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Title: The impact of ultrasound imaging on the assessment of the carpometacarpal joint in hand osteoarthritis
Author: Brandon, Mhairi
ISNI:       0000 0004 2739 0635
Awarding Body: Glasgow Caledonian University
Current Institution: Glasgow Caledonian University
Date of Award: 2012
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Emerging evidence suggests that ultrasound imaging is being increasingly used to assess peripheral joints in clinical practice. However, much of the research focus has been on patients with inflammatory arthritis. Recent studies have explored the use of ultrasound in the evaluation of symptomatic hand osteoarthritis. Assessment of this condition can be challenging particularly with the possibility of coexisting soft tissues pathologies that may arise. The clinical management of hand osteoarthritis with corticosteroid injections as a targeted intervention for symptom modification is routine practice. However, evidence of clinical efficacy is limited. This study evaluated ultrasound imaging as a diagnostic tool in addition to clinical examination in patients with symptomatic hand osteoarthritis. A consecutive sample of forty patients attending Glasgow Royal Infirmary Rheumatology Department were recruited to this study. The primary aim of this study was to establish if the symptoms of carpometacarpal joint osteoarthritis could be improved by identifying and treating coexisting pathologies such as median nerve entrapment and/or De Quervain's tenosynovitis. The study was divided into three stages: Stage 1 investigated the carpometacarpal joint and associated pathologies; Stage 2 identified whether knowledge of the ultrasound scan influenced clinical decision- making and planning of corticosteroid injections following the random allocation of patients to two groups; and Stage 3 measured the level of disease burden to the individual using the Australian/Canadian Osteoarthritis Hand Index over 12 weeks following intervention. The study findings demonstrated that ultrasound scanning when used in addition to routine clinical examination is beneficial to image the associated pathologies of median nerve entrapment and De Quervain's tenosynovitis in osteoarthritis of the carpometacarpal joint. Ultrasound was found to influence the clinical decision making in targeting corticosteroid injections for the management of symptomatic hand osteoarthritis. However, prior knowledge of ultrasound findings did not result in improved clinical outcomes as measured by the AUSCAN. The detection of additional pathologies in carpometacarpal joint disease may allow for earlier targeted treatment with corticosteroid injections aimed at improving hand symptoms and function.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Prof.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available