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Ann Rheum Dis doi:10.1136/annrheumdis-2012-202515
  • Clinical and epidemiological research
  • Extended report

Metric properties of advanced imaging methods in osteoarthritis of the hand: a systematic review

  1. Jolanda J Luime5
  1. 1Department of Radiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
  2. 2Department of Plastic, Reconstructive and Hand Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
  3. 3Department of Rehabilitation Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
  4. 4Department of Family Practice, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
  5. 5Department of Rheumatology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
  1. Correspondence to Michael S Saltzherr, Department of Radiology, Erasmus MC, PO Box 2040, 3000 CA Rotterdam, The Netherlands; m.saltzherr{at}erasmusmc.nl
  • Received 17 August 2012
  • Revised 16 December 2012
  • Accepted 19 December 2012
  • Published Online First 24 January 2013

Abstract

Objective To assess the value of advanced imaging techniques in the detection of hand osteoarthritis (OA) and hand OA progression.

Methods PubMed/Medline and Embase were searched until April 2012 for studies on imaging of hand OA that presented quantitative data on validity, reliability or responsiveness. Articles presenting only data on conventional radiography (CR) were excluded. Methodological quality was assessed by the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) checklist for validity, the Quality Appraisal of Reliability Studies (QAREL) for reliability and the COSMIN (COnsensus-based Standards for the selection of health Measurement INstruments) for responsiveness.

Results Of 627 citations, 25 studies on ultrasonography (US), MRI or scintigraphy were included. No studies on CT, positron emission tomography or single photon emission CT met our eligibility criteria. Validity was generally assessed against healthy controls, CR or clinical examination. Overall, US and MRI detected more disease than CR and found significant differences between patients and healthy controls. Scintigraphy detected fewer pathological joints than CR. Intra- and inter-reader reliability varied for US (κ=0.01–1.0) and MRI (κ=0.15–0.84 and intraclass correlation coefficient=0.21–0.99) and was good for scintigraphy (κ=0.61–0.84). There were no responsiveness studies for MRI. US responsiveness studies showed a reduction of soft-tissue changes after treatment which correlated with decrease in pain (r=0.7–0.8). For scintigraphy, scores decreased over time while CR showed progression of hand OA.

Conclusions MRI and US seem to be the most promising candidates for early detection of hand OA and for future use in clinical trials. However, further research is needed to improve scoring methods, to compare US with MRI, to confirm reliability of MRI and to further determine the responsiveness of US and MRI.