Histopathological correlation supports the use of x-rays in the diagnosis of hand osteoarthritis
Annals of Rheumatic Diseases, 05/22/2012
Exclusive author commentary
Sunk IG et al. – On the basis of histopathological changes of distal and proximal interphalangeal (DIP and PIP) joints, this investigation demonstrates the validity of x–ray examinations and supports the use of plain radiography in the diagnosis of hand OA and in the classification of hand osteoarthritis (OA) in clinical trials.
Klaus Bobacz (06/05/2012) comments:
Many physicians make use of hand x-rays in the diagnostic process of hand osteoarthritis (OA). However, the current hand OA classification criteria do not require x-rays and rely on clinical examination alone. It is, however, not known wheather x-ray examinations would be beneficial to this diagnostic progress. Our study is the first to compare histopathological changes with radiographic alterations of the very same distal and proximal interphalangeal (DIP and PIP) joints in order to elucidate wheather x-ray changes would mirror histological changes. We showed a significant correlation between histological and x-ray alterations and moreover identified a subgroup of hand OA patients that wohld not have been diagnosed applying clinical criteria alone. We assume that x-rays should be incorporated into the diagnosis process to acurately indentify patients with underlying hand OA as the current clinical criteria would not apply to all patients suffering from hand OA. On the other hand, radiographs of the hands would help to definitively exclude hand OA as differential diagnosis in patients suffering from arthralgias of the finger joints.