Validation of HAND OA US inflammatory and structural damage score (HOUSE) for thumb-base joints: systematic review on truth and discrimination

Abstract

Objectives: Recently, the HAND OA US Examination (HOUSE) inflammatory and structural damage scores were developed by the OMERACT US Working Group. However, the thumb base was not, or was only partly, included. This systematic review examines US scoring methods and scanning techniques assessing thumb-base OA, alongside existing evidence on validity, reliability and responsiveness.

Methods: A comprehensive search strategy in three different databases identified 30 eligible studies.

Results: In general, studies predominantly focused on US assessment of the CMC1 joint, with fewer investigating the scaphotrapeziotrapezoid (STT) joint. Most studies utilized a semiquantitative scale for scoring structural and inflammatory features, aligning with the HOUSE scoring system. Validity was supported by a limited number of studies, with one demonstrating a positive association between US structural damage and radiographic damage, and another showing a similar association with function. Associations between US inflammatory features and pain were observed, albeit with some variability. Reliability was from moderate to good for the CMC1 joint but limited for the STT joint. Responsiveness varied across studies. The methodological quality of included studies varied, indicating areas for future research improvement.

Conclusion: While promising, additional research is necessary to validate the HOUSE scoring system and improve its clinical utility for thumb-base OA assessment. Future research should concentrate on optimal scanning positions and on the reliability and responsiveness of the HOUSE scoring system.

Keywords: discrimination; hand; osteoarthritis; thumb; truth; ultrasound.