Ultrasonography of Hand Osteoarthritis
Research type
Research Study
Full title
Ultrasonographic Features of Hand Osteoarthritis and their Association with Hand Pain and Function
IRAS ID
263840
Contact name
Abhishek Abhishek
Contact email
Sponsor organisation
University of Nottingham
Clinicaltrials.gov Identifier
000, N/A
Duration of Study in the UK
3 years, 11 months, 30 days
Research summary
Research Summary
Osteoarthritis (OA) is a highly common form of arthritis and the joints of the hands are among the most commonly affected. Due to lack of drug treatment for OA in general, current management approach is targeted at controlling symptoms. Therefore, precise understanding of specific features OA that associate with the common symptoms is important in improving clinical decision-making.
Several studies have shown that ultrasound can potentially improve our understanding of some of these features. Hence, the primary aim of this study is to examine the association between ultrasound-defined features of hand OA, and hand pain and function in a community-derived group. The study will include 104 people aged 18 years and above with self-reported nodal hand OA, living within the East Midlands region of the UK. These participants will be recruited from previous studies carried out in the Academic Rheumatology Department, University of Nottingham. However, if enough participants are not sourced from the primary recruitment source, people with hand OA will be recruited from the Rheumatology Outpatient Clinics in Nottingham.
Participants will be involved in the study for three years. However, they will be required to visit the study site only twice, which will include first visit at the start of the study (baseline visit) and then three years later at the end of the study. During the visits, hand radiographs (baseline visit only), ultrasound scan of the hand joints, and clinical assessments including grip and pinch strength and physical hand assessment will be performed. Participants will also be asked to complete established and validated short questionnaires designed to assess presence and severity of any hand pain and other hand OA symptoms.
Informed consent will be obtained from all participants in accordance with the REC guidance, and Good Clinical Practice.Summary of Results
We invited people with hand osteoarthritis living in the East-Midlands region of the UK. They answered questions about arthritis affecting their hands, including about hand function, pain, and attended the hospital for a single visit. During this, they had hand joint examination and underwent ultrasound scan and plain X-rays of both hands. Changes of arthritis were formally assessed against agreed criteria. We calculated how often each joint was affected. We examined the association between changes of arthritis visible on ultrasonography and joint tenderness (i.e., pain on pressing the joints) and symptoms of arthritis. We took steps to account for any effect due to age, gender, body mass index, and pain characteristic.
We found that structural changes of arthritis were more common than inflammatory features. The structural changes were present in between half to almost all joints examined. Inflammatory changes were present in a third to a half of joints examined. All features were associated with joint tenderness. Only increased blood flow in the joints ( a marker of inflammation) was associated with symptoms. Other markers of inflammation e.g., fluid in the joint, joint line thickening were not associated with symptoms. Bony overgrowth was linked with reduced hand function.
We anticipated to invite 92 people and see them on two occasions. However, due to the Covid-19 lockdown in January 2021, we stopped the study with only 68 people recruited and they had only completed a single visit.
REC name
East Midlands - Nottingham 1 Research Ethics Committee
REC reference
19/EM/0210
Date of REC Opinion
23 Jul 2019
REC opinion
Further Information Favourable Opinion