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Pain in hand osteoarthritis is associated with inflammation: the value of ultrasound
  1. Marion C Kortekaas1,
  2. Wing-Yee Kwok1,
  3. Monique Reijnierse2,
  4. Iain Watt2,
  5. Tom W J Huizinga1,
  6. Margreet Kloppenburg3
  1. 1Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
  2. 2Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
  3. 3Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
  1. Correspondence to Marion C Kortekaas, Department of Rheumatology, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands; m.c.kortekaas{at}lumc.nl

Abstract

Objectives To investigate the association of ultrasound (US) features—grey scale (GS) synovitis, synovial thickening, effusion and power Doppler signal (PDS)—with symptoms in hand osteoarthritis (HOA).

Methods Fifty-five consecutive patients (mean age 62 years, 87% women) with HOA, fulfilling the American College of Rheumatology criteria, were assessed for pain upon palpation and filled in Australian/Canadian Osteoarthritis Index (AUSCAN) scores, visual analogue scale pain and Short Form-36 (SF-36). US was performed in all metacarpophalangeal, proximal interphalangeal, distal interphalangeal, first interphalangeal and first carpometacarpal joints, and features were semiquantitatively scored (0–3). Generalised estimating equations were used to calculate OR (95% CI) for the association between US features and pain per joint adjusted for relevant confounders. The association between US features summated scores and self-reported outcomes was studied by linear regression analysis.

Results GS synovitis, effusion, synovial thickening and PDS were shown in 96%, 91%, 73% and 86% of patients, respectively. US features were dose-dependently associated with pain upon palpation (OR 4.5 (95% CI 2.2 to 9.0), 4.4 (2.0 to 9.4), 4.9 (2.2 to 11.0) and 4.1 (2.2 to 7.9)). GS synovitis was associated with AUSCAN pain, stiffness and SF-36, and effusion with AUSCAN pain.

Conclusions GS synovitis, effusion, synovial thickening and PDS are associated with pain in HOA, suggesting a role for inflammation. Further follow-up studies are warranted.

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Footnotes

  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval This study was conducted with the approval of the medical ethics committee of the Leiden University Medical Center, Leiden, The Netherlands.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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