Background Hand osteoarthritis (OA) is usually a slowly progressing disease. Some patients show a more rapid progression, leading to considerable pain and disability. Currently, we have limited evidence for predictors for hand OA progression. Magnetic Resonance Imaging (MRI) can visualize the whole joint, providing valuable information about inflammatory and structural features. Due to lack of longitudinal hand OA studies, in which MRI has been obtained, it is unknown whether MRI can predict future radiographic progression.
Objectives To examine whether MRI features can predict radiographic progression 5 years later in hand OA patients.
Methods We included 74 patients (67 women) from the Oslo hand OA cohort with a mean (SD) age of 67.9 (5.3) years. They underwent MRI of the 2nd-5th interphalangeal joints of the dominant hand at baseline (2008-09) and hand radiographs at baseline (2008-09) and follow-up (2013). Pre-and post-Gadolinium T1w fat-suppressed images and Short Tau Inversion Recovery (STIR) images were obtained in a 1.0 T extremity scanner. Eight patients had no post-Gadolinium images, and additionally one patient had STIR images only. The MRIs were scored according to the Oslo hand OA MRI score (1), whereas the paired hand radiographs were scored according to the Kellgren-Lawrence (KL) scale (grade 0-4) with known time sequence. Using Generalized Estimating Equations (unstructured correlation matrix), we evaluated whether presence of MRI features could predict radiographic progression in the same joint (adjusted for age, sex and BMI). Progression was assessed in joints with baseline KL grade 0-3, and was defined as an increase in KL score of ≥1.
Results Mean (SD) follow-up time was 4.6 (0.4) years. We included 497 joints with KL grade 0-3 in the analyses, of which 120 (24.1%) showed radiographic progression. Baseline bone marrow lesions (BMLs) were associated with radiographic progression (p=0.02), whereas the association was borderline statistically significant for synovitis (p=0.07) (Table 1).
Conclusions The Oslo hand OA cohort represents the first longitudinal hand OA study, in which MRI has been obtained. Joints with synovitis and BMLs were more likely to progress radiographically, although the association was statistically significant for BMLs only. Future larger studies are needed to confirm our findings.
Haugen et al. ARD 2011 Jun;70(6):1033-8.
Disclosure of Interest None declared
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