J Rheum Dis.  2021 Jan;28(1):17-24. 10.4078/jrd.2021.28.1.17.

Ultrasound Findings were Associated With Radiographic Changes, But Not Clinical and Functional Outcomes in Hand Osteoarthritis

• Kim SK
• Jung UH
• Kim JW
• Choe JY

• KMID: 2510338
• DOI: http://doi.org/10.4078/jrd.2021.28.1.17

Abstract

Objective
. There is a debate over the relevance of ultrasound abnormalities to the pain, functional impairment, and radiologic severity in hand osteoarthritis (OA). This study aims to determine the association between ultrasound abnormalities and clinical, functional, and radiographic measures in hand OA.
Methods
. A total of 66 patients was consecutively enrolled. All patients with gray-scale synovitis, joint effusion, and osteophytes were examined by ultrasound for 20 hand joints. Radiographic changes in both hands were evaluated by the Kellgren-Lawrence (K-L) grading system and were described as total radiographic severity score and number of affected joints. Other measures were also assessed, including each patient’s visual analogue scale for pain, the Functional Index for Hand Osteoarthritis for functional disability, and grip and pinch strength for hand muscle strength.
Results
. In total, 10 patients with gray-scale synovitis, 35 with joint effusion, and 66 with osteophytes were detected in hand OA scans on ultrasound. Osteophytes on ultrasound were significantly associated with total radiographic severity score and number of affected joint (r=0.293, p=0.003 and r=0.336, p＜0.001, respectively). In addition, there were weak associations of synovitis and joint effusion with radiographic changes. Patients with higher total radiographic severity score showed larger number of ultrasound-detected abnormalities, such as synovitis, joint effusion, and osteophytes (p=0.011, p=0.002, and p＜0.001, respectively).
Conclusion
. This study shows that ultrasound findings, especially osteophytes, were associated with radiographic changes based on K-L grade, but not clinical and functional status in hand OA.

Keyword

Osteoarthritis; Hand; Radiography; Ultrasound; Kellgren-Lawrence grade

Figure

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  Figure 1 Correlation between radiographic changes and ultrasound abnormalities. p-values were calculated after adjustment with sex, age, and symptom duration. β: regression coefficient in multivariate regression analysis.

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  Figure 2 Comparison of scores for each ultrasound abnormality according to Kellgren-Lawrence grade.

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