Metric properties of advanced imaging methods in osteoarthritis of the hand: a systematic review.
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.
Department of Radiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
Michael S
MS
Saltzherr
Ruud W
RW
Selles
Sita M A
SM
Bierma-Zeinstra
Galied S R
GS
Muradin
J Henk
JH
Coert
Johan W
JW
van Neck
Jolanda J
JJ
Luime
D018450:Disease Progression; D042241:Early Diagnosis; D050823:Hand Joints / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D010003:Osteoarthritis / Q000175:diagnosis* / Q000000981:diagnostic imaging; D015203:Reproducibility of Results; D014463:Ultrasonography
Hand Osteoarthritis; Magnetic Resonance Imaging; Ultrasonography