Three-Dimensional Ultrasound Imaging For Blood Flow Assessment In First Carpometacarpal Osteoarthritis

Osteoarthritis (OA) is a common joint disease, which frequently affects the first carpometacarpal (CMC1) joint in the thumb. Detection of early features of OA, including inflammation and vascular changes, can lead to improved disease assessment, diagnosis, and treatment. Current clinical imaging modalities, x-ray and magnetic resonance imaging, are limited by their soft tissue contrast, and accessibility, respectively. There is a clinical need for point-of-care imaging tools to improve OA care. This thesis reports on an investigation of the use of three-dimensional (3D) Doppler ultrasound (US) blood flow imaging and an assessment of the reliability of 3D US joint blood flow measures in CMC1 OA patients. Five healthy volunteers had 3D US imaging of their thumbs submerged in a water solution at increasing temperatures. Increased blood flow was observed with increased temperature, which informed future scanning with the 3D US system. Eighteen CMC1 OA patients had 3D US scans with blood flow detection and visualization of the thumb repeated twice to assess test-retest reliability. 3D joint blood flow volumes were determined from the 3D US images. The results showed that 3D US measures of inflammation and joint blood flow have excellent reliability. The development of 3D US scanning systems with Doppler imaging capability and quantitative measures of early features of OA provides tools to clinicians and researchers to further understand the disease and improve patient care.