Correlates between magnetic resonance imaging and X-ray abnormalities and hand symptoms in older adults

Abstract

Purpose: The clinical relevance of abnormal features seen on hand magnetic resonance imaging (MRI) have been investigated in patients with hand osteoarthritis (HOA). However, whether these relationships are similar in the general population and if they are independent of features seen on radiographs is not known. Therefore, we aimed to describe cross-sectional associations between presence of MRI-detected effusion-synovitis, bone marrow lesions, erosions, collateral ligaments (CL), osteophytes; radiograph-detected osteophytes and joint space narrowing (JSN) with joint symptoms and grip strength in community-based older adults. Methods: Distal and proximal interphalangeal index finger joints (n=221, mean age= 72, 44% females) were imaged using MRI, conventional radiographs (XR) and assessed using the Oslo HOA score and OARSI atlas, respectively. Joints were assessed clinically for pain and tenderness. Hand pain, function, and stiffness were assessed using the Australian/Canadian HOA index (AUSCAN) questionnaire; grip strength was assessed using a dynamometer. Data was analysed using log binomial, ordinal logistic, and linear regression and adjusted for age, sex, and other MRI or XR abnormalities. Results: Participants with above average (worse) AUSCAN pain scores had higher proportions of women (55%), met clinical HOA criteria (92%), and have poorer grip strength (9psi), and quality of life (AQoL utility 0.66) than those with mild or no pain. Absent CL’s on MRI (RR=3.33 (95% confidence interval; 1.45, 7.61)) and JSN on X-ray (RR=2.47 (1.06, 5.74)) were associated with higher risk of having a painful joint after adjustment for age, sex, and other structures. Participants with JSN had higher odds of moving to a higher category of AUSCAN pain (OR=1.59 (1.08, 2.35)) while effusion, surprisingly, inferred lower odds (OR=0.51 (0.28, 0.91)) of pain. JSN was also associated with lower grip strength independent of pain and other features (β=-0.95 (-1.74, -0.15)). No abnormalities were independently associated with tender joints, AUSCAN function limitation or stiffness. Conclusions: Absence of CL’s, and JSN were independently associated with painful joints; JSN was also associated with weak grip strength. Unexpectedly, effusions were associated with reduced odds of pain. This data does not support using MRI to identify potential targets for therapeutic interventions for hand pain.Tabled 1Associations of presence of MRI and radiographic abnormalities and HOA symptoms and grip strength.Presence of painful joint RR (95% CI)Presence of tender joint OR (95% CI)AUSCAN pain OR (95% CI)AUSCAN physical function limitation OR (95% CI)AUSCAN stiffness OR (95% CI)Grip strength beta (95% CI)MRI abnormalitiesEffusion0.65 (0.16, 2.57)0.46 (0.15, 1.43)0.51 (0.28, 0.91)1.03 (0.40, 2.61)0.72 (0.33, 1.56)0.35 (-0.85, 1.55)Absence of collateral ligament3.33 (1.45, 7.61)0.69 (0.10, 5.01)1.74 (0.82, 3.65)2.66 (0.79, 9.02)2.26 (0.84, 6.05)-1.46 (-2.96, 0.04)BML1.32 (0.34, 5.16)1.31 (0.42, 4.06)1.20 (0.79, 1.81)0.89 (0.50, 1.57)1.40 (0.81, 2.40)0.09 (-0.73, 0.91)Erosion1.80 (0.60, 5.33)1.01 (0.37, 2.76)0.92 (0.62, 1.38)0.61 (0.34, 1.10)0.97 (0.58, 1.63)0.09 (-0.73, 0.91)Osteophytes2.55 (0.33, 19.56)1.02 (0.28, 3.62)1.14 (0.74, 1.75)1.10 (0.61, 1.98)1.25 (0.68, 2.27)0.62 (-0.23, 1.47)X-ray abnormalitiesOstephytes0.58 (0.24, 1.41)0.82 (0.31, 2.19)0.79 (0.52, 1.20)1.07 (0.59, 1.94)1.11 (0.66, 1.87)0.16 (-0.68, 1.00)Joint space narrowing2.47 (1.06, 5.74)1.97 (0.84, 4.58)1.59 (1.08, 2.35)1.37 (0.79, 2.36)1.04 (0.64, 1.68)-0.95 (-1.74, -0.15) Open table in a new tab