Background/Purpose: Ultrasound (US) is an emerging technique for the examination of osteoarthritis of the hands (HOA).Bone erosions and osteophytes are hallmarks of advanced HOA. We studied the reliability of US findings in proximal interphalangeal (PIP) and distal interphalangeal (DIP) joints compared to micro computed tomography (µCT) and histology in fingers of dissecting room cadavers.

Methods: We obtained 30 fingers with and without signs of nodal HOA from 15 cadavers donated to the Institute of Anatomy. Written informed consent had prior been given in the lifetime of the individuals. We analyzed PIP and DIP joints using an Esaote MyLabTwice US machine with a 6-18Mhz probe and a Siemens INVEON µCT. The occurrence of erosions and osteophytes was scored for 16 defined regions of each joint (ulnar, radial, dorsal, palmar, dorso-ulnar, palmo-ulnar, dorso-radial, palmo-radial aspect of the joint region of the proximal and distal articulating bone). Thereafter, finger joints were fixed in 4% formalin and embedded in acrylic resin. Serial sections of the joints were stained with haematoxilin/eosin, safranin O, and Pappenheim’s solution. Erosions and osteophytes in the different joint regions were assessed. Differences between groups were analyzed using Wilcoxon signed-rank test. Correlations were analyzed with Spearman-Rho test.

Results: In the PIP joints US detected more erosions than µCT (28 vs. 19, p=0.028). The findings of both methods correlated well (r=0.51, p=0.004). The number of erosions in histology correlated significantly with the findings of the µCT (r=0.61, p=0.047) but not with US. US and µCT detected a similar frequency of osteophytes (225 vs. 248, p=0.028) in the PIP joints. Both methods correlated well with each other(r=0.47, p=0.009). Only US correlated with histology (r=0.76, p=0.006). In the DIP joints US, µCT and histology did not yield correlating results. US and µCT detected a similar number of osteophytes in the DIP joints (333 vs. 245, p=0.13) and the findings of both methods correlated significantly (r=0.46, p=0.013). The number of osteophytes on histologic examination did not correlate with osteophytes in US or µCT (r=0.14, p=0.63 and r=0.43, p=0.13, respectively).

Conclusion: US is comparable to µCT in the identification of osteophytes in PIP and DIP joints. Erosions identified by US should be interpreted with caution. Both US and µCT overestimate the frequency of erosions and osteophytes compared to histologic examination.

« Back to 2016 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/detection-of-finger-joint-osteophytes-and-bone-erosions-by-ultrasound-a-comparison-to-computed-tomography-and-histology/