Assessment of structural lesions, synovitis and bone marrow lesions in erosive hand osteoarthritis on MRI (0.3T) compared to the radiographic anatomical Verbruggen-Veys score

PLoS One. 2020 Jun 23;15(6):e0234972. doi: 10.1371/journal.pone.0234972. eCollection 2020.

Abstract

Objective: To evaluate prevalence of structural lesions, synovitis and bone marrow lesions (BMLs) on MRI performed with a 0.3T imaging system in patients with erosive hand osteoarthritis (EHOA) and to compare them to the anatomic radiographic Verbruggen-Veys score (VV).

Design: For this Cross-sectional study, fifty-five EHOA patients were studied with 0.3T contrast-enhanced MRI and radiography (RX) of their dominant hand. Structural lesions were scored according to the OMERACT Hand Osteoarthritis MRI Scoring System as follows: osteophytes and erosions were graded from 0 to 3. On joint destruction lesion synovitis and BMLs were graded from 0 to 1. And on MRI, we evaluated the presence of several structural features: N: normal, O: osteophytic lesions, E: erosive lesions, E/O: osteophytic and erosive lesions and D: joint destruction. RX was scored according to the VV system. Relations between MRI features and VV stages were analysed.

Results: MRI identified more structural lesions than RX (77.3% versus 74.8%) and particularly more erosive lesions (E or E/O) than VV Phase E (33.5% versus 20.2%). E/O and D were mostly found on MRI. Synovitis and BMLs were significantly associated with E/O and D with the following odds ratios (ORs): 8.4 (95% CI 1.8-13.6); OR: 13.7 (95% CI 2.9-21.0); OR: 15.7 (95% CI 3.2-23.5); OR: 38.5 (95% CI 9.5-57.0), respectively.

Conclusion: MRI 0.3T appears completely relevant for EHOA lesion analysis. First, MRI shows more erosive lesions than RX in EHOA; second, it allows for the analysis of synovitis and BMLs to be associated with more specific structural MRI features (E/O and D).

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Bone Marrow / diagnostic imaging
  • Bone Marrow / pathology*
  • Cross-Sectional Studies
  • Female
  • Hand Joints / diagnostic imaging
  • Hand Joints / pathology*
  • Humans
  • Magnetic Resonance Imaging / statistics & numerical data*
  • Male
  • Methotrexate / therapeutic use
  • Middle Aged
  • Osteoarthritis / complications*
  • Osteoarthritis / diagnostic imaging
  • Osteoarthritis / drug therapy
  • Osteoarthritis / pathology
  • Prospective Studies
  • Radiography / statistics & numerical data*
  • Randomized Controlled Trials as Topic
  • Severity of Illness Index
  • Synovitis / diagnostic imaging
  • Synovitis / epidemiology*
  • Synovitis / etiology

Substances

  • Methotrexate

Grants and funding

This work was supported by a grant from the « Clinical Research Hospital Program » from the French Ministry of Health obtained by Pr ch roux.