Association of Clinical Assessments of Hand Function and Quantitative Ultrasound Metrics in First Carpometacarpal Osteoa
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ORIGINAL ARTICLE
Association of Clinical Assessments of Hand Function and Quantitative Ultrasound Metrics in First Carpometacarpal Osteoarthritis O. Kenechi Nwawka, MD
& Gwen
Weinstock-Zlotnick, PH.D, OTR/L, CHT & Bin Lin, Sc.M & Lydia M. Ko, MPH
Received: 15 April 2020/Accepted: 20 August 2020/ * Hospital for Special Surgery 2020
Abstract Background: Thumb carpometacarpal (CMC) osteoarthritis (OA), a degenerative condition affecting hand use, is typically evaluated through radiographs and clinical examination. Although this can determine treatment, it is difficult to evaluate functional limitations. Shear wave elastography (SWE) is a quantitative ultrasound technique that characterizes tissue stiffness. Questions/Purposes: This pilot study aimed to establish data of the SWE findings in the thenar eminence muscles in patients with first CMC OA and correlate these findings with the clinical tests of hand function. Methods: This cross-sectional study correlated the SWE stiffness of thenar eminence muscles to clinical tests of hand function in patients with first CMC OA and in asymptomatic control subjects, using Spearman’s correlation coefficient. Mean SWE values of the thenar eminence muscles in patients were compared with those in control subjects. The study was performed in a non-profit tertiary care hospital setting. Patients and control subjects were recruited on a volunteer basis. Results: SWE values in the abductor pollicis Level of Evidence: Level IV: Cross-sectional Study Electronic supplementary material The online version of this article (https://doi.org/10.1007/s11420-020-09795-z) contains supplementary material, which is available to authorized users. O. K. Nwawka, MD (*) : B. Lin, Sc.M : L. M. Ko, MPH Department of Radiology and Imaging, Hospital for Special Surgery, 535 East 70th Street, 3rd Floor, New York, NY 10021, USA e-mail: [email protected] O. K. Nwawka, MD Department of Radiology, Weill Cornell Medicine, New York, NY, USA G. Weinstock-Zlotnick, PH.D, OTR/L, CHT Department of Rehabilitation, Hospital for Special Surgery, New York, NY, USA
brevis and flexor pollicis brevis muscles showed moderate to very strong correlation with multiple measures of hand function. Mean SWE values of the thenar eminence muscles in first CMC OA patients were lower than those in asymptomatic control subjects. Conclusions: Correlations between mean SWE values in the thenar eminence muscles and clinical measures of hand function suggest decreased function in subjects with less stiff thenar eminence muscles. KEYWORDS thumb . hand
ultrasound . elastography . osteoarthritis .
Introduction Osteoarthritis (OA) of the thumb carpometacarpal (CMC) joint affects greater than 30% of the general population, with a higher prevalence in women [5, 9]. Thumb CMC OA, typically idiopathic in etiology, leads to pain and functional impairment that if non-surgical measures fail to reverse may require surgery. The current modality of choice for imaging and evaluating CMC OA is radiographs and clinical examinations. However, radiograp
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