Department of Musculoskeletal Radiology, Leeds Teaching Hospitals NHS Trust, UK.
Clin Radiol. 2013 May;68(5):461-5. doi: 10.1016/j.crad.2012.10.006. Epub 2012 Dec 5.
To evaluate grading of thumb carpometacarpal joint (CMCJ) osteoarthritis (OA) using ultrasound, correlating findings with disability and treatment response.
Patients with symptomatic thumb OA attending for ultrasound-guided CMCJ steroid injection and a group of asymptomatic controls were recruited prospectively. Thumb CMCJ ultrasound was graded (osteophytes, joint-space narrowing, capsule size, and measured capsule size), and a Disabilities of the Arm Shoulder and Hand (DASH) questionnaire was completed for each patient. Symptomatic patients then underwent injection with DASH repeated 6 weeks post-treatment. Ultrasound features were correlated with the initial DASH disability score and response as defined by change in DASH 6 weeks after treatment.
Thirty-one patients with symptomatic OA and 37 asymptomatic controls were recruited. With the exception of osteophytes (p = 0.017), no statistically significant correlation was demonstrated between severity of ultrasound features and patient disability. However, all features demonstrated statistically significant higher grades in the symptomatic group compared to controls. Ultrasound grading did not have statistical correlation with treatment response.
No correlation was found between the majority of ultrasound features and the clinical severity of OA or likely response to treatment. However, these features are significantly more common in the symptomatic population.
使用超声评估拇指腕掌关节（CMC）骨关节炎（OA）的分级，并将结果与残疾和治疗反应相关联。
前瞻性招募接受超声引导下 CMCJ 类固醇注射治疗的有症状拇指 OA 患者和一组无症状对照者。对拇指 CMCJ 进行超声分级（骨赘、关节间隙变窄、囊大小和测量囊大小），并为每位患者完成上肢残疾问卷（Disabilities of the Arm, Shoulder and Hand，DASH）。有症状的患者在治疗后 6 周进行注射，DASH 重复。将超声特征与初始 DASH 残疾评分和治疗 6 周后 DASH 变化定义的反应进行相关性分析。
共招募了 31 名有症状 OA 患者和 37 名无症状对照者。除骨赘外（p=0.017），超声特征严重程度与患者残疾之间未发现统计学显著相关性。然而，与对照组相比，所有特征在有症状组中均显示出统计学上更严重的分级。超声分级与治疗反应无统计学相关性。
在大多数超声特征与 OA 的临床严重程度或对治疗的可能反应之间未发现相关性。然而，这些特征在有症状的人群中更为常见。
