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Norwegian imaging study yields 'important insights' into hand osteoarthritis progress

by John W. Mitchell, Senior Correspondent | April 13, 2015
Dr. Alexander Mathiessen
Imaging has yielded "important insights" into the progress of hand osteoarthritis (OA), researchers reported in the Annals of the Rheumatic Diseases.

OA, which can be found in any joint, is a common and painful condition that affects 27 million people in the United States alone.

Lead author Dr. Alexander Mathiessen, with the Department of Rheumatology at Diakonhjemmet Hospital in Oslo, Norway explained to DOTmed News the study was devised to fill in gaps in knowledge about OA.

“We found it important to establish a large hand OA cohort, as most studies have focused on OA in the hips and knees. But hand OA is also highly prevalent, especially in the elderly,” said Dr. Mathiessen. “Interestingly, soft tissue swelling identified through clinical examination was also shown to be a significant predictor for radiographic progression. However ultrasound seems to be an even stronger predictor.”

Hand OA is a degenerative disease found in the wrist, fingertips, knuckles and between the thumb and wrist. Dr. Mathiessen noted the study provided new insight into a common affliction.

“With modern imaging modalities such as ultrasound, we have gained important new insights into the disease. Inflammation of the OS joints is more common than we thought. In the present study we found that finger joints with inflammation are more likely to progress in disease severity compared to non-inflamed joints. With ultrasound, we then have a tool to locate these patients,” said Dr. Mathiessen. He added that the improved diagnosis does not require any safety trade-off.

“Unlike conventional radiographs, there is no ionizing exposure associated with ultrasound imaging.”

The research team looked at 78 patients, with a mean age of 67.8 years, from the hospital’s rheumatology outpatient clinic. It established their baseline data from 2008-09 and concluded the study with images and associated data collected in 2013.

The study indicated the severity of initial diagnosis on a grade of 1-3 was a strong factor in predicting OA progression. From 12-18 percent of the study group were found to suffer from progression, depending upon the clinical factors considered.

“Our results are… promising as there are no current treatments,” noted Dr. Mathiessen. “Synovitis (inflammation of the join membrane) might be a target to treat. Perhaps we can slow down and even prevent disease progression, which needs to be considered in future studies.”

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