Page 50 - Imaging of Osteoarthritis and Rheumatoid Arthritis in Hand Joints

Chapter 3
Abstract
Objective To compare Computed Tomography (CT) with digital radiography for the detection of osteoarthritis (OA) of the first carpometacarpal (CMC1) and scaphotrapeziotrapezoid (STT) joint.
Materials and Methods We retrospectively identified patients who were assessed for CMC1 OA or STT OA at our hand surgery outpatient clinic between January 2008 and March 2011, and who had both a digital radiograph and a CT-scan of the hand within a three-month period. CT and radiographic images were scored independently by two musculoskeletal radiologists for joint space narrowing (JSN), osteophytes, subchondral sclerosis, bone cysts, and erosions in the CMC1 and STT joint.
Results Thirty patients were identified. The inter-reader reliability of CT for the detection of CMC1 OA (ICC 1.00) and STT OA (ICC 0.80) was higher than radiography (ICC’s 0.15 and 0.45). In comparison with their own radiographical scoring, both readers detected with CT three more patients with CMC1 OA, and 13 and 5 more patients with STT OA.
Conclusion CT had a higher inter-reader reliability and detection rate for both CMC1 and STT OA, compared to radiography. As surgical treatment selection of thumb base OA depends on the presence of pathology in the CMC1 and STT joints, CT may improve treatment selection and surgical planning.
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