Imaging. Radiological assessment of hand OA.

OBJECTIVE

The different radiographic procedures and methods for reading films and assessing the status and progression of hand osteoarthritis (OA) were reviewed.

METHODS

The methods that relate to each of the above procedures were assigned to categories upon which there was or was not general agreement.

RESULTS

It was agreed that the radiographic method should use published standardized radiographic protocols; that X-ray features should be graded separately for determining the extent of the disease and that changes in osteophyte size was the most sensitive indicator of progression. For epidemiological studies films should be read blind and randomly, but for assessing progression films should be read in pairs and in sequence. No agreement was obtained on the value of the lateral radiographic view of the hand nor on which radiographic atlas would be best for long-term longitudinal studies.

CONCLUSIONS

Further work was required to evaluate the role of MRI and scintigraphy in hand OA; radiographic atlases could be improved by incorporating diagrams to illustrate the change in grade for each feature; validation was required for methods of assessment in long-term trials.