Department of Rheumatology, Diakonhjemmet Hospital, P,O, Box 23, Vinderen, 0319 Oslo, Norway.
Arthritis Res Ther. 2011;13(6):248. doi: 10.1186/ar3509. Epub 2011 Dec 13.
Hand osteoarthritis (OA) is very frequent in middle-aged and older women and men in the general population. Currently, owing to high feasibility and low costs, conventional radiography (CR) is the method of choice for evaluation of hand OA. CR provides a two-dimensional picture of bony changes, such as osteophytes, erosions, cysts, and sclerosis, and joint space narrowing as an indirect measure of cartilage loss. There are several standardized scoring methods for evaluation of radiographic hand OA. The scales have shown similar reliability, validity, and sensitivity to change, and no conclusion about the preferred instrument has been drawn. Patients with hand OA may experience pain, stiffness, and physical disability, but the associations between radiographic findings and clinical symptoms are weak to moderate and vary across studies. OA is, indeed, recognized to involve the whole joint, and modern imaging techniques such as ultrasound (US) and magnetic resonance imaging (MRI) could be valuable tools for better evaluation of hand OA. Standardized scoring methods have been proposed for both modalities. Several studies have examined the validity of US features in hand OA, whereas knowledge of the validity of MRI is more limited. However, both synovitis (detected by either US or MRI) and MRI-defined bone marrow lesions have been associated with pain, indicating that treatment of inflammation is important for pain management in hand OA. Both US and MRI have shown better sensitivity than CR in detection of erosions, and this may indicate that erosive hand OA may be more common than previously thought.
手部骨关节炎（OA）在中老年人群中非常常见，无论男女。目前，由于常规放射摄影术（CR）具有可行性高、成本低的特点，因此成为手部 OA 评估的首选方法。CR 提供了骨骼变化的二维图像，例如骨赘、侵蚀、囊肿和硬化，以及关节间隙变窄，这是软骨丢失的间接测量指标。有几种用于评估手部放射照相 OA 的标准化评分方法。这些量表在可靠性、有效性和对变化的敏感性方面表现相似，尚未得出首选仪器的结论。手部 OA 患者可能会出现疼痛、僵硬和身体残疾，但影像学发现与临床症状之间的关联是弱到中度的，并且因研究而异。OA 确实涉及整个关节，现代成像技术，如超声（US）和磁共振成像（MRI），可以成为更好地评估手部 OA 的有价值的工具。这两种模式都提出了标准化评分方法。一些研究已经检验了 US 在手部 OA 中的特征的有效性，而 MRI 的有效性知识则更为有限。然而，无论是 US 还是 MRI 检测到的滑膜炎（通过 US 或 MRI 检测到）和 MRI 定义的骨髓病变都与疼痛相关，这表明治疗炎症对于手部 OA 的疼痛管理很重要。US 和 MRI 在检测侵蚀方面的敏感性均优于 CR，这可能表明侵蚀性手部 OA 比以前认为的更为常见。
