Page 34 - Imaging of Osteoarthritis and Rheumatoid Arthritis in Hand Joints

Chapter 2
specificity=1.0).38 Joint pain, tender joints and swollen joints were used as comparator in four studies and agreed poorly with US greyscale measurements of synovitis, effusion, PD measurements, JSN and osteophytes.31, 42, 45, 46
One out of five MRI studies compared hand OA patients with healthy controls, reporting significantly more ligament abnormalities, tendon abnormalities, cartilage abnormalities, joint effusion, osteophytes, bone marrow lesions (BML), erosions and cysts in patients.29 Two other studies compared MRI with CR, and found that MRI detected significantly more osteophytes and erosions, while CR detected significantly more cases with malalignment.33, 36 A fourth study investigated associations between MRI and joint pain on palpation, and found the highest associations for synovitis (OR 2.4 95%CI=1.6-3.8) and bone attrition (OR 2.5 95%CI=1.5-4.1).35 One study compared US with MRI, and reported moderate agreement between these modalities (k=0.41-0.55). US detected more osteophytes and effusion, while MRI detected more erosions and synovitis.53
Three scintigraphy studies compared isotope uptake in bone with joint pain and CR. Isotope uptake was correlated with joint pain (τ=0.24),28 and OA on CR (r=0.50-0.61).32, 50 Scintigraphy detected less pathological joints than CR.
32