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| ==Overview== | | ==Overview== |
| ==X Ray== | | ==X Ray== |
| [[Diagnosis]] is normally done through [[x-ray]]s. This is possible because loss of cartilage, subchondral ("below cartilage") [[sclerosis]], subchondral [[cyst]]s, narrowing of the joint space between the articulating bones, and [[bone spur]] formation (osteophytes) show up clearly on x-rays. Plain films, however, often do not correlate well with the findings of physical examination of the affected joints.
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| With or without other techniques, such as [[Magnetic resonance imaging|MRI]] (magnetic resonance imaging), [[arthrocentesis]] and [[arthroscopy]], diagnosis can be made by a careful study of the duration, location, the character of the joint symptoms, and the appearance of the joints themselves. As yet, there are no methods available to detect OA in its early and potentially treatable stages.
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| In 1990, the [http://www.rheumatology.org/about/index.asp?aud=mem|American College of Rheumatology], using data from a multi-center study, developed a set of criteria for the based on hard tissue enlargement and swelling of certain joints. These criteria were found to be 92% [[sensitivity (tests)|sensitive]] and 98% [[specificity (tests)|specific]] for hand osteoarthritis versus other entities such as [[rheumatoid arthritis]] and [[spondyloarthropathy|spondyloarthropities]] <ref>{{cite journal |author=Altman R, Alarcón G, Appelrouth D, ''et al'' |title=The American College of Rheumatology criteria for the classification and reporting of osteoarthritis of the hand |journal=Arthritis Rheum. |volume=33 |issue=11 |pages=1601-10 |year=1990 |pmid=2242058 |doi=}}</ref>.
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| Since 80% of all people will have evidence of osteoarthritis (even when only 20% are experiencing pain) it is important to keep in mind that the mere presence of osteoarthritis on imaging studies does mean that osteoarthritis is where any individuals pain is coming from. Other factors such as muscle, nerve and ligament may be involved.
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| '''Erosive osteoarthritis'''
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| * X-rays of the hands usually reveal severe degenerative changes with [[osteophyte]]s and [[subchondral]] [[sclerosis]] at the DIP and PIP joints of the fingers, and the CMC and IP joints of the thumb.
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| * Central erosions due to destruction of articular cartilage are seen with relative sparing of the joint margins ('''Seagull sign''').
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| * [[Deformity]] at the distal joints with sparing of the MCPs can lead to mediolateral [[subluxation]] and [[contracture]]s.
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| <gallery>
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| Image:
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| Erosive-osteoarthritis-001.jpg
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| Image:
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| Erosive-osteoarthritis-002.jpg
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| Image:
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| Erosive-osteoarthritis-003.jpg
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| </gallery>
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| ==References==
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| {{reflist|2}}
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| {{WH}}
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| {{WS}}
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| [[Category:Rheumatology]] | | [[Category:Rheumatology]] |