Identify Finger Rotation Angles with ArUco Markers and Action Cameras

Measuring the motions of human hand joints is often a challenge due to the high number of degrees of freedom. In this study, we proposed a hand tracking system utilizing action cameras and ArUco markers to continuously measure the rotation angles of hand joints. Three methods were developed to estimate the joint rotation angles. The pos-based method transforms marker positions to a reference coordinate system (RCS) and extracts a hand skeleton to identify the rotation angles. Similarly, the orient-x-based method calculates the rotation angles from the transformed x-orientations of the detected markers in the RCS. In contrast, the orient-mat-based method first identifies the rotation angles in each camera coordinate system using the detected orientations, and then, synthesizes the results regarding each joint. Experiment results indicated that the repeatability errors with one camera regarding different marker sizes were around 2.64 to 27.56 degrees and 0.60 to 2.36 degrees using the marker positions and orientations respectively. When multiple cameras were employed to measure the joint rotation angles, the angles measured by using the three methods were comparable with that measured by a goniometer. Despite larger deviations occurred when using the pos-based method. Further analysis indicated that the results of using the orient-mat-based method can describe more types of joint rotations, and the effectiveness of this method was verified by capturing hand movements of several participants. Thus it is recommended for measuring joint rotation angles in practical setups.

Articular Syndrome Characteristics in Children with Mucopolysaccharidosis Type I

Background. Mucopolysaccharidosis type I is disease from the group of lysosomal storage disease developing due to mutations in the IDUA gene. It leads to the accumulation of glycosaminoglycans (GAGs) in organs and tissues. Joints damage in this disease is systemic and progressive.Objective. The aim of the study. Nowadays, relevant issue is to investigate the effects of various types of pathogenetic therapy on the state of the osteoarticular system in patients with severe and mild phenotypes of MPS I to prevent further progression of joint pathology.Methods. The study included 46 patients diagnosed with “mucopolysaccharidosis type I”. 35 children had severe phenotype (Hurler syndrome) and 11 — with mild phenotypes (Hurler-Scheie and Scheie syndromes). The onset age of clinical manifestations in osteoarticular system, the state of large and small joints, and the presence of cervical stenosis according to the therapy were evaluated in these patients.Results. The osteoarticular system pathology can be usually revealed in all patients with MPS I, in both mild and severe phenotypes. The contractures of shoulder, ulnar, wrist, and small hand joints have been revealed in most patients with Hurler syndrome, regardless of the administered therapy. Hip joints pathology was observed in children who was administered with: enzyme replacement therapy (ERT) — in 46.7% of cases, hematopoietic stem cell transplantation (HSCT) in combination with ERT — in 34.4% of cases. Patients with Hurler syndrome administered with HSCT in combination with ERT had cervical stenosis statistically significantly more rarely (p = 0.018) compared to patients treated with ERT only. Patients with Hurler syndrome who were on ERT had statistically significantly lower growth rates than patients after HSCT in combination with ERT. Lesions in ulnar, wrist, knee and small hand joints were the most common in children with mild phenotypes (in 90% of cases).Conclusion. Combined therapy (HSCT and ERT) in patients with Hurler syndrome reduces severe manifestations in osteoarticular system.

Elevated resting heart rate is associated with increased radiographic severity of knee but not hand joints

Although the resting heart rate (RHR) predicts the clinical outcomes of cardiovascular disease, chronic obstructive lung disease, diabetes mellitus, and the risk of cancer, its role in patients with musculoskeletal diseases, such as osteoarthritis (OA), remains unclear. We explored the association of the RHR with the extents of radiographic changes in the knees and hands of 2369 subjects from the Dong-gu Study. The radiographic hand and knee joint findings were graded semi-quantitatively; we calculated total hand and knee joint scores. Multiple linear regression was performed to examine the associations between the RHR and the radiographic characteristics of these joints. For the knee joints, the RHR was associated positively with the total (p < 0.01), osteophyte (p < 0.01), joint space narrowing (JSN; p < 0.01), and tibial attrition (p = 0.02) scores after adjustment for age, sex, body mass index, smoking status, alcohol consumption, educational and physical activity levels, and comorbidities. For the hand joints, the RHR was associated positively with the JSN (p = 0.01) and subchondral cyst (p < 0.01) scores after such adjustment. The RHR was not associated with the total, osteophyte, sclerosis, erosion, or malalignment score for the hand joints. This study is the first to reveal an association between the RHR and the radiographic severity of knee, but not hand, OA.

Sonographic and Duplex Evaluation of Synovial activity in Wrist and Hand Joints in Rheumatoid Arthritis

Background Rheumatoid arthritis is a long-term autoimmune disease and inflammatory disorder. The damaging effect on cartilage, bone, ligaments, and tendons has raised the importance of the accurate diagnosis of structural damage, disease activity and severity assessment to enable therapeutic decisions and to evaluate disease outcome. US is non invasive, relatively cheap and widely accessible imaging tool that facilitates the detection of synovitis joint effusin and erosions more better than clinical, laboratory investigations alone and x-ray. Aim of the Work assess the role of of gray-scale and Doppler ultrasound early detection and characterization of synovitis and structural bone changes in wrist and hand joints in patients with Rheumatoid Arthritis by comparing qualitative and quantitative US parameters with clinical and laboratory indicators of disease activity. Patients and Methods A cross sectional study conducted onthirty five adult patients with RA . All the patients were diagnosed according to the 2010 ACR/European League . The patients were recruited from the Rheumatology and Rehabilitation Outpatient Clinic, Faculty of Medicine, Ain Shams Hospitals .The study was approved by the ethical committee, and consents were taken from all patients enrolled in the study. Patients assessed by history taking, Clinical examination, Laboratory investigations and US gray scale and US power Doppler was done for each patient. Results This study included 35 patients with established RA, 27 females (77.1%) and 8 males (22.9%). Ranged in age between 20-70 years with mean age [45.66±12.76],the mean CDAS28 was [4.62±1.37], ESR [44.93±20.79], CRP [15.92±9.03], 33 patients (94.3%) were found to have synovial thickening, 14 patient (40%) were found to have increased vascularity by PD, joint effusion was detected in 12 patient (34.3%) particularly in MCP joints, 13 (37.1%) had bone erosion and only 9 patients (25.7%) had Tenosynovitis, most of them were detected at the extensor compartment of the wrist joint.positive correlations found between the clinical disease activity indices, laboratory investigations, duration of illness and components of the US findings. Conclusion Ultrasound is non invasive, relatively cheap and widely accessible imaging tool that facilitates the detection of synovitis and erosions,, high resolution gray scale images combined with Doppler technique have made it possible to detect slow low volume blood flow, thus improving the outcome of the standard clinical assessment in Rheumatoid synovial inflammation.

Metabolic Syndrome and Osteoarthritis Distribution in the Hand Joints: A Propensity-Score Matched Analysis from Osteoarthritis Initiative

Objective To investigate the metabolic syndrome (MetS) association with radiographic and symptomatic hand osteoarthritis (OA). Methods Using 1:2 propensity-score-matching for relevant confounders, we included 2509 (MetS+896: MetS–1613) participants from the Osteoarthritis Initiative dataset. MetS and its components, according to the International Diabetes Federation criteria, were extracted from baseline data, including hypertension, abdominal obesity, dyslipidemia, and diabetes. We scored distinct hand joints based on modified Kellgren–Lawrence grade (mKL) of baseline radiographs, with OA defined as mKL≥2. In the cross-sectional analysis, we investigated the association between MetS and its components with radiographic hand OA and the presence of nodal and erosive OA phenotypes using regression models. In the longitudinal analysis, we performed Cox regression analysis for hand pain incidence in follow-up visits. Results MetS was associated with higher odds of radiographic hand OA, including the number of joints with OA (odds ratio, 95%confidence interval:1.32, 1.08–1.62), the sum of joints mKLs (2.42, 1.24–4.71), mainly in distal and proximal interphalangeal joints (DIPs:1.52, 1.08–2.14, PIPs:1.38, 1.09–1.75), but not metacarpophalangeal (MCP) and first carpometacarpal (CMC1) joints. Hand pain incidence during follow-up was higher with MetS presence (hazard ratio, 95%CI:1.25, 1.07–1.47). Erosive hand OA phenotype and joints' nodal involvement were more frequent with MetS (1.40, 1.01–1.97, and 1.28, 1.02–1.60). Conclusion MetS, a potentially modifiable risk factor, is associated with radiographic DIP and PIP OA and longitudinal hand pain incidence while sparing MCPs and CMC1. Nodal and erosive OA phenotypes are associated with MetS, suggestive of possible distinct pathophysiology.

POS1062 ULTRASOUND ASSESSMENT OF SUB-CLINICAL HAND JOINT SYNOVITIS: A COMPARATIVE STUDY BETWEEN PSORIATIC AND RHEUMATOID ARTHRITIS

Background:Ultrasound (US) detected subclinical synovitis can be present in early psoriatic arthritis (PsA) and rheumatoid arthritis (RA), and also in patients fulfilling clinical remission criteria[1-2]. Numerous evidences support that the persistence of subclinical synovitis detected by US is associated with a high risk of disease progression [2-3].Objectives:To evaluate sub-clinical synovitis of PsA and RA at the level of small joints of the hand and wrist by B-mode and Power Doppler US.Methods:21 patients of early PsA and 25 patients of early RA (no clinical evidence of hand joint involvement, PsA disease duration <2 years, and RA disease duration <1 year) were recruited. DAS28 and DAPSA score used for assessment of articular disease activity for RA and PsA, respectively. US [grey scale (GS) and power Doppler (PD)] was performed to assess synovitis of bilateral wrists, metacarpophalangeal joints, proximal and distal interphalangeal joints, altogether 30 joints. A GS score ≥2 and/or a PD score ≥1 were used to identify US detected synovitis.Results:A total of 25 patients were included in the RA group, including 5 males and 20 females. A total of 21 patients were included in the PsA group, including 7 males and 14 females. There were no significant differences in gender composition, age, and duration of disease between the two groups (P>0.05) (Table 1). 14 (66.67%) PsA patients and 12 (48%) RA patients had sub-clinical hand joint synovitis. Among 630 hand joints scanned in PsA group, 49 (7.78%) joints showed evidence of sub-clinical synovitis. Wrist joint was most commonly involved (24.49%), followed by MCP3 (14.29%), MCP1 (12.24%) and DIP3 (10.20%). Among 750 hand joints scanned in RA group, 110 (14.67%) joints showed evidence of sub-clinical synovitis. Wrist joint was most commonly involved (60.00%), followed by MCP3 (8.24%), MCP1 (8.24%) and MCP2 (7.06%). No correlation noted between numbers of joints with subclinical synovitis with DAPSA and DAS28 score. There was no correlation between number of joints with sub-clinical synovitis and disease activity indices.Conclusion:Almost two-thirds patients with PsA and half patients with RA had US evidence of sub-clinical synovitis in wrist and hand joints, most commonly in wrist. There are some similarities in the joint involvement of sub-clinical synovitis between RA and PsA, physicians should take this into account in clinical work.Table 1.Demographic characteristics of RA and PsA patientsRA (n=25)PsA (n=21)PFemale, n(%)20 (80.00%)14 (66.67%)0.305Age, years, mean±SD56.32±12.1854.31±15.820.637Disease duration, years, mean±SD1.06±0.590.90±0.580.363References:[1]Freeston JE, Coates LC, Nam JL, Moverley AR, Hensor EM, Wakefield RJ, et al. Is there subclinical synovitis in early psoriatic arthritis? A clinical comparison with gray-scale and power Doppler ultrasound. Arthritis care & research 2014, 66:432-439.[2]Kawashiri SY, Suzuki T, Nakashima Y, Horai Y, Okada A, Iwamoto N, et al. Ultrasonographic examination of rheumatoid arthritis patients who are free of physical synovitis: Power doppler subclinical synovitis is associated with bone erosion. Rheumatology (Oxford), 2014, 53:562-569.[3]Vreju FA, Filippucci E, Gutierrez M, Di Geso L, Ciapetti A, Ciurea ME, et al. Subclinical ultrasound synovitis in a particular joint is associated with ultrasound evidence of bone erosions in that same joint in rheumatoid patients in clinical remission. Clinical and experimental rheumatology, 2016, 34:673-678.Acknowledgements:This work was supported by National Natural Science Foundation of China (No. 82071930 and 81571684).Disclosure of Interests:None declared.

Increased adiponectin levels are associated with higher radiographic scores in the knee joint, but not in the hand joint

Several studies have evaluated the association between serum adiponectin levels and knee and hand osteoarthritis (OA); mixed results have been reported. We investigated the relationship between OA and serum adiponectin levels according to the radiographic features of knee and hand OA. A total of 2402 subjects was recruited from the Dong-gu Study. Baseline characteristics were collected via a questionnaire, and X-rays of knee and hand joints were scored using a semi-quantitative grading system. The relationship between serum adiponectin levels and radiographic severity was evaluated by linear and logistic regression analysis. Subjects in the higher serum adiponectin levels tertiles were older and had a lower body mass index (BMI) than those in the lower tertiles. Regarding knee joint scores, serum adiponectin levels was positively associated with the total (P < 0.001), osteophyte (P = 0.003), and joint space narrowing (JSN) scores (P < 0.001) after adjustment for age, sex, BMI, smoking, alcohol consumption, education, and physical activity. In terms of hand joint scores, no association was found between serum adiponectin levels and the total, osteophyte, JSN, subchondral cyst, sclerosis, erosion, or malalignment score after the above-mentioned adjustments. Similarly, subjects with serum adiponectin levels above the median had higher total radiographic scores in the knee joints, but not in the hand joints, after adjustment. An increased serum adiponectin levels was associated with a higher radiographic score in the knee joint, but not in the hand joint, suggesting the involvement of different pathophysiologic mechanisms in the development of OA between those joints.