Background: Ultrasound is one of the most promising candidates for the detection of
inflammation and structural damage in hand osteoarthritis.
Objective: To evaluate new advances of US as a diagnostic and prognostic tool in hand osteoarthritis
Methods: We conducted a Medline on PubMed search for articles about “ultrasonography” and
“hand OA” published between January 2012 and 15th April 2016, limiting our search to articles on
human adults in English, excluding those involving systemic inflammatory diseases, visualization of
joints other than hands, ultrasound guided injections and surgical procedures. Reviews, case reports,
letters, position statements and ex vivo studies were excluded. Concordance between ultrasound and
conventional radiography and magnetic resonance imaging was evaluated.
Results: Total 46 records were identified, and 16 articles were selected: four showed only ultrasound
structural damage (osteophytes, cartilage pathology), six only ultrasound inflammatory variables
(synovial thickness, effusion and power Doppler signal), six should considered both ultrasound structural
and inflammatory features as well as erosions and two were epidemiological studies. Ultrasound
synovitis and power Doppler signal were more frequent in erosive hand osteoarthritis. Followup
studies found that ultrasound inflammatory features at baseline are independently associated with
radiographic progression; power Doppler signal was the strongest predictor of structural damage.
Ultrasound is a reliable tool for cartilage and osteophyte assessment (when performed with static
images) and shows a good concordance with magnetic resonance imaging for osteophytes, erosions
Conclusions: Ultrasound detected inflammation may predict radiographic progression and may be
used in prospective clinical trials of hand osteoarthritis and in everyday clinical practice.