| Background:Osteoarthritis(OA),a disease that initially hurts joint cartilage and eventually destroys all joint tissues,is the world’s most common joint disease.As one of the best parts of osteoarthritis,hand joints will seriously affect the normal work and life of patients.Therefore,the early diagnosis and treatment of hand osteoarthritis(HOA)is very important.Musculoskeletal joint ultrasound(US)has a wide application prospect because it can detect soft tissue and osteophytes,and is more sensitive in detecting osteophytes,which is more convenient to observe the relationship between inflammation and structural changes.Objective:1.Myoskeletal joint ultrasound detection the predilection site of hand osteoarthritis osteophytes.2.To evaluate the relationship between myoskeletal joint ultrasound detection of hand osteoarthritis lesions and the pain degree and joint function status of patients.3.Evaluation the clinical value of musculoskeletal joint ultrasound detection for diagnosis of hand osteoarthritis,and provide imaging basis for clinical diagnosis of hand OA.Methods:1.72 HOA patients and 50 RA patients,visiting Shanxi Bethune Hospital from November 2021 to November 2022,were included as controls.Statistical information included general demographic data such as age and gender.The VAS scale quantifies the degree of pain in each joint,and the FIHOA scale evaluates hand joint function.2.All patients underwent musculoskeletal joint ultrasound examination,and 30 hand joints of both hands were examined for osteophytes and tendonitis,with a semiquantitative score of 0-3.Some patients in the HOA group(21 cases)underwent Xray radiation examination and K-L score.3.Statistical analysis of the incidence of osteophyte and tendonitis in different parts of hand joint,analyze the correlation of osteophyte and various clinical characteristics,evaluate the sensitivity and specificity of myossious ultrasound osteophyte diagnosis of hand osteoarthritis,compare the sensitivity of myosseous ultrasound and X-ray osteophyte,and detect the pain group and pain group,draw the ROC curve comparing the myosseous joint ultrasound and X-ray to predict the value of symptomatic hand osteophyte joint.Results:1.Of the 72 HOA patients,22 had complicated tendonitis with detection rate of30.56%,mean score of 0.64 ± 1.01;2160 joints,498(23.06%).2.Of all joint regions,the proximal interphalangeal joint(PIP)osteophytes had the highest detection rate(34.3%,247 / 720),followed by the distal interphalangeal joint(DIP 27.43%,158 / 576),first brachiocaracarpal joint(CMC1 22.23%,32 / 144),and the lowest detection probability of the metacarpophalangeal joint(MCP)(8.47%,61 / 720).The highest in MCP was MCP 2(40.98%,25 / 61),the highest osteophyte in PIP was PIP1(30.36%,75 / 247),and the highest in DIP was DIP2(31.65%,50 /158).3.Osteophyte OSGS score was positively correlated with the severity of VAS,FIHOA and tendinitis.VAS plays a mediating role in the process of OSGS affecting FIHOA.Tendinitis has obvious mediating effects in OSGS,FIHOA and VAS,indicating that soft tissue injuries such as tendinitis caused by osteophytes play an important role in joint pain and decreased joint function in hand osteoarthritis.4.The sensitivity for the diagnosis of HOA was 72/72(100%)and the specificity was 72/94(76.6%),and the AUC for the diagnosis of HOA by musculoskeletal ultrasound was 0.947(95% CI: 0.891-1.000).5.Among the 21 patients who underwent musculoskeletal joint ultrasound and X-ray examination at the same time,630 joints,151 osteophyte joints detected by ultrasound,and 137 osteophyte joints were found on X-ray.The 156 joints with osteophytes were divided into two groups according to whether they had pain,and the KLG and OSGS of the pain group were significantly higher than those in the painless group.Analysis using ROC showed that the AUC for predicting osteophyte pain by musculoskeletal joint ultrasound and x-ray were 0.675(98% CI: 0.591-0.759)and0.633(98% CI: 0.547-0.719).Conclusions:1.Hand osteoarthritis osteophytes are most common in PIP,followed by DIP and CMC1.2.Ultrasound detection of osteophyte score is obviously related to joint pain and decreased hand function,and soft tissue injuries such as tendonitis caused by osteophytes play an important role in joint pain and decreased joint function of hand osteoarthritis.3.Musculoskeletal joint ultrasound detection of HOA has high sensitivity and specificity,and can be used as a powerful tool for the differential diagnosis of HOA from other inflammatory arthritis.4.Myoskeletal joint ultrasound is more sensitive than X-ray detection of osteophytes,and the correlation of osteophytes and joint pain is stronger. |
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