Background/Purpose

To investigate the frequency of osteoarthritis (OA) in musculoskeletal ultrasound of the MCP, MTP and PIP joints in a volunteer population using the US-7 score.

Methods

“Rheuma-Truck” was a mobile rheumatology office located in different city center of North Rhine Westphalia, Germany offering a screening for rheumatic diseases including Rheuma-Check questionnaire, lab-tests (MCV capillary test) and imaging (US, capillaroscopy). Musculoskeletal ultrasound (MyLab 25 Gold, Esaote linear scanner, 15, Typ LA435) of the dominant hand of 605 volunteers (Rheuma-Truck-Cohort) was performed, using US-7 score for the detection of inflammatory joint alteration. Additionally, the foot joints were investigated according to US-7 criteria in 236 volunteers. Osteoarthritis in US was defined as the presence of osteophyte formations (discrete, moderate or severe). Due to the US-7 scoring system DIP joints were not assessed. Descriptive statistics for the patients were obtained and are reported as means ± standard deviation, ranges, frequencies or proportions as appropriate. Correlation coefficients are Pearson-correlations.

Results

605 volunteers of the “Rheuma-Truck” Cohort were screened by musculoskeletal ultrasound according to the US-7 scoring system.  The mean age of the investigated population was 52.72 years (min. 10 years; max. 89 years). Sex distribution shows 72.2% females and 27.8% males. 181 volunteers were displayed arthritis by ultrasound. Moreover 337 (55.7%) probands showed sonographically detectable sings for osteoarthritis in the investigated joints. The mean age of the OA-positive probands was 57.78 years (min. 12, max. 89 years). The sex distribution reflected that of the entire cohort (72.4% f; 27.6% males). 73.1% of the sonographically positive OA volunteers were older than 50 years, 13% between 40-50 years, 5.2% between 30-40 years and 8.7% under 30 years. MCP-2 was the most frequently involved joint, wherein 36.6% of the sonographically positive OA volunteers showed osteophytes. The MCP-3 was sonographyically positive in 15.4% followed by the wrist (10.4%), PIP-2 (9.3%), PIP-3 (7.6%), MTP-2 and 5 (each 7.2%). Of all volunteers enrolled, 16.8% (102 of 605) were diagnosed with both, OA an RA. Of all patients diagnosed with RA, 56.4% (102 of 181) also showed sonographically detectable OA-sings.

Conclusion

In the “Rheuma-Truck” Cohort, nearly 3 of 4 volunteers over 50 y of age exhibited sonographic findings compatible with osteoarthritis. Also nearly 14% of newly diagnosed OA according to ultrasonographic findings were below the age of 40. Strikingly, MCP joints were the most frequently involved joints within the US-7 scoring, which however ignores the DIP-joints. Thus, this study highlights a previously unrecognized high burden of hand OA.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/musculoskeletal-ultrasound-of-finger-and-foot-joints-in-a-population-of-volunteers-is-osteoarthritis-an-underestimated-problem-results-from-the-german-rheuma-truck-cohort/