 2012. All patients and volunteers provided written informed consent prior to the investigation. The study was approved by the local ethics committee.
                                    Figure 1. Flow chart of patient recruitment and inclusion.

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