A systematic review of the association between ultrasound-detected features and laboratory inflammatory biomarkers in hand osteoarthritis.

Objectives: To systematically review observational studies for the relationship between ultrasound (US)-detected features and laboratory inflammatory biomarkers in hand osteoarthritis (OA).

Methods: A systematic literature search was performed in MEDLINE, EMBASE, CINAHL, and Web of Science from their inception to June 2025 to identify relevant observational studies. Study quality was evaluated using the Newcastle-Ottawa Scale (NOS), with two independent reviewers validating the papers. Correlation coefficients and corresponding confidence intervals and P values between US-detected features and biomarkers were extracted and analysed.

Results: Out of 5,128 citations, four studies (546 participants, 91.75% female, mean age 56.1-66.3 years) scored >5 on the NOS. Significant correlations ( = 0.3-0.57) were found between serum inflammatory markers (e.g. TNF, MIP-β, PDGF-bb, IP-10) and grey-scale synovitis (GSS) specifically in erosive hand OA. No significant correlations were observed between other US-detected features (e.g. power Doppler (PD) signals, osteophytes (OST), effusion, cartilage thickness) and inflammatory biomarkers, with coefficients generally <0.2.

Conclusion: These findings highlight a critical gap in research linking US-detected features and serum inflammatory markers in hand OA. While some evidence suggests that US-detected GSS may reflect subclinical inflammation, particularly in erosive hand OA, inconsistent results across studies underscore the need for larger, standardised research to support phenotyping and inform targeted diagnostic and therapeutic strategies.