title: Ultrasound-detected inflammation predicts radiographic progression in hand osteoarthritis after 5 years.
abstract: OBJECTIVE
  To examine whether ultrasound predicts radiographic hand osteoarthritis (OA) progression after 5 years.
  
  
  METHODS
  We included 78 participants (71 women, mean (SD) age 67.8 (5.2) years) from the Oslo Hand OA cohort with ultrasound examination (gray-scale (GS) synovitis and power Doppler (PD) signals) at baseline and conventional radiographs and clinical examination at baseline and 5-year follow-up. Radiographic progression was defined as an increase in global OA according to the Kellgren-Lawrence (KL) scale or progression of individual radiographic OA features. We examined whether baseline ultrasound features and clinical examination predicted radiographic progression using generalised estimating equations, adjusted for age, sex, body mass index and follow-up time.
  
  
  RESULTS
  Radiographic progression occurred in 17.9% joints for KL, 12.1% for joint space narrowing, 11.7% for osteophytes and 4.5% for erosions. Ultrasound-detected inflammation predicted KL progression, and dose-response associations were observed for GS synovitis grade 1 (OR=2.8, 95% CI 1.8 to 4.2), grade 2 (OR=3.6, 95% CI 2.2 to 5.8) and grade 3 (OR=15.2, 95% CI 6.9 to 33.6), and for PD signal grade 1 (OR=2.9, 95% CI 1.2 to 6.8) and grades 2-3 (OR=12.0, 95% CI 3.5 to 41.0). Significant associations were also observed between ultrasound inflammation and progression of all individual radiographic features, and between clinical soft tissue swelling at baseline and radiographic progression.
  
  
  CONCLUSIONS
  Ultrasound-detected GS synovitis and PD signals were significantly associated with radiographic progression after 5 years. This study supports the use of ultrasound as a tool to detect patients with hand OA who are likely to progress.
authors.affiliation: Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.
authors.forename: Alexander
authors.initials: A
authors.lastname: Mathiessen
authors.affiliation: Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.
authors.forename: Barbara
authors.initials: B
authors.lastname: Slatkowsky-Christensen
authors.affiliation: Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.
authors.forename: Tore K
authors.initials: TK
authors.lastname: Kvien
authors.affiliation: Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.
authors.forename: Hilde Berner
authors.initials: HB
authors.lastname: Hammer
authors.affiliation: Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.
authors.forename: Ida K
authors.initials: IK
authors.lastname: Haugen
mesh_terms: D000368:Aged; D003240:Connective Tissue Diseases / Q000175:diagnosis; D018450:Disease Progression; D004487:Edema / Q000175:diagnosis; D005260:Female; D050823:Hand Joints / Q000000981:diagnostic imaging*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000000981:diagnostic imaging*; D011379:Prognosis; D011859:Radiography; D012307:Risk Factors; D012720:Severity of Illness Index; D013585:Synovitis / Q000000981:diagnostic imaging; D018608:Ultrasonography, Doppler
keywords: Inflammation; Osteoarthritis; Ultrasonography