Comparison of clinical, radionuclide, and radiographic features of osteoarthritis of the hands

Article Abstract:

Osteoarthritis, rather than being a true disease, is a disorder in which joints disintegrate due to many causes. It is characterized by loss of joint cartilage, in reaction to which new bone forms at joint margins. Synovitis (inflammation of the joint lining) and fibrous thickening of the capsule surrounding the joint also occur. Trauma and abnormal development are implicated as causes in the hip and knee, while the factors contributing to osteoarthritis of the hands is unknown, but likely include genetic factors. Osteoarthritis is very common, but difficult to identify in early stages, so it is difficult to determine by X-ray which changes are due to the disorder and which to processes of aging. While X-rays indicate structure and show the result of repair and destruction, bone scans, or scintigraphy, can evaluate function and reflect bone formation and resorption activity and presence of blood vessels. Thus, bone scans indicate the response of bone to insults such as trauma, inflammation, or tumors. To better understand the disease process in osteoarthritis of the hand, results from scintigraphy, medical observation, and microfocal radiography (high-resolution X-rays) in evaluation of 32 patients (29 female) with osteoarthritis were compared. During the 18-month study, the number of mid-finger joints affected by osteoarthritis increased significantly, as did the joint size. The layer of subchondral bone (below joint cartilage) in the wrist was thicker than normal and increased significantly during the study. The number and size of osteophytes (bone spurs) increased significantly. There was an increase in radiolucencies (areas of decreased bone density on X-ray) near the wrist and finger joints, the significance of which is unclear. Joint space width narrowed in 47 percent of patients. Two thumb joints, one index finger joint, a middle finger joint, and a wrist joint had positive bone scans. Positive scans correlated with osteophyte size, joint tenderness, and number of osteophytes. Bone scan results did not correlate with subchondral thickening, joint space width, or radiolucencies. The study indicates that osteophyte formation seemed to be key in causing medical symptoms, and was a marker for subsequent joint disintegration, which was predicted by positive bone scans. (Consumer Summary produced by Reliance Medical Information, Inc.)

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Osteophytes in the osteoarthritic hand: their incidence, size, distribution, and progression

Article Abstract:

Osteophytes (bone spurs) are a classic sign of osteoarthritis. However, these also correlate with age, and so their presence is of questionable usefulness in diagnosing the disorder, which can be difficult to identify. Osteophyte formation may be a component of the degenerative process, and in middle and terminal finger joints it is thought to result from long-term repetitive pinching actions. However, mechanical trauma may not entirely explain the disease process, as osteoarthritis in workers doing pinch operations were more affected in wrist joints of the non-dominant hand. To better understand osteoarthritis of the hand, osteophyte formation was studied by microfocal (high-resolution) radiography, and results were compared with force distribution in the hand. Forty-five patients (29 female) were studied for 18 months. All patients had spurs in the hand or wrist at the start of the study. Osteophytes were present at the joint between the wrist and thumb in 84 percent of patients, probably related to forces exerted during a power grip. Osteophytes were more common and larger on hands and wrists of the dominant side, especially in the middle and terminal finger joints. Spurs were about twice as large in the second and third fingers as those in the fourth and fifth fingers, probably due to those fingers' use in precision grips. The second finger terminal joint was the single most affected hand joint, probably due to pulp-pinching done by the finger. Osteophytes on the outside (toward the fifth finger) of the third finger terminal joint were likely related to usage during power grips. During the study, the number and size of spurs increased significantly. Significant changes occurred in the middle and terminal joints of both hands and the finger joints above the wrist in the non-dominant hand, but not in the wrist or thumb-wrist joint. The study suggests that osteophyte formation is probably caused by exertion of normal forces on bone where joint cartilage is already altered, rather than to abnormal forces in the joints. (Consumer Summary produced by Reliance Medical Information, Inc.)

Abnormalities, Development and progression, Hand

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Fractal signature analysis measures cancellous bone organization in macroradiographs of patients with knee osteoarthritis

Article Abstract:

A technique called fractal signature analysis (FSA) that measures the roughness of an X-rayed image appears to be useful in measuring bone changes that take place in patients with osteoarthritis. Researchers used FSA to examine magnified knee X-rays of 90 patients with osteoarthritis and 14 healthy volunteers. There was a significant correlation between FSA measurements and the number of bone strands present in the patients' bone as well as the degree of joint space narrowing, particularly in the diseased areas.

Knee

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