Characterizing the Structure-Function Relationship of Hand Osteoarthritis Using Dynamic and High Resolution CT Imaging

Osteoarthritis (OA) is the most common form of arthritis and affects the trapeziometacarpal (TMC) joint. While the etiology of OA is still not fully understood, it is a multifactorial disease with biomechanical factors associated in its development. The thumb is estimated to account for over 40% of the hand’s entire function, largely due to the TMC joint. A better understanding of structural and functional changes in TMC OA may improve our understanding of this degenerative joint disease. A recent advancement in computed tomography (CT) now allows for imaging moving joints in vivo. This technique, termed dynamic CT, provides a unique opportunity to quantify joint biomechanics in vivo. In this thesis, novel methodologies are presented that improve processing of dynamic and high-resolution peripheral quantitative CT (HRpQCT) scans. These methodologies allow for semi-automated quantification of joint space and bone mineral density (BMD) in HR-pQCT scans and biomechanical outcomes from dynamic CT. The methodologies developed in this dissertation drastically reduce processing time for dynamic CT scans compared to previous literature. A cross-sectional study is presented that utilizes HR-pQCT to measure joint space (JS) changes in hand OA, the first of its kind. Maximum JS was significantly greater in OA than controls in the second and third distal interphalangeal (DIP2, DIP3) joints (DIP2: 2.07 mm vs. 1.88 mm; DIP3: 2.01 mm vs. 1.86 mm), and decreased hand function and increased hand disability were associated with increased radiographic TMC OA. A study was conducted to characterize normal TMC joint biomechanics in vivo using the presented methodologies. BMD was computed in anatomical quadrants of the TMC joint, and it was found that the radial-volar quadrant of the first metacarpal (426 mg HA/cm³) and ulnar-volar quadrant of the trapezium (373 mg HA/cm³) were significantly greater than other quadrants. When compared with proximity maps from dynamic CT, areas with high contact corresponded to quadrants with higher BMD. The results from this dissertation provide methodologies to analyze bone and joint changes with HR-pQCT and dynamic CT to better understand hand osteoarthritis.

Year	Entry
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Year

Entry

in press

Mattes D, Haynor DR, Vesselle H, Lewellen TK, Eubank W. Nonrigid multimodality image registration. In: Sonka M, Hanson KM, eds. Medical Imaging 2001: Image Processing.1609-1620. Proceedings of the SPIE; vol 4322.

1990

Kwan MK, Lai WM, Mow VC. A finite deformation theory for cartilage and other soft hydrated connective tissues, I: equilibrium results. J Biomech. 1990;23(2):145-155.

1983

Grood ES, Suntay WJ. A joint coordinate system for the clinical description of three-dimensional motions: application to the knee. J Biomech Eng. May 1983;105(2):136-144.

2008

Lawrence RC, Felson DT, Helmick CG, Arnold LM, Choi H, Deyo RA, Gabriel S, Hirsch R, Hochberg MC, Hunder GG, Jordan JM, Katz JN, Kremers HM, Wolfe F; National Arthritis Data Workgroup. Estimates of the prevalence of arthritis and other rheumatic conditions in the United States: part II. Arthritis Rheum. January 2008;58(1):26-35.

2006

Yushkevich PA, Piven J, Hazlett HC, Smith RG, Ho S, Gee JC, Gerig G. User-guided 3D active contour segmentation of anatomical structures: significantly improved efficiency and reliability. NeuroImage. July 1, 2006;31(3):1116-1128.