In fact, dp, oblique and lateral views can be applied for the radiographic evaluation of the hand skeleton and multiplanar views are regarded important for routine imaging of the hands. This, in turn, is in conflict with the basic concepts of radiology that at least two projections are required to evaluate any structure. However, dorso/palmar (dp) images alone are suggested in the diagnostic process of HOA. Thus, in hand osteoarthritis (HOA), the most prevalent joint disorder, plain radiography still represents the gold standard in imaging and is recommended by international societies. Despite emerging imaging options, such as musculoskeletal ultrasound, plain radiography is the perhaps most commonly used modality due to its high spatial resolution and wide availability. Detecting dvOPs can facilitate the diagnosis process and improve damage estimation in HOA.ĭiagnosis of musculoskeletal disorders is often supported by clinical imaging. ConclusionĭvOPs are associated with increasing structural alterations in DIP and PIP joints and can be seen as markers of advanced joint damage. Synovial inflammation was mainly present in joints displaying dvOPs and correlated with joint damage. Joint damage in osteoarthritic DIP and PIP joints without any dvOPs was less severe compared to joints with dvOPs. All joints displaying dvOPs were classified as OA and the presence of dvOPs in DIP and PIP joints correlated with the extent of histological and radiographic joint damage, as well as with patient age. Resultsīony proliferations that were only detectable on lateral views but reminiscent of OPs on dp images were termed dorso-ventral osteophytes (dvOPs). Differences between groups were determined by Mann-Whitney test. Spearman’s correlation was applied to examine the relationship between histological and radiographical changes. Inflammatory changes of the synovial membrane were scored using the general synovitis score (GSS). Joint samples were prepared for histological analysis and cartilage damage was graded according to the Mankin scoring system. Radiographic OA was determined by the Kellgren and Lawrence classification. Multiplanar plain x-rays were taken (dorso/palmar (dp) and lateral views). Methodsĭistal interphalangeal (DIP) and proximal interphalangeal (PIP) joints were obtained from post mortem specimens ( n = 40). To detect dorsally located osteophytes (OP) on lateral x-ray views and to correlate their presence with the extent of structural joint damage, determined by histologic grading (cartilage damage and synovial inflammation) and radiographic scoring in hand osteoarthritis (HOA).
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