Ultrasound of hand osteoarthritis. Validity, reliability and predictive value of ultrasonography in patients with hand osteoarthritis

Abstract

Osteoarthritis (OA) is the most common musculoskeletal disorder. During the past decades, the concepts of OA have been forever changed with the application of modern imaging techniques such as ultrasonography. While traditionally considered a non-inflammatory “wear-and-tear” disorder of the cartilage, we now acknowledge OA as a complex and multi-tissue disorder of the whole joint, involving cartilage, subchondral bone, ligaments and (increasingly recognized) inflammation of the synovium. Plain radiographs, the current standard for detecting disease incidence and progression, are insensitive and nonspecific to critical changes in joint structure. Ultrasound can visulize both bony and soft tissue aspects of a joint, and detects structural changes that may be early signs of future OA and potential targets for treatment. Exploring the validity and reliability of meaningful sonographic features is critical for their application in future research and clinical practice. With this thesis, the aim is to demonstrate the potentials (and limitations) of ultrasonography as a diagnostic tool in hand OA and how sonographic biomarkers can be used to detect early OA and predict disease progression.