Three-dimensional Ultrasound Imaging for Characterization of Synovitis in First Carpometacarpal Osteoarthritis
Abstract
First carpometacarpal osteoarthritis is one of the most common forms of OA and is a significant source of pain and disability for patients. Discrepancies between traditional imaging modalities and patient reported outcomes have led galvanized researchers to developing objective point of care based imaging tools for assessing OA progression and treatment response. This thesis aims to describe the development and validation of a semi-submerged mechanical three-dimensional ultrasound device against magnetic resonance imaging. The validation of the 3D US device was conducted on a series of imaging phantoms, as well as ten CMC1 OA patients. Two-raters manually segmented areas of synovial effusion and membrane hypertrophy during two separate sessions to evaluate intra- and inter-rater reliability. The results showed that 3D US had a strong concurrent validity with MRI and that it demonstrated excellent rater reliability, indicating its potential for clinical use. Additionally, this thesis explored the implications of synovitis morphology presented in 3D US images and investigated synovial tissue volume as a possible predictor of CMC1 OA stage as determined by x-ray radiographic grading systems. Eaton-Littler and OMERACT semi-quantitative grading systems were used to indicate OA and synovitis severity. These values were compared to patient reported pain and disability, pinch grip force, synovial tissue volume, age and sex to determine which would be the most significant indicator patient reported pain.US images of CMC1 synovitis were analyzed and three distinct morphologies were identified based on location, volume and features of synovial effusion and hypertrophy.