Older asymptomatic women exhibit patterns of thumb carpometacarpal joint space narrowing that precede changes associated with early osteoarthritis.
In small joints, where cartilage is difficult to image and quantify directly, three-dimensional joint space measures can be used to gain insight into potential joint pathomechanics. Since the female sex and older age are risk factors for carpometacarpal (CMC) joint osteoarthritis (OA), the purpose of this in vivo computed tomography (CT) study was to determine if there are any differences with sex, age, and early OA in the CMC joint space. The thumbs of 66 healthy subjects and 81 patients with early stage CMC OA were scanned in four range-of-motion, three functional-task, and one neutral positions. Subchondral bone-to-bone distances across the trapezial and metacarpal articular surfaces were computed for all the positions. The joint space area, defined as the articular surface that is less than 1.5mm from the mating bone, was used to assess joint space. A larger joint space area typically corresponds to closer articular surfaces, and therefore a narrower joint space. We found that the joint space areas are not significantly different between healthy young men and women. Trends indicated that patients with early stage OA have larger CMC joint space areas than healthy subjects of the same age group and that older healthy women have larger joint space areas than younger healthy women. This study suggests that aging in women may lead to joint space narrowing patterns that precede early OA, which is a compelling new insight into the pathological processes that make CMC OA endemic to women.
Center for Biomedical Engineering and School of Engineering, Brown University, Providence, RI 02912, United States.
Eni
E
Halilaj
Department of Orthopaedics, The Warren Alpert Medical School of Brown University and Rhode Island Hospital, Providence, RI 02903, United States.
Douglas C
DC
Moore
Department of Orthopaedics, The Warren Alpert Medical School of Brown University and Rhode Island Hospital, Providence, RI 02903, United States.
Tarpit K
TK
Patel
Department of Computer Science, Brown University, Providence, RI 02912, United States.
David H
DH
Laidlaw
Robert A. Chase Hand & Upper Limb Center, Department of Orthopaedic Surgery, Stanford University, Stanford, CA 94304, United States.
Amy L
AL
Ladd
Department of Orthopaedics, The Warren Alpert Medical School of Brown University and Rhode Island Hospital, Providence, RI 02903, United States.
Arnold-Peter C
AP
Weiss
Center for Biomedical Engineering and School of Engineering, Brown University, Providence, RI 02912, United States; Department of Orthopaedics, The Warren Alpert Medical School of Brown University and Rhode Island Hospital, Providence, RI 02903, United States. Electronic address: joseph_crisco@brown.edu.
Joseph J
JJ
Crisco
D000328:Adult; D000368:Aged; D000375:Aging / Q000473:pathology* / Q000502:physiology; D052737:Carpometacarpal Joints / Q000000981:diagnostic imaging* / Q000473:pathology / Q000502:physiology; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D050279:Metacarpal Bones / Q000000981:diagnostic imaging; D008875:Middle Aged; D010003:Osteoarthritis / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology; D016059:Range of Motion, Articular; D013933:Thumb / Q000000981:diagnostic imaging* / Q000473:pathology / Q000502:physiology; D014057:Tomography, X-Ray Computed; D051222:Trapezium Bone / Q000000981:diagnostic imaging; D055815:Young Adult
Cartilage; Computed tomography; In vivo; Joint biomechanics; Joint space; Osteoarthritis; Thumb CMC