scholarly journals The relationship between soft tissue swelling, joint space narrowing and erosive damage in hand X‐rays of patients with rheumatoid arthritis

Rheumatology ◽  
2001 ◽  
Vol 40 (3) ◽  
pp. 297-301 ◽  
Author(s):  
J. Kirwan ◽  
M. Byron ◽  
I. Watt
Keyword(s):  
Rheumatoid Arthritis ◽  
Soft Tissue ◽  
Joint Space Narrowing ◽  
Joint Space ◽  
X Rays ◽  
Soft Tissue Swelling ◽  
The Relationship

Film-Screen Vs. Digital Radiography in Rheumatoid Arthritis of the Hand

1994 ◽  
Vol 35 (4) ◽  
pp. 311-318 ◽  
Author(s):  
Á. Jónsson ◽  
A. Borg ◽  
P. Hannesson ◽  
K. Herrlin ◽  
K. Jonsson ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Soft Tissue ◽  
Digital Radiography ◽  
Joint Space Narrowing ◽  
Digital Images ◽  
Roc Curves ◽  
Joint Space ◽  
Hard Copy ◽  
Significant Difference ◽  
Soft Tissue Swelling

In a prospective investigation the diagnostic accuracy of film-screen and digital radiography in rheumatoid arthritis of hands was compared. Seventy hands of 36 patients with established rheumatoid arthritis were included in the study. Each of 11 joints in every hand was evaluated regarding the following radiologic parameters: soft tissue swelling, joint space narrowing, erosions and periarticular osteopenia. The digital images were obtained with storage phosphor image plates and evaluated in 2 forms; as digital hard-copy on film and on a monitor of an interactive workstation. The digital images had a resolution of either 3.33 or 5.0 lp/mm. ROC curves were constructed and comparing the area under the curves no significant difference was found between the 3 different imaging forms in either resolution group for soft tissue swelling, joint space narrowing and erosions. The film-screen image evaluation of periarticular osteopenia was significantly better than the digital hard-copy one in the 3.33 lp/mm resolution group, but no significant difference was found in the 5.0 lp/mm group. These results support the view that currently available digital systems are capable of adequate diagnostic performance.

scholarly journals Internet hand x-rays: A comparison of joint space narrowing and erosion scores (Sharp/Genant) of plain versus digitized x-rays in rheumatoid arthritis patients

2002 ◽  
Vol 3 (1) ◽  
Author(s):  
Hector O Arbillaga ◽  
Gregory P Montgomery ◽  
Luis P Cabarrus ◽  
Margaret M Watson ◽  
Liam Martin ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Joint Space Narrowing ◽  
Joint Space ◽  
X Rays

scholarly journals POS0126 EARLY STAGE HAND OSTEOARTHRITIS IN PATIENTS WITH THE EHLERS-DANLOS SYNDROME: AN EXPLORATIVE STUDY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 275.1-275
Author(s):  
L. Rombaut ◽  
K. De Baere ◽  
E. Debacker ◽  
L. Decavele ◽  
F. Malfait ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Clinical Features ◽  
Joint Space Narrowing ◽  
Early Stage ◽  
Hand Function ◽  
Joint Space ◽  
Joint Hypermobility ◽  
Finger Joints ◽  
Explorative Study ◽  
Soft Tissue Swelling

Background:The Ehlers-Danlos Syndromes (EDS) are a group of rare heritable connective tissue disorders caused by various defects in the biosynthesis or secretion of fibrillar collagens. The three main clinical features of EDS are joint hypermobility, skin fragility and general soft tissue fragility. 13 clinical subtypes of EDS are recognized, of which the hypermobile type (hEDS) and classical type (cEDS) are the most prevalent. It has been hypothesized that the (micro-)trauma in the joint due to typical subluxations and dislocations, make EDS patients prone to developing osteoarthritis (OA) in early stage. Conversely, it has been mentioned that joint hypermobility provides a larger joint surface area and prevents OA. Abnormal biomechanical loading has been identified as a risk factor for the development of OA in the wrist and hand. However, no studies have yet been performed in EDS patients.Objectives:The primary aim was to investigate the presence of any degenerative features for hand OA, and if this differs between cEDS and hEDS patients. The second aim was to evaluate hand function and pain related to OA signs in EDS patients.Methods:cEDS and hEDS patients between 35 and 50 years old were invited to participate. cEDS diagnosis was genetically confirmed and hEDS diagnosis was performed according the clinical 2017 hEDS criteria. Exclusion criteria were a body mass index ≥35, not being able to stand straight up for five minutes, suffering from an auto-immune disease or rheumatological condition, or pregnancy. Conventional X-rays of both hands were performed and scored independently by three assessors according to Kallman1. Presence of osteophytes (0-3), joint space narrowing (0-3), malalignment (>15°)(0/1), erosions (0/1), subchondral sclerosis (0/1), and subchondral cysts (0/1) were scored in all interphalangeal (distal and proximal), metacarpophalangeal and thumb base joints of both hands1. We defined early hand OA as minimally three features (≥1) were present. Several clinical assessments were made, e.g. tenderness, bony swelling and soft tissue swelling. The Michigan Hand Outcomes Questionnaire (MHOQ) and Australian/Canadian Osteoarthritis Hand Index (AUSCAN) questionnaires were completed.Results:In total, 31 patients (mean age 41 ± 5.6 years, 13 men and 18 women) diagnosed with EDS participated, of whom 19 with cEDS and with 12 hEDS. In total, 927 joints were assessed. Level of agreement of radiographic assessments was very high (>98%). Early hand OA was found in more than 40% of the EDS patients, with a significant higher frequency in cEDS patients compared to hEDS patients (58% vs. 17%) (p=0.032). Joint space narrowing was most frequently present and significantly more in the cEDS patients compared to hEDS patients (79% vs. 21%) (p=0.003). However, radiographic changes were found in only 10% of all finger joints. Of all fingers, thumb joints were most affected. Regarding the clinical features of hand OA, all patients showed deformity in one or more finger joints, most frequently at the thumb, especially the IP joint (both hyperflexion and hyperextension). Tenderness and bony swelling was present in 36% and 45% of all patients, respectively, whereas soft tissue swelling was less frequently observed (10% of all patients). Here, no significant differences were found between cEDS and hEDS patients. Moderate disability was present (mean (SD) AUSCAN= 45.47 (27.10) and MHQ = 65.97 (14.21). cEDS showed significant less hand pain (p=0.03), a better hand function (p=0.03) and less disability (p=0.026) than hEDS.Conclusion:This explorative study demonstrates that a high number of EDS patients present with minimal degenerative features of hand OA, but in a minority of joints. Patients with cEDS were significantly more affected, but showed a better function compared to hEDS. Possibly, cEDS patients are more susceptible to develop hand OA.References:[1]Altman R, Gold G. Atlas of individual radiographic features in osteoarthritis, revised. OARSI. 2007;15:A1-A56.Disclosure of Interests:None declared

scholarly journals AB0867 INCREASED ADIPONECTIN LEVELS ARE ASSOCIATED WITH HIGHER RADIOGRAPHIC SCORES IN THE KNEE JOINT, BUT NOT IN THE HAND JOINT: THE DONG-GU STUDY

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1740.1-1740
Author(s):  
J. H. Kang ◽  
S. E. Choi ◽  
H. Xu ◽  
D. J. Park ◽  
S. S. Lee
Keyword(s):  
Body Mass Index ◽  
Knee Joint ◽  
Body Mass ◽  
Linear Regression Analysis ◽  
Joint Space ◽  
Serum Adiponectin ◽  
Hand Osteoarthritis ◽  
X Rays ◽  
Subchondral Cyst ◽  
The Relationship

Background:Several studies have evaluated the association between serum adiponectin levels and knee and hand osteoarthritis (OA), with mixed results.Objectives:The aim of this study was to investigate the relationship between OA and serum adiponectin levels according to the radiographic features of knee and hand OA.Methods:A total of 2,402 subjects were recruited from the Dong-gu Study. Baseline characteristics were collected via a questionnaire, and X-rays of knee and hand joints were scored by a semi-quantitative grading system. The relationship between serum adiponectin levels and radiographic severity was evaluated by linear regression analysis.Results:Subjects with higher tertiles of serum adiponectin were older and had a lower body mass index than those with lower tertiles. In the knee joint scores, serum adiponectin levels were positively associated with the total score (P<0.001), osteophyte score (P=0.003), and joint space narrowing (JSN) score (P<0.001) among the three tertiles after adjustment for age, sex, body mass index, smoking, alcohol consumption, education, and physical activity. In the hand joint scores, no association was found between serum adiponectin levels and the total score, osteophyte score, JSN score, subchondral cyst score, sclerosis score, erosion score, and malalignment score among the three tertiles after adjustment.Conclusion:In this study, we found that increased adiponectin levels were associated with higher radiographic scores in the knee joint, but not in the hand joint, suggesting different pathophysiologic mechanisms in the development of OA.Disclosure of Interests:None declared

scholarly journals Increased radiographic progression of distal hand osteoarthritis occurring during biologic DMARD monotherapy for concomitant rheumatoid arthritis

2021 ◽  
Vol 23 (1) ◽  
Author(s):  
C. A. Lechtenboehmer ◽  
T. Burkard ◽  
S. Reichenbach ◽  
U. A. Walker ◽  
A. M. Burden ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Joint Space Narrowing ◽  
Radiographic Progression ◽  
Cox Regression ◽  
Joint Space ◽  
Estimating Equation ◽  
Considerable Proportion ◽  
Hand Osteoarthritis ◽  
Increased Risk ◽  
Subchondral Sclerosis

Abstract Objectives A considerable proportion of patients with rheumatoid arthritis (RA) also suffer from hand osteoarthritis (OA). We here assess the association between conventional synthetic (cs) and biological (b) disease-modifying antirheumatic drugs (DMARDs) and radiographic distal interphalangeal-(DIP) OA in patients with RA. Methods Adult RA patients from a longitudinal Swiss registry of rheumatic diseases who had ≥ 2 hand radiographs were included at the first radiograph and followed until the outcome or the last radiograph. Patients were grouped into two cohorts based on whether DIP OA was present or absent at cohort entry (cohorts 1 and 2, respectively). Modified Kellgren-Lawrence scores (KLS) were obtained by evaluating DIP joints for the severity of osteophytes, joint space narrowing, subchondral sclerosis, and erosions. KLS ≥ 2 in ≥ 1 DIP joint indicated incident or existing OA, and increase of ≥ 1 in KLS in ≥ 1 DIP joint indicated progression in existing DIP OA. Time-varying Cox regression and generalized estimating equation (GEE) analyses were performed. We estimated hazard ratios (HRs) and odds ratios (ORs) with 95% confidence intervals (CI) of DIP OA incidence (cohort 2), or progression (cohort 1), in bDMARD monotherapy, bDMARD/csDMARD combination therapy, and past or never DMARD use, when compared to csDMARD use. In post hoc analyses, we descriptively and analytically assessed the individual KLS features in cohort 1. Results Among 2234 RA patients with 5928 radiographs, 1340 patients had DIP OA at baseline (cohort 1). Radiographic progression of DIP OA was characterized by new or progressive osteophyte formation (666, 52.4%), joint space narrowing (379, 27.5%), subchondral sclerosis (238, 17.8%), or erosions (62, 4.3%). bDMARD monotherapy had an increased risk of radiographic DIP OA progression compared to csDMARD monotherapy (adjusted HR 1.34 [95% CI 1.07–1.69]). The risk was not significant in csDMARD/bDMARD combination users (HR 1.12 [95% CI 0.96–1.31]), absent in past DMARD users (HR 0.96 [95% CI 0.66–1.41]), and significantly lower among never DMARD users (HR 0.54 [95% CI 0.33–0.90]). Osteophyte progression (HR 1.74 [95% CI 1.11–2.74]) was the most significantly increased OA feature with bDMARD use compared to csDMARD use. In 894 patients without initial DIP OA (cohort 2), the risk of incident OA did not differ between the treatment groups. The results from GEE analyses corroborated all findings. Conclusions These real-world RA cohort data indicate that monotherapy with bDMARDs is associated with increased radiographic progression of existing DIP OA, but not with incident DIP OA.

scholarly journals Intra-Articular Pressure in Osteoarthritis of the Knee

2020 ◽  
Author(s):  
kai niu ◽  
le hai Pan
Keyword(s):  
Joint Space Narrowing ◽  
Normal Subjects ◽  
Joint Space ◽  
Positive Pressure ◽  
Osteoarthritis Of The Knee ◽  
Research Subjects ◽  
Pressure Profiles ◽  
Control Knee ◽  
Group 2 ◽  
The Relationship

Abstract Background: IAP （intra-articular pressure）of the knee has been extensively studied in the knee of rheumatoid arthritis1.3 . the relationship between IAP and osteoarthrosis of knee rarely mentioned in the literature. The purpose of the study was to discover the pressure profiles observed in OA(Osteoarthritis ）. The characteristics of osteoarthritis are multiple osteophytes, unstable chondral flaps ,joint-space narrowing，sclerosis. Whether these factors effect of osteoarthritis intra-articular pressure.Methods: Fifty three research subjects were studied. They were divided into two subgroups, group 1: Forty osteoarthritis (OA). group 2: Thirteen control knee of healthy volunteer. IAP was measured using the hand held portable water manometer. before operation of arthroscopic procedures in OAgroup . Research data were analyzed to identify IAP between the two groups. Results: The main findingwasthat Resting IAP was positive pressure in all Osteoarthritis joints, otherwise subatmospheric or weakly atmospheric in normal subjects. Conclusions: The IAP rising is a feature of all patients with OAgroup. Therefore, These observations we recognize that significantly increased resting IAP is major influences by multiple osteophytes, joint-space narrowing，sclerosis , loose bodies and definite deformity of bony ends.

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