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Álvarez B, Montero A, Alonso R, Valero J, López M, Ciérvide R, Sánchez E, Hernando O, García-Aranda M, Martí J, Prado A, Chen-Zhao X, Rubio C. Low-dose radiation therapy for hand osteoarthritis: shaking hands again? Clin Transl Oncol 2021; 24:532-539. [PMID: 34585316 DOI: 10.1007/s12094-021-02710-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 09/13/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Hand osteoarthritis (HOA) is one of the most common causes of pain and functional disability in western countries and there is still no definitive cure. Low-dose radiation therapy (LDRT) has anti-inflammatory properties that have shown to be effective in the symptomatic relief of various degenerative musculoskeletal disorders. We designed a clinical protocol using LDRT for symptomatic HOA and present results and tolerance in the first 100 patients included. MATERIALS AND METHODS Between April 2015 and March 2021, 100 patients with a median age of 60 were treated. Fifty-seven patients suffering from proximal/distal interphalangeal joint pain, 40 patients with thumb arthritis, 2 patients with radiocarpal joint affection and 1 patient with metacarpophalangeal joint pain were enrolled. LDRT comprised of 6 fractions of 0.5-1 Gy on every other day up to a total dose of 3-6 Gy. Clinical response was evaluated according to the visual analog scale (VAS) for pain level and the von Pannewitz score (VPS) for joint functionality. Any patients not achieving subjective adequate pain relief after 8 weeks of treatment were offered a second identical LDRT course. RESULTS With a median follow-up of 10.5 months (range 7.55-12.45), 94% reported an improvement in the pain, with a significant reduction in the VAS level after 3, 6 and 12 months (p < 0.001). Sixty-three patients needed a second course of treatment at a median time interval of 12 weeks (range 9-14). The mean VAS score before treatment was 8 (range 3-10). After treatment, it was 5 (range 1-10). After 3, 6 and 12 months, the mean VAS scores were 4 (range 0-9), 3 (range 0-9) and 3.5 (range 0-9), respectively. Seventy patients reported functionality improvements after LDRT according to the von Pannewitz score. No acute or late complications were observed. CONCLUSION LDRT appears to be safe and useful for HOA and is associated with good rates of pain relief and functionality improvements. However, further studies are necessary to confirm these promising results.
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Affiliation(s)
- B Álvarez
- Department of Radiation Oncology, HM Hospitales, Calle Oña 10, 28050, Madrid, Spain
| | - A Montero
- Department of Radiation Oncology, HM Hospitales, Calle Oña 10, 28050, Madrid, Spain.
| | - R Alonso
- Department of Radiation Oncology, HM Hospitales, Calle Oña 10, 28050, Madrid, Spain
| | - J Valero
- Department of Radiation Oncology, HM Hospitales, Calle Oña 10, 28050, Madrid, Spain
| | - M López
- Department of Radiation Oncology, HM Hospitales, Calle Oña 10, 28050, Madrid, Spain
| | - R Ciérvide
- Department of Radiation Oncology, HM Hospitales, Calle Oña 10, 28050, Madrid, Spain
| | - E Sánchez
- Department of Radiation Oncology, HM Hospitales, Calle Oña 10, 28050, Madrid, Spain
| | - O Hernando
- Department of Radiation Oncology, HM Hospitales, Calle Oña 10, 28050, Madrid, Spain
| | - M García-Aranda
- Department of Radiation Oncology, HM Hospitales, Calle Oña 10, 28050, Madrid, Spain
| | - J Martí
- Department of Medical Physics, HM Hospitales, Madrid, Spain
| | - A Prado
- Department of Medical Physics, HM Hospitales, Madrid, Spain
| | - X Chen-Zhao
- Department of Radiation Oncology, HM Hospitales, Calle Oña 10, 28050, Madrid, Spain
| | - C Rubio
- Department of Radiation Oncology, HM Hospitales, Calle Oña 10, 28050, Madrid, Spain
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Öncel A, Küçükşen S, Ecesoy H, Sodali E, Yalçin Ş. Comparison of efficacy of fluidotherapy and paraffin bath in hand osteoarthritis: A randomized controlled trial. Arch Rheumatol 2021; 36:201-209. [PMID: 34527924 PMCID: PMC8418774 DOI: 10.46497/archrheumatol.2021.8123] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 08/09/2020] [Indexed: 01/01/2023] Open
Abstract
Objectives
This study aims to compare the efficacy of paraffin bath therapy and fluidotherapy on pain, hand muscle strength, functional status, and quality of life (QoL) in patients with hand osteoarthritis (OA). Patients and methods
This prospective randomized controlled study included 77 patients (8 males, 69 females; mean age: 63.1±10.3 years; range 39 to 88 years) with primary hand OA who applied between July 2017 and March 2018. The patients were randomized into two groups with the sealed envelope method: Paraffin bath therapy (20 min, one session per day, for two weeks) was applied for 36 patients whereas 41 patients received fluidotherapy for the same period. The pain severity of the patients, both at rest and during activities of daily living (ADL) within the last 48 hours was questioned and scored using Visual Analog Scale. Duruöz Hand Index (DHI) was used to evaluate hand functions. Gross grip strength was measured using Jamar dynamometer whereas fine grip strength was measured using pinch meter in three different positions (lateral pinch, tip pinch, and palmar pinch). The 36-Item Short Form (SF-36) was used to analyze the QoL. All measurements were performed before, immediately after, and three months after treatment. Results
Improvement was observed in pain score at rest and during ADL, DHI scores, gross and fine grip strengths, and SF-36 subscores in both groups after treatment. However, no significant difference was observed between the groups. Conclusion Both fluidotherapy and paraffin bath therapy have been found to have positive effects on pain, hand muscle strength, functional status, and QoL in the treatment of hand OA. However, no superiority was observed between the two treatment modalities.
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Affiliation(s)
- Adil Öncel
- Department of Physical Medicine and Rehabilitation, Sultanbeyli State Hospital, Istanbul, Turkey
| | - Sami Küçükşen
- Department of Physical Medicine and Rehabilitation, Necmettin Erbakan University Medical School, Konya, Turkey
| | - Hilal Ecesoy
- Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Necmettin Erbakan University Medical School, Konya, Turkey
| | - Emre Sodali
- Department of Physical Medicine and Rehabilitation, Sabuncuoğlu Training and Research Hospital, Amasya, Turkey
| | - Şevket Yalçin
- Department of Physical Medicine and Rehabilitation, İpekyolu Hospital, Mardin, Turkey
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Gløersen M, Steen Pettersen P, Maugesten Ø, Mulrooney E, Mathiessen A, Gammelsrud H, Hammer HB, Neogi T, Ohrndorf S, Faraj K, Sjølie D, Slatkowsky-Christensen B, Kvien TK, Haugen IK. Study protocol for the follow-up examination of the Nor-Hand study: A hospital-based observational cohort study exploring pain and biomarkers in people with hand osteoarthritis. OSTEOARTHRITIS AND CARTILAGE OPEN 2021; 3:100198. [PMID: 36474811 PMCID: PMC9718069 DOI: 10.1016/j.ocarto.2021.100198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 07/24/2021] [Accepted: 07/26/2021] [Indexed: 11/16/2022] Open
Abstract
Objective This study aims to increase the understanding of pain mechanisms in hand OA and explore potential risk factors for pain development or worsening in a biopsychosocial framework. Another important aim is to validate potential soluble and imaging OA biomarkers. Design The follow-up examination of the Nor-Hand hospital-based observational cohort study started in October 2019 and was completed in May 2021. In total, 212 of the 300 participants with hand OA who were examined at baseline attended the follow-up study. The participants underwent clinical joint examinations, medical and functional assessments, quantitative sensory testing, fluorescence optical imaging, ultrasound of the hands, acromioclavicular joints, feet, knees and hips, conventional radiographs of the hands and feet and magnetic resonance imaging of the dominant hand. Blood and urine samples were collected, and all participants answered questions about demographic factors and OA-related questionnaires. Associations between disease variables and symptoms will be examined in cross-sectional and longitudinal analyses. Longitudinal analyses will be performed to assess the predictive value of baseline variables on hand OA outcomes. Conclusion Current knowledge about predictors for disease progression in hand OA is limited, but with longitudinal data we will be able to explore the predictive value of baseline variables on hand OA outcomes, such as changes in patient-reported outcomes or changes in soluble and imaging biomarkers. This provides a unique opportunity to gain more knowledge about the natural disease course of hand OA.
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Affiliation(s)
- Marthe Gløersen
- Division of Rheumatology and Research, Diakonhjemmet Hospital, Oslo, Norway
- University of Oslo, Faculty of Medicine, Oslo, Norway
| | - Pernille Steen Pettersen
- Division of Rheumatology and Research, Diakonhjemmet Hospital, Oslo, Norway
- University of Oslo, Faculty of Medicine, Oslo, Norway
| | - Øystein Maugesten
- Division of Rheumatology and Research, Diakonhjemmet Hospital, Oslo, Norway
- University of Oslo, Faculty of Medicine, Oslo, Norway
| | - Elisabeth Mulrooney
- Division of Rheumatology and Research, Diakonhjemmet Hospital, Oslo, Norway
- University of Oslo, Faculty of Medicine, Oslo, Norway
| | | | - Heidi Gammelsrud
- Division of Rheumatology and Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Hilde Berner Hammer
- Division of Rheumatology and Research, Diakonhjemmet Hospital, Oslo, Norway
- University of Oslo, Faculty of Medicine, Oslo, Norway
| | - Tuhina Neogi
- Section of Rheumatology, Boston University School of Medicine, Boston, United States
| | - Sarah Ohrndorf
- Department of Rheumatology and Clinical Immunology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Karwan Faraj
- Department of Radiology, Diakonhjemmet Hospital, Oslo, Norway
| | - Dag Sjølie
- Department of Radiology, Diakonhjemmet Hospital, Oslo, Norway
| | | | - Tore Kristian Kvien
- Division of Rheumatology and Research, Diakonhjemmet Hospital, Oslo, Norway
- University of Oslo, Faculty of Medicine, Oslo, Norway
| | - Ida Kristin Haugen
- Division of Rheumatology and Research, Diakonhjemmet Hospital, Oslo, Norway
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Current Epidemiology and Risk Factors for the Development of Hand Osteoarthritis. Curr Rheumatol Rep 2021; 23:61. [PMID: 34216294 DOI: 10.1007/s11926-021-01025-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/22/2021] [Indexed: 12/23/2022]
Abstract
PURPOSE OF REVIEW Hand osteoarthritis (hand OA), the most common peripheral arthritis in the world, is less studied than osteoarthritis (OA) of the knee and hip. However, it is uniquely situated to offer novel insight into OA as a disease process by removing weight-bearing as a confounder of systemic disease mechanisms. Here we review the epidemiology of hand OA and key risk factors for its development. RECENT FINDINGS Mounting evidence points to obesity as an important risk factor for hand OA development, with new evidence implicating a role for leptin and serum fatty acids. Disease progression in hand OA and specifically the erosive OA subtype may be associated with diabetes. New evidence supports an association between cardiovascular disease progression and symptomatic hand OA. Alcohol use may be associated with increased synovitis and erosive hand OA. Differences in ethnical distributions of hand OA have become more apparent, with a lower prevalence in Black patients compared to White patients. Novel genetic insights implicating the WNT gene pathway and IL-1β have led to novel potential targets in hand OA pathogenesis. Hand OA is a heterogeneous disease with many modifiable and non-modifiable risk factors that can determine disease severity and shed light on disease pathogenesis.
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Initial stages of hand osteoarthritis do not affect the extrinsic muscles of the hand: a cross-sectional study. Sci Rep 2021; 11:5381. [PMID: 33686217 PMCID: PMC7970882 DOI: 10.1038/s41598-021-85054-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 02/19/2021] [Indexed: 02/07/2023] Open
Abstract
The objective of this study was to verify whether women in the initial stages of hand osteoarthritis (HOA) already have impaired grip strength and flexor and extensor torque of the wrist compared to healthy women. It also aimed to correlate these variables with pain, stiffness, and function of the hand. Twenty-six women were divided into a control group [CG, n = 13; 56 (51–61) years old] and a hand osteoarthritis group [HOAG, n = 13; 58 (53–63) years old]. Grades II and III were included in the HOA group according to the criteria of Kellgren and Lawrence. All volunteers answered an initial assessment form, the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire and the Australian/Canadian Hand Osteoarthritis Index (AUSCAN). The grip strength and isometric wrist flexor and extensor torque were evaluated by a hydraulic dynamometer. Comparisons between groups used Student’s t test for independent samples and the Mann–Whitney test. Spearman's correlation was used to correlate grip strength and flexor and extensor wrist torque to the degree of disease and DASH and AUSCAN scores. There were no differences between the groups in grip strength or flexor and extensor torque values. In terms of the DASH and the AUSCAN, the HOA group had higher scores, indicating worse hand function. A strong negative correlation was found between grip strength and the degree of HOA (r = − 0.70, p = 0.008), and a moderate positive correlation was found between flexor torque and the degree of HOA (r = 0.53, p = 0.05). The pain (r = − 0.61, p = 0.02) and function (r = − 0.66, p = 0.01) sections of the AUSCAN correlated negatively with grip strength. Pain can be an important feature in the HOA rehabilitation process, as it can influence handgrip strength and function. It is important that rehabilitation is implemented as soon as possible to guarantee the maintenance of strength and function since with the severity of the disease, patients tend to have deficits in grip strength and function.
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Sellam J, Maheu E, Crema MD, Touati A, Courties A, Tuffet S, Rousseau A, Chevalier X, Combe B, Dougados M, Fautrel B, Kloppenburg M, Laredo JD, Loeuille D, Miquel A, Rannou F, Richette P, Simon T, Berenbaum F. The DIGICOD cohort: A hospital-based observational prospective cohort of patients with hand osteoarthritis - methodology and baseline characteristics of the population. Joint Bone Spine 2021; 88:105171. [PMID: 33689840 DOI: 10.1016/j.jbspin.2021.105171] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Accepted: 02/17/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Despite its prevalence, there are few worldwide hand osteoarthritis (HOA) cohorts. The main objective of DIGItal COhort Design (DIGICOD) cohort is to investigate prognostic clinical, biological, genetic and imaging factors of clinical worsening after 6years follow-up. METHODS DIGICOD is a hospital-based prospective cohort including patients>35years-old with symptomatic HOA fulfilling: (i) ACR criteria for HOA with≥2 symptomatic joints among proximal/distal interphalangeal joints or 1st interphalangeal joint with Kellgren-Lawrence (KL)≥2; or (ii) symptomatic thumb base OA with KL≥2. Main exclusion criteria were inflammatory arthritis and crystal arthropathies. Annual clinical evaluations were scheduled with imaging (X-rays of the hands and of other OA symptomatic joints) and biological sampling every 3years. Hand radiographs are scored using KL and anatomical Verbruggen-Veys scores. Follow-up visits are ongoing. Cohort methodology and baseline characteristics are presented. RESULTS Between April 2013 and June 2017, from the 436 HOA included patients, 426 have been analysed of whom 357 (84%) are women. Mean age±standard deviation was 66.7±7.3years and mean disease duration was 12.6±9.6years. Metabolic syndrome affected 151 (36.5%) patients. Mean Visual Analog Scale (VAS) hand pain (0-100mm) was 44.4±26.7mm at activity. Mean FIHOA (0-100) was 19.9±18.6. Elevated serum CRP level (≥5mg/L) involved 10% patients. Mean KL score (0-128) was 46.7±18 and the mean number of joint with KL≥2 was 15.1±6.3. Erosive HOA (defined as≥1 Erosive or Remodeling phase joint according to Verbruggen-Veys score) involved 195/426 (45.8%) patients and the median number (interquartile range) of erosive joints in erosive patients was 3.0 (1.0-5.0). CONCLUSION DIGICOD is a unique prospective HOA cohort with a long-term 6years standardized assessment and has included severe radiologically HOA patients with a high prevalence of erosive disease.
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Affiliation(s)
- Jérémie Sellam
- Assistance Publique-Hôpitaux de Paris (AP-HP), Sorbonne Université, Service de rhumatologie, Hôpital Saint-Antoine, Paris, France; Centre de Recherche Saint-Antoine, Inserm URMS_938, Paris, France
| | - Emmanuel Maheu
- Assistance Publique-Hôpitaux de Paris (AP-HP), Sorbonne Université, Service de rhumatologie, Hôpital Saint-Antoine, Paris, France
| | - Michel D Crema
- Institut d'Imagerie du Sport, Institut National du Sport, de l'Expertise et de la Performance (INSEP), Paris, France
| | - Amel Touati
- AP-HP, Sorbonne Université, Service de Pharmacologie Clinique et Plateforme de Recherche Clinique de l'Est Parisien (URCEST, CRB, CRC), Hôpital Saint-Antoine, Paris, France
| | - Alice Courties
- Assistance Publique-Hôpitaux de Paris (AP-HP), Sorbonne Université, Service de rhumatologie, Hôpital Saint-Antoine, Paris, France; Centre de Recherche Saint-Antoine, Inserm URMS_938, Paris, France
| | - Sophie Tuffet
- AP-HP, Sorbonne Université, Service de Pharmacologie Clinique et Plateforme de Recherche Clinique de l'Est Parisien (URCEST, CRB, CRC), Hôpital Saint-Antoine, Paris, France
| | - Alexandra Rousseau
- AP-HP, Sorbonne Université, Service de Pharmacologie Clinique et Plateforme de Recherche Clinique de l'Est Parisien (URCEST, CRB, CRC), Hôpital Saint-Antoine, Paris, France
| | - Xavier Chevalier
- AP-HP, UPEC, Service de rhumatologie, Hôpital Henri-Mondor, Paris, France
| | - Bernard Combe
- Département de rhumatologie, CHU, Université de Montpellier, Montpellier, France
| | - Maxime Dougados
- AP-HP, Service de rhumatologie, Université de Paris, Service de rhumatologie, Hôpital Cochin, Paris, France
| | - Bruno Fautrel
- AP-HP, Sorbonne Université, Service de rhumatologie, Hôpital Pitié-Salpêtrière, Paris, France
| | - Margreet Kloppenburg
- Departments of Rheumatology and Clinical Epidemiology, Leiden University Medical Center, Leiden, Netherlands
| | - Jean-Denis Laredo
- Service de radiologie, Université de Paris, Hôpital Lariboisière, Paris, France
| | | | - Anne Miquel
- AP-HP, Sorbonne Université, Service de radiologie, Hôpital Saint-Antoine, Paris, France
| | - François Rannou
- Service de Rééducation et de Réadaptation de l'Appareil Locomoteur et des Pathologies du Rachis, AP-HP, Centre-Université de Paris, Hôpital Cochin, Paris, France; Université de Paris, Faculté de Santé, UFR de Médecine, Université de Paris, 75006 Paris, France; INSERM UMRS-1124, Toxicité Environnementale, Cibles Thérapeutiques, Signalisation Cellulaire et Biomarqueurs (T3S), Campus Saint-Germain-des-Prés, Paris, France
| | - Pascal Richette
- AP-HP, Université de Paris, Service de rhumatologie, Hôpital Lariboisière, Paris, France
| | - Tabassome Simon
- AP-HP, Sorbonne Université, Service de Pharmacologie Clinique et Plateforme de Recherche Clinique de l'Est Parisien (URCEST, CRB, CRC), Hôpital Saint-Antoine, Paris, France
| | - Francis Berenbaum
- Assistance Publique-Hôpitaux de Paris (AP-HP), Sorbonne Université, Service de rhumatologie, Hôpital Saint-Antoine, Paris, France; Centre de Recherche Saint-Antoine, Inserm URMS_938, Paris, France.
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Kazmers NH, Meeks HD, Novak KA, Yu Z, Fulde GL, Thomas JL, Barker T, Jurynec MJ. Familial Clustering of Erosive Hand Osteoarthritis in a Large Statewide Cohort. Arthritis Rheumatol 2021; 73:440-447. [PMID: 32940959 PMCID: PMC7914133 DOI: 10.1002/art.41520] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 09/04/2020] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Erosive hand osteoarthritis (OA) is a severe and rapidly progressing subset of hand OA. Its etiology remains largely unknown, which has hindered development of successful treatments. This study was undertaken to test the hypothesis that erosive hand OA demonstrates familial clustering in a large statewide population linked to genealogical records, and to determine the association of potential risk factors with erosive hand OA. METHODS Patients diagnosed as having erosive hand OA were identified by searching 4,741,840 unique medical records from a comprehensive statewide database, the Utah Population Database (UPDB). Affected individuals were mapped to pedigrees to identify high-risk families with excess clustering of erosive hand OA as defined by a familial standardized incidence ratio (FSIR) of ≥2.0. The magnitude of familial risk of erosive hand OA in related individuals was calculated using Cox regression models. Association of potential erosive hand OA risk factors was analyzed using multivariate conditional logistic regression and logistic regression models. RESULTS We identified 703 affected individuals linked to 240 unrelated high-risk pedigrees with excess clustering of erosive hand OA (FSIR ≥2.0, P < 0.05). The relative risk of developing erosive hand OA was significantly elevated in first-degree relatives (P < 0.001). There were significant associations between a diagnosis of erosive hand OA and age, sex, diabetes, and obesity (all P < 0.05). CONCLUSION Familial clustering of erosive hand OA observed in a statewide database indicates a potential genetic contribution to the etiology of the disease. Age, sex, diabetes, and obesity are risk factors for erosive hand OA. Identification of causal gene variants in these high-risk families may provide insight into the genes and pathways that contribute to erosive hand OA onset and progression.
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Affiliation(s)
- Nikolas H. Kazmers
- Department of Orthopaedics, University of Utah, Salt Lake City, UT 84108
| | - Huong D. Meeks
- Population Science, Huntsman Cancer Institute, University of Utah Health, Salt Lake City, UT 84112
| | - Kendra A. Novak
- Department of Orthopaedics, University of Utah, Salt Lake City, UT 84108
| | - Zhe Yu
- Population Science, Huntsman Cancer Institute, University of Utah Health, Salt Lake City, UT 84112
| | - Gail L. Fulde
- Intermountain Healthcare, Precision Genomics, St. George, UT 84790
| | - Joy L. Thomas
- Intermountain Healthcare, Precision Genomics, St. George, UT 84790
| | - Tyler Barker
- Intermountain Healthcare, Precision Genomics, Murray, UT 84107
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT 84112
| | - Michael J. Jurynec
- Department of Orthopaedics, University of Utah, Salt Lake City, UT 84108
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Neuprez A, Kaux JF, Locquet M, Beaudart C, Reginster JY. The presence of erosive joints is a strong predictor of radiological progression in hand osteoarthritis: results of a 2-year prospective follow-up of the Liège Hand Osteoarthritis Cohort (LIHOC). Arthritis Res Ther 2021; 23:12. [PMID: 33407767 PMCID: PMC7788934 DOI: 10.1186/s13075-020-02390-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Accepted: 12/09/2020] [Indexed: 11/10/2022] Open
Abstract
Background This study measured the magnitude and determinants of clinical and radiological progression in patients with hand osteoarthritis (HOA) over a 2-year prospective follow-up to gain a greater understanding of the disease time course. Methods Two hundred three consecutive outpatients diagnosed with HOA were followed for 2 years (183 women, median age 69 years). Pain and function were evaluated using the Australian/Canadian Osteoarthritis Hand Index (AUSCAN), and clinical examination recorded the number of painful/swollen joints and nodes. X-rays were scored using Kellgren-Lawrence (KL) and Verbruggen-Veys scales. Clinical progression was defined as deterioration in AUSCAN ≥ the minimal clinically important difference. Radiographic progression was defined as (a) one new erosive/remodeled joint, (b) progression of ≥ one anatomical stage in one joint, or (c) change in KL total score above the smallest detectable difference. Logistic regression was performed to determine whether patient characteristics influenced clinical and radiological progression. Results After 2 years, all radiographic scores deteriorated significantly in the study population (p < 0.05), and the number of proximal and distal interphalangeal nodes was significantly higher (p < 0.01). The AUSCAN, number of painful joints at rest or at pressure, number of swollen joints, and pain measure on a visual analog scale remained unchanged. At the individual level, the number of patients with clinically meaningful progression ranged from 25 to 42% (clinical progression) and from 22 to 76% (radiological progression). The only significant predictor of worsening of total AUSCAN was AUSCAN pain subscale < 74.5 (odds ratio [OR] 1.02 [1.01, 1.03]; p < 0.01). The presence of ≥ four swollen joints (OR 2.78 [1.21, 6.39]; p = 0.02) and erosive osteoarthritis (OR 13.23 [5.07, 34.56]; p < 0.01) at baseline predicted a new erosive joint. A meaningful change in KL was more frequent with painful joints at baseline (OR 3.43 [1.68, 7.01]; p < 0.01). Conclusions Evidence of radiological progression over 2 years was observed in patients with HOA in the LIHOC population even without clinical worsening of disease. For individual patients, baseline pain level is predictive for clinical progression and the presence of erosive or swollen joints are significant predictors of radiological progression. Supplementary Information The online version contains supplementary material available at 10.1186/s13075-020-02390-x.
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Affiliation(s)
- Audrey Neuprez
- Division of Public Health, Epidemiology and Health Economics University of Liège, WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Agin, Liège, Belgium. .,Rehabilitation and Sports Traumatology Department, University and University Hospital of Liège, Liège, Belgium.
| | - Jean-François Kaux
- Rehabilitation and Sports Traumatology Department, University and University Hospital of Liège, Liège, Belgium
| | - Médéa Locquet
- Division of Public Health, Epidemiology and Health Economics University of Liège, WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Agin, Liège, Belgium
| | - Charlotte Beaudart
- Division of Public Health, Epidemiology and Health Economics University of Liège, WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Agin, Liège, Belgium
| | - Jean-Yves Reginster
- Division of Public Health, Epidemiology and Health Economics University of Liège, WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Agin, Liège, Belgium.,Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh, Kingdom of Saudi Arabia
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Tveter AT, Østerås N, Nossum R, Eide REM, Klokkeide Å, Hoegh Matre K, Olsen M, Kjeken I. Short-term effects of occupational therapy on hand function and pain in patients with carpometacarpal osteoarthritis: secondary analyses from a randomized controlled trial. Arthritis Care Res (Hoboken) 2020; 74:955-964. [PMID: 33338325 DOI: 10.1002/acr.24543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 11/24/2020] [Accepted: 12/15/2020] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To assess the short-term effects of multimodal occupational therapy on pain and hand function in patients referred for surgical consultation due to carpometacarpal joint (CMC1) osteoarthritis (OA). METHODS In this randomized controlled trial, CMC1 OA patients referred for surgical consultation at three rheumatology departments were randomized to 3 months multimodal occupational therapy (including patient education, hand exercises, orthoses, and assistive devices) or usual treatment (OA information). Pain was measured on a numeric rating scale from 0-10 (0, no pain). Function included grip and pinch strength (Newtons), range-of-motion [palmar and CMC1 abduction (°); flexion deficit in digits 2-5 (mm)], and self-reported Measure of Activity Performance of the Hand (MAP-Hand; range: 1-4; 1, no activity limitation) and QuickDASH (range: 0-100; 0, no disability). Between-group difference was assessed with follow-up values as dependent variables and group as an independent variable, adjusted for baseline values and time to follow-up. RESULTS Among 180 patients (mean age 63 (SD 8) years; 81% women), 170 completed the short-term follow-up assessment (3-4 months after baseline). Compared to usual treatment, occupational therapy yielded significantly improved pain at rest (-1.4 [-0.7, -2.0], P < 0.001), pain following grip strength (-1.1 [-0.5, -1.7], P = 0.001), grip strength (23.4 [7.5, 39.3], P = 0.004), MAP-Hand (-0.18 [-0.09, -0.28], P = 0.001), and QuickDASH (-8.1 [-4.6, -11.5], P < 0.001). CONCLUSION The multimodal occupational therapy intervention had significant short-term effects on pain, grip strength, and hand function in patients with CMC1 OA.
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Affiliation(s)
- Anne Therese Tveter
- National Advisory Unit on Rehabilitation in Rheumatology, Division of Rheumatology and Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Nina Østerås
- National Advisory Unit on Rehabilitation in Rheumatology, Division of Rheumatology and Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Randi Nossum
- St.Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | | | | | | | - Monika Olsen
- Haugesund Rheumatism Hospital AS, Haugesund, Norway
| | - Ingvild Kjeken
- National Advisory Unit on Rehabilitation in Rheumatology, Division of Rheumatology and Research, Diakonhjemmet Hospital, Oslo, Norway
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60
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Fjellstad CM, Mathiessen A, Slatkowsky-Christensen B, Kvien TK, Hammer HB, Haugen IK. Associations Between Ultrasound‐Detected Synovitis, Pain, and Function in Interphalangeal and Thumb Base Osteoarthritis: Data From the Nor‐Hand Cohort. Arthritis Care Res (Hoboken) 2020; 72:1530-1535. [DOI: 10.1002/acr.24047] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 08/13/2019] [Indexed: 11/06/2022]
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61
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Boer CG, Yau MS, Rice SJ, Coutinho de Almeida R, Cheung K, Styrkarsdottir U, Southam L, Broer L, Wilkinson JM, Uitterlinden AG, Zeggini E, Felson D, Loughlin J, Young M, Capellini TD, Meulenbelt I, van Meurs JB. Genome-wide association of phenotypes based on clustering patterns of hand osteoarthritis identify WNT9A as novel osteoarthritis gene. Ann Rheum Dis 2020; 80:367-375. [PMID: 33055079 PMCID: PMC7892373 DOI: 10.1136/annrheumdis-2020-217834] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 09/07/2020] [Accepted: 09/08/2020] [Indexed: 12/14/2022]
Abstract
Background Despite recent advances in the understanding of the genetic architecture of osteoarthritis (OA), only two genetic loci have been identified for OA of the hand, in part explained by the complexity of the different hand joints and heterogeneity of OA pathology. Methods We used data from the Rotterdam Study (RSI, RSII and RSIII) to create three hand OA phenotypes based on clustering patterns of radiographic OA severity to increase power in our modest discovery genome-wide association studies in the RS (n=8700), and sought replication in an independent cohort, the Framingham Heart Study (n=1203). We used multiple approaches that leverage different levels of information and functional data to further investigate the underlying biological mechanisms and candidate genes for replicated loci. We also attempted to replicate known OA loci at other joint sites, including the hips and knees. Results We found two novel genome-wide significant loci for OA in the thumb joints. We identified WNT9A as a possible novel causal gene involved in OA pathogenesis. Furthermore, several previously identified genetic loci for OA seem to confer risk for OA across multiple joints: TGFa, RUNX2, COL27A1, ASTN2, IL11 and GDF5 loci. Conclusions We identified a robust novel genetic locus for hand OA on chromosome 1, of which WNT9A is the most likely causal gene. In addition, multiple genetic loci were identified to be associated with OA across multiple joints. Our study confirms the potential for novel insight into the genetic architecture of OA by using biologically meaningful stratified phenotypes.
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Affiliation(s)
- Cindy Germaine Boer
- Department of Internal Medicine, Genetic Laboratories, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Michelle S Yau
- Hebrew SeniorLife, Beth Israel Deaconess Medical Center. Harvard Medical School, Hinda and Arthur Marcus Institute for Aging Research, Boston, Massachusetts, USA.,Department of Rheumatology, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Sarah J Rice
- Biosciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Rodrigo Coutinho de Almeida
- Department of Biomedical Data Sciences, Section Molecular Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Kathleen Cheung
- Biosciences Institute, Newcastle University, Newcastle upon Tyne, UK.,Newcastle University, Bioinformatics Support Unit, Newcastle upon Tyne, UK
| | | | - Lorraine Southam
- Institute of Translational Genomics, Helmholtz Zentrum München Deutsches Forschungszentrum für Gesundheit und Umwelt, Neuherberg, Germany
| | - Linda Broer
- Department of Internal Medicine, Genetic Laboratories, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | | | - André G Uitterlinden
- Department of Internal Medicine, Genetic Laboratories, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Eleftheria Zeggini
- Institute of Translational Genomics, Helmholtz Zentrum München Deutsches Forschungszentrum für Gesundheit und Umwelt, Neuherberg, Germany
| | - David Felson
- Arthritis Research UK Epidemiology Unit, The University of Manchester, Manchester, UK
| | - John Loughlin
- Biosciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Mariel Young
- Human Evolutionary Biology, Harvard University, Cambridge, Massachusetts, USA
| | | | - Ingrid Meulenbelt
- Department of Biomedical Data Sciences, Section Molecular Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Joyce Bj van Meurs
- Department of Internal Medicine, Genetic Laboratories, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
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Simon D, Tascilar K, Unbehend S, Bayat S, Berlin A, Liphardt AM, Meinderink T, Rech J, Hueber AJ, Schett G, Kleyer A. Bone Mass, Bone Microstructure and Biomechanics in Patients with Hand Osteoarthritis. J Bone Miner Res 2020; 35:1695-1702. [PMID: 32395822 DOI: 10.1002/jbmr.4046] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 04/14/2020] [Accepted: 04/22/2020] [Indexed: 01/13/2023]
Abstract
The impact of primary hand osteoarthritis (HOA) on bone mass, microstructure, and biomechanics in the affected skeletal regions is largely unknown. HOA patients and healthy controls (HCs) underwent high-resolution peripheral quantitative computed tomography (HR-pQCT). We measured total, trabecular, and cortical volumetric bone mineral densities (vBMDs), microstructural attributes, and performed micro-finite element analysis for bone strength. Failure load and scaled multivariate outcome matrices from distal radius and second metacarpal (MCP2) head measurements were analyzed using multiple linear regression adjusting for age, sex, and functional status and reported as adjusted Z-score differences for total and direct effects. A total of 105 subjects were included (76 HC: 46 women, 30 men; 29 HOA: 23 women, six men). After adjustment, HOA was associated with significant changes in the multivariate outcome matrix from the MCP2 head (p < .001) (explained by an increase in cortical vBMD (Δz = 1.07, p = .02) and reduction in the trabecular vBMD (Δz = -0.07, p = .09). Distal radius analysis did not show an overall effect of HOA; however, there was a gender-study group interaction (p = .044) explained by reduced trabecular vBMD in males (Δz = -1.23, p = .02). HOA was associated with lower failure load (-514 N; 95%CI, -1018 to -9; p = 0.05) apparent in males after adjustment for functional status. HOA is associated with reduced trabecular and increased cortical vBMD in the MCP2 head and a reduction in radial trabecular vBMD and bone strength in males. Further investigations of gender-specific changes of bone architecture in HOA are warranted. © 2020 The Authors. Journal of Bone and Mineral Research published by American Society for Bone and Mineral Research.
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Affiliation(s)
- David Simon
- Department of Internal Medicine 3, Rheumatology and Immunology, Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Koray Tascilar
- Department of Internal Medicine 3, Rheumatology and Immunology, Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Sara Unbehend
- Department of Internal Medicine 3, Rheumatology and Immunology, Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Sara Bayat
- Department of Internal Medicine 3, Rheumatology and Immunology, Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Andreas Berlin
- Department of Internal Medicine 3, Rheumatology and Immunology, Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Anna-Maria Liphardt
- Department of Internal Medicine 3, Rheumatology and Immunology, Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Timo Meinderink
- Department of Internal Medicine 3, Rheumatology and Immunology, Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Juergen Rech
- Department of Internal Medicine 3, Rheumatology and Immunology, Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Axel J Hueber
- Department of Internal Medicine 3, Rheumatology and Immunology, Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Georg Schett
- Department of Internal Medicine 3, Rheumatology and Immunology, Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Arnd Kleyer
- Department of Internal Medicine 3, Rheumatology and Immunology, Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
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63
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Damman W, Liu R, Reijnierse M, Rosendaal FR, Bloem JL, Kloppenburg M. Effusion attenuates the effect of synovitis on radiographic progression in patients with hand osteoarthritis: a longitudinal magnetic resonance imaging study. Clin Rheumatol 2020; 40:315-319. [PMID: 32862337 PMCID: PMC7782402 DOI: 10.1007/s10067-020-05341-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Revised: 07/27/2020] [Accepted: 08/09/2020] [Indexed: 11/27/2022]
Abstract
An exploratory study to determine the role of effusion, i.e., fluid in the joint, in pain, and radiographic progression in patients with hand osteoarthritis. Distal and proximal interphalangeal joints (87 patients, 82% women, mean age 59 years) were assessed for pain. T2-weighted and Gd-chelate contrast-enhanced T1-weighted magnetic resonance images were scored for enhanced synovial thickening (EST, i.e., synovitis), effusion (EST and T2-high signal intensity [hsi]) and bone marrow lesions (BMLs). Effusion was defined as follows: (1) T2-hsi > 0 and EST = 0; or 2) T2-hsi = EST but in different joint locations. Baseline and 2-year follow-up radiographs were scored following Kellgren-Lawrence, increase ≥ 1 defined progression. Associations between the presence of effusion and pain and radiographic progression, taking into account EST and BML presence, were explored on the joint level. Effusion was present in 17% (120/691) of joints, with (63/120) and without (57/120) EST. Effusion on itself was not associated with pain or progression. The association with pain and progression, taking in account other known risk factors, was stronger in the absence of effusion (OR [95% CI] 1.7 [1.0–2.9] and 3.2 [1.7–5.8]) than in its presence (1.6 [0.8–3.0] and 1.3 [0.5–3.1]). Effusion can be assessed on MR images and seems not to be associated with pain or radiographic progression but attenuates the association between synovitis and progression.Key Points • Effusion is present apart from synovitis in interphalangeal joints in patients with hand OA. • Effusion in finger joints can be assessed as a separate feature on MR images. • Effusion seems to be of importance for its attenuating effect on the association between synovitis and radiographic progression. |
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Affiliation(s)
- W Damman
- Department of Rheumatology, Leiden University Medical Center, C1-R, PO Box 9600, 2300, RC, Leiden, The Netherlands.
| | - R Liu
- Department of Rheumatology, Leiden University Medical Center, C1-R, PO Box 9600, 2300, RC, Leiden, The Netherlands
| | - M Reijnierse
- Radiology, Leiden University Medical Center (LUMC), Leiden, The Netherlands
| | - F R Rosendaal
- Clinical Epidemiology, Leiden University Medical Center (LUMC), Leiden, The Netherlands
| | - J L Bloem
- Radiology, Leiden University Medical Center (LUMC), Leiden, The Netherlands
| | - M Kloppenburg
- Department of Rheumatology, Leiden University Medical Center, C1-R, PO Box 9600, 2300, RC, Leiden, The Netherlands
- Clinical Epidemiology, Leiden University Medical Center (LUMC), Leiden, The Netherlands
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Donaubauer AJ, Zhou JG, Ott OJ, Putz F, Fietkau R, Keilholz L, Gaipl US, Frey B, Weissmann T. Low Dose Radiation Therapy, Particularly with 0.5 Gy, Improves Pain in Degenerative Joint Disease of the Fingers: Results of a Retrospective Analysis. Int J Mol Sci 2020; 21:ijms21165854. [PMID: 32824064 PMCID: PMC7461565 DOI: 10.3390/ijms21165854] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 07/27/2020] [Accepted: 08/12/2020] [Indexed: 01/07/2023] Open
Abstract
Low-dose radiation therapy (LDRT) has been successfully established for decades as an alternative analgesic treatment option for patients suffering from chronic degenerative and inflammatory diseases. In this study, 483 patients were undergoing LDRT for degenerative joint disease of the fingers and thumb at the University Hospital Erlangen between 2004 and 2019. Radiotherapy was applied according to the German guidelines for LDRT. Several impact factors on therapeutic success, such as the age and gender, the number of affected fingers, the single and cumulative dose, as well as the number of series, were investigated. In summary, 70% of the patients showed an improvement of their pain following LDRT. No significant impact was found for the factors age, gender, the number of series or the cumulative dosage. Patients with an involvement of the thumb showed a significantly worse outcome compared to patients with an isolated affection of the fingers. In this cohort, patients receiving a single dose of 0.5 Gy reported a significantly better outcome than patients receiving 1.0 Gy, strongly suggesting a reduction in the total dose. In summary, LDRT is a good alternative treatment option for patients suffering from degenerative and inflammatory joint disease of the fingers.
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Affiliation(s)
- Anna-Jasmina Donaubauer
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (A.-J.D.); (J.-G.Z.); (O.J.O.); (F.P.); (R.F.); (U.S.G.); (B.F.)
| | - Jian-Guo Zhou
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (A.-J.D.); (J.-G.Z.); (O.J.O.); (F.P.); (R.F.); (U.S.G.); (B.F.)
- Department of Oncology, The Second Affiliated Hospital of Zunyi Medical University, Zunyi 563000, China
| | - Oliver J. Ott
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (A.-J.D.); (J.-G.Z.); (O.J.O.); (F.P.); (R.F.); (U.S.G.); (B.F.)
| | - Florian Putz
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (A.-J.D.); (J.-G.Z.); (O.J.O.); (F.P.); (R.F.); (U.S.G.); (B.F.)
| | - Rainer Fietkau
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (A.-J.D.); (J.-G.Z.); (O.J.O.); (F.P.); (R.F.); (U.S.G.); (B.F.)
| | - Ludwig Keilholz
- Department of Radiotherapy, Clinical Center Bayreuth, 95447 Bayreuth, Germany;
| | - Udo S. Gaipl
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (A.-J.D.); (J.-G.Z.); (O.J.O.); (F.P.); (R.F.); (U.S.G.); (B.F.)
| | - Benjamin Frey
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (A.-J.D.); (J.-G.Z.); (O.J.O.); (F.P.); (R.F.); (U.S.G.); (B.F.)
| | - Thomas Weissmann
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (A.-J.D.); (J.-G.Z.); (O.J.O.); (F.P.); (R.F.); (U.S.G.); (B.F.)
- Correspondence: ; Tel.: +49-(0)9131-85-44209
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65
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Liu L, Wang S, Wen Y, Li P, Cheng S, Ma M, Zhang L, Cheng B, Qi X, Liang C, Zhang F. Assessing the genetic relationships between osteoarthritis and human plasma proteins: a large scale genetic correlation scan. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:677. [PMID: 32617297 PMCID: PMC7327363 DOI: 10.21037/atm-19-4643] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background Osteoarthritis (OA) is a multifactorial complex disease. The impact of plasma proteins on OA remains elusive now. Methods The UK Biobank genome-wide association study data of OA was used here. Genome-wide SNP genotyping was performed using the Affymetrix UK BiLEVE Axiom or UK Biobank Axiom array. Equally, the GWAS summary data of 3,622 plasma proteins was derived from a recently published study. Consequently, linkage disequilibrium score regression (LD score regression) analysis was performed to evaluate the genetic correlation between each plasma protein and different sites of OA. Results Several suggestive plasma proteins were identified for OA. For hand OA, evidence of genetic correlation was observed for inter-alpha-trypsin inhibitor heavy chain H1 (coefficient =−0.3854, P value =0.0198), multiple inositol polyphosphate phosphatase 1 (coefficient =−1.1721, P value =0.0303). For hip OA, 7 suggestive genetic correlation signals were observed, such as Transmembrane glycoprotein NMB (coefficient =0.6944, P value =0.0098), Endothelial cell-specific molecule 1 (coefficient =0.6337, P value =0.03). For Knee OA, 12 suggestive genetic correlation signals were identified, including Elafin (coefficient =−0.5562, P value =0.0092), Interleukin-16 (coefficient =0.3949, P value =0.0435). Conclusions We investigated the genetic correlations between plasma proteins and different sites of OA in a systematic way. Our results provide novel evidence that OA is a heterogeneous disease.
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Affiliation(s)
- Li Liu
- Key Laboratory of Trace Elements and Endemic Diseases of National Health Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Sen Wang
- Key Laboratory of Trace Elements and Endemic Diseases of National Health Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Yan Wen
- Key Laboratory of Trace Elements and Endemic Diseases of National Health Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Ping Li
- Key Laboratory of Trace Elements and Endemic Diseases of National Health Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Shiqiang Cheng
- Key Laboratory of Trace Elements and Endemic Diseases of National Health Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Mei Ma
- Key Laboratory of Trace Elements and Endemic Diseases of National Health Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Lu Zhang
- Key Laboratory of Trace Elements and Endemic Diseases of National Health Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Bolun Cheng
- Key Laboratory of Trace Elements and Endemic Diseases of National Health Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Xin Qi
- Key Laboratory of Trace Elements and Endemic Diseases of National Health Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Chujun Liang
- Key Laboratory of Trace Elements and Endemic Diseases of National Health Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Feng Zhang
- Key Laboratory of Trace Elements and Endemic Diseases of National Health Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
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Taik FZ, Tahiri L, Rkain H, Aachari I, Maheu E, Allali F. Cross-cultural adaptation and validation of the Arabic version of the functional index for hand osteoarthritis. BMC Musculoskelet Disord 2020; 21:390. [PMID: 32560719 PMCID: PMC7305589 DOI: 10.1186/s12891-020-03418-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 06/12/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Functional Index of Hand Osteoarthritis (FIHOA) is a clinically and methodologically validated score used to assess functional impact in patients with hand osteoarthritis (OA). The aim of the study was to translate the FIHOA into classical Arabic, and to validate the psychometric properties of the translated version. METHODS The FIHOA was translated into Arabic (FIHOA-AR) according to cross-cultural adaptation guidelines. The FIHOA-AR was administrated to patients diagnosed with hand OA according to the criteria of the American College of Rheumatology (ACR). A 5-day test-retest reliability and internal consistency study was performed using the intra-class correlation coefficient (ICC) and the Cronbach's alpha coefficient. External validity was measured by correlations between FIHOA-AR, hand pain visual analog scale (VAS) and the Health Assessment Questionnaire (HAQ). RESULTS The sample consisted of 101 patients with hand OA. The obtained ICC > 0.9 and Cronbach's alpha of 0.93 indicated excellent reliability and internal consistency respectively. The evaluation of external validity showed strong correlation with hand pain VAS (r = 0.88, p < 0.001), and strong correlation with HAQ score (r = 0.86, p < 0.001). CONCLUSION The FIHOA-AR is a reliable and valid score to assess functional disability in Arabic- speaking patients with hand OA.
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Affiliation(s)
- Fatima Zahrae Taik
- Department of Rheumatology B, El Ayachi Hospital, Ibn Sina University Hospital, Rabat, Morocco. .,Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco.
| | - Latifa Tahiri
- Department of Rheumatology B, El Ayachi Hospital, Ibn Sina University Hospital, Rabat, Morocco.,Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
| | - Hanan Rkain
- Department of Rheumatology B, El Ayachi Hospital, Ibn Sina University Hospital, Rabat, Morocco.,Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco.,Laboratory of Physiology, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
| | - Ilham Aachari
- Department of Rheumatology B, El Ayachi Hospital, Ibn Sina University Hospital, Rabat, Morocco.,Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
| | - Emmanuel Maheu
- Department of Rheumatology, Saint-Antoine Hospital, Paris, France
| | - Fadoua Allali
- Department of Rheumatology B, El Ayachi Hospital, Ibn Sina University Hospital, Rabat, Morocco.,Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
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Tenti S, Giordano N, Mondanelli N, Giannotti S, Maheu E, Fioravanti A. A retrospective observational study of glucosamine sulfate in addition to conventional therapy in hand osteoarthritis patients compared to conventional treatment alone. Aging Clin Exp Res 2020; 32:1161-1172. [PMID: 31429006 DOI: 10.1007/s40520-019-01305-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 08/03/2019] [Indexed: 12/23/2022]
Abstract
BACKGROUND The optimal management of hand osteoarthritis (HOA) is still challenging. AIM To evaluate the effects of glucosamine sulfate (GS) in addition to conventional therapy compared to conventional therapy alone in HOA. METHODS This 6-month retrospective study included 108 patients with concomitant knee and hand OA. Fifty-five patients (GS Group) were treated for six consecutive months with crystalline GS (1500 mg once/day) in addition to conventional therapy for HOA [exercise combined with acetaminophen and/or non-steroidal anti-inflammatory drugs (NSAIDs)] and 53 patients (Control Group) with the conventional therapy alone. Primary outcomes were the difference between groups in the change of hand pain on a Visual Analogue Scale (VAS) and in the Functional Index for Hand Osteoarthritis (FIHOA) from baseline to 6 months. Secondary outcomes were Health Assessment Questionnaire (HAQ), medical outcomes study 36-item short form (SF-36) and symptomatic drug consumption. RESULTS The patients who received GS presented a significant decrease (p < 0.001) in VAS pain and FIHOA scores compared with the Control Group at 3 and 6 months. Furthermore, GS therapy was associated to a significant improvement of HAQ score and to a significant reduction of acetaminophen and NSAID consumption during the follow-up. No differences in the number of side effects were observed between the groups. DISCUSSION GS could represent a potential successful therapy for HOA and should be tried in large randomized placebo and active controlled trials. CONCLUSIONS The combination of GS with conventional treatment seems to be more effective in improving pain and function than conventional HOA treatment alone. TRIAL REGISTRATION ClinicalTrials.gov, http://www.clinicaltrials.gov date of registration: April 9, 2019, NCT03911570. The present trial was retrospectively registered.
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Affiliation(s)
- Sara Tenti
- Clinic for the Diagnosis and Management of Hand Osteoarthritis, Rheumatology Unit, Department of Medicine, Surgery and Neurosciences, Azienda Ospedaliera Universitaria Senese, Policlinico Le Scotte, Viale Bracci 1, 53100, Siena, Italy
| | - Nicola Giordano
- Scleroderma Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, Policlinico Le Scotte, Viale Bracci 1, 53100, Siena, Italy
| | - Nicola Mondanelli
- Orthopedics and Traumatology Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, Policlinico Le Scotte, Viale Bracci 1, 53100, Siena, Italy
| | - Stefano Giannotti
- Orthopedics and Traumatology Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, Policlinico Le Scotte, Viale Bracci 1, 53100, Siena, Italy
| | - Emmanuel Maheu
- Rheumatology Department, AP-HP, Saint-Antoine Hospital, 4 Blvd. Beaumarchais, 75011, Paris, France
| | - Antonella Fioravanti
- Clinic for the Diagnosis and Management of Hand Osteoarthritis, Rheumatology Unit, Department of Medicine, Surgery and Neurosciences, Azienda Ospedaliera Universitaria Senese, Policlinico Le Scotte, Viale Bracci 1, 53100, Siena, Italy.
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Nakagawa Y, Kurimoto S, Maheu E, Matsui Y, Kanno Y, Menuki K, Hayashi M, Nemoto T, Nishizuka T, Tatebe M, Yamamoto M, Iwatsuki K, Dreiser RL, Hirata H. Cross-cultural translation, adaptation and validation of a Japanese version of the functional index for hand osteoarthritis (J-FIHOA). BMC Musculoskelet Disord 2020; 21:173. [PMID: 32178665 PMCID: PMC7333425 DOI: 10.1186/s12891-020-03193-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2019] [Accepted: 03/09/2020] [Indexed: 11/22/2022] Open
Abstract
Background Hand osteoarthritis (OA) has a wide spectrum of clinical presentations and physical function is one of the core domains where patients suffer. The Functional Index for Hand Osteoarthritis (FIHOA) is a leading assessment tool for hand OA-related functional impairment. Our objective was to make a Japanese version of FIHOA (J-FIHOA) and validate it among Japanese hand OA patients. Methods Forward and backward translation processes were completed to create a culturally adapted J-FIHOA. A prospective, observational multicenter study was undertaken for the validation process. Seventeen collaborating hospitals recruited Japanese hand OA patients who met the American College of Rheumatology criteria. A medical record review and responses to the following patient-rated questionnaires were collected: J-FIHOA, Hand20, Health Assessment Questionnaire (HAQ), numerical rating scale for pain (NRS pain) and Short Form 36 Health Survey (SF-36). We explored the structure of J-FIHOA using factor analysis. Cronbach’s alpha coefficients and item-total correlations were calculated. Correlations between J-FIHOA and other questionnaires were evaluated for construct validity. Participants in clinically stable conditions repeated J-FIHOA at a one- to two-week interval to assess test-retest reliability. To evaluate responsiveness, symptomatic patients who started new pharmacological treatments had a 1-month follow-up visit and completed the questionnaires twice. Effect size (ES) and standardized response mean (SRM) were calculated with pre- and post-treatment data sets. We assessed responsiveness, comparing ES and SRM of J-FIHOA with other questionnaires (construct approach). Results A total of 210 patients participated. J-FIHOA had unidimensional structure. Cronbach’s alphas (0.914 among females and 0.929 among males) and item-total correlations (range, 0.508 to 0.881) revealed high internal consistency. Hand20, which measures upper extremity disability, was strongly correlated with J-FIHOA (r = 0.82) while the mental and role-social components of SF-36 showed no correlations (r = − 0.24 and − 0.26, respectively). Intraclass correlation coefficient for test-retest reliability was 0.83 and satisfactory. J-FIHOA showed the highest ES and SRM (− 0.68 and − 0.62, respectively) among all questionnaires, except for NRS pain. Conclusions Our results showed J-FIHOA had good measurement properties to assess physical function in Japanese hand OA patients both for ambulatory follow-up in clinical practice, and clinical research and therapeutic trials.
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Affiliation(s)
- Yasunobu Nakagawa
- Department of Hand Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan.
| | - Shigeru Kurimoto
- Department of Hand Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | - Emmanuel Maheu
- Department of Rheumatology, AP-HP, Hospital Saint-Antoine, Paris, France
| | - Yuichiro Matsui
- Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Yuri Kanno
- Hand Surgery and Microsurgery Center, Yotsuya Medical Cube, Tokyo, Japan
| | - Kunitaka Menuki
- Department of Orthopaedic Surgery, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Masanori Hayashi
- Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Tetsuya Nemoto
- Department of Orthopaedic Surgery, Showa University School of Medicine, Tokyo, Japan
| | | | - Masahiro Tatebe
- Department of Hand Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | - Michiro Yamamoto
- Department of Hand Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | - Katsuyuki Iwatsuki
- Department of Hand Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | | | - Hitoshi Hirata
- Department of Hand Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
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Tenti S, Ferretti F, Gusinu R, Gallo I, Giannotti S, Pozza A, Fioravanti A, Coluccia A. Impact of thumb osteoarthritis on pain, function, and quality of life: a comparative study between erosive and non-erosive hand osteoarthritis. Clin Rheumatol 2020; 39:2195-2206. [PMID: 32088802 DOI: 10.1007/s10067-020-04982-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 01/20/2020] [Accepted: 02/07/2020] [Indexed: 01/04/2023]
Abstract
OBJECTIVE The study was aimed to compare the impact of thumb base osteoarthritis (TBOA) on pain, function, and quality of life in patients with erosive or non-erosive hand osteoarthritis (HOA). METHODS This observational retrospective study included 232 patients: 64 with erosive HOA (EHOA) and concomitant TBOA, 36 with isolated EHOA, 97 with non-erosive HOA (non-EHOA) and TBOA, and 35 with isolated non-EHOA. Hand pain by a visual analogue scale (VAS), Functional Index for Hand Osteoarthritis (FIHOA) score, Health Assessment Questionnaire (HAQ), the Medical Outcomes Study 36-Item Short Form (SF-36), and the possible correlations between VAS and FIHOA with radiological score were assessed. RESULTS No differences were found between EHOA with TBOA and isolated EHOA in VAS and FIHOA scores; opposite, there was a significant difference in VAS (p < 0.01) and FIHOA (p < 0.001) between subjects with non-EHOA and TBOA and patients with only non-EHOA. VAS and FIHOA values resulted slightly higher in patients with EHOA and TBOA vs non-EHOA and TBOA; they were significantly more elevated in EHOA and TBOA group compared to isolated non-EHOA (p ≤ 0.001) and in isolated EHOA vs isolated non-EHOA (p < 0.01 and p < 0.001, respectively). HAQ, SF-36 resulted significantly better in isolated non-EHOA patients compared to the other groups. Finally, we observed a significant correlation between FIHOA and all the Kallman scales in EHOA patients with TBOA and between FIHOA and Kallman's thumb score in non-EHOA-TBOA group. CONCLUSIONS EHOA has a more severe clinical burden than non-EHOA; the presence of TBOA appeared an important determinant of pain and disability in non-EHOA.Key Points• Each subset of HOA can have a different impact on pain and functionality, with EHOA determining more severe effects on hand symptoms and disability than non-EHOA.• The presence of TBOA appeared an important determinant of pain and disability in non-EHOA, but not in EHOA.• Our findings support the need for an individualized therapy for each phenotype of hand osteoarthritis.
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Affiliation(s)
- Sara Tenti
- Clinic for the diagnosis and management of Hand Osteoarthritis, Rheumatology Unit, Department of Medicine, Surgery and Neuroscience, Azienda Ospedaliera Universitaria Senese, Policlinico Le Scotte, Viale Bracci 1, 53100, Siena, Italy
| | - Fabio Ferretti
- Department of Medical Sciences, Surgery and Neurosciences, Santa Maria alle Scotte University Hospital of Siena, Viale Bracci 1, 53100, Siena, Italy
| | - Roberto Gusinu
- Health Service Management Board, Santa Maria alle Scotte University Hospital, Siena, Italy
| | - Ines Gallo
- Clinic for the diagnosis and management of Hand Osteoarthritis, Rheumatology Unit, Department of Medicine, Surgery and Neuroscience, Azienda Ospedaliera Universitaria Senese, Policlinico Le Scotte, Viale Bracci 1, 53100, Siena, Italy
| | - Stefano Giannotti
- Orthopedics and Traumatology Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, Policlinico Le Scotte, Viale Bracci 1, 53100, Siena, Italy
| | - Andrea Pozza
- Department of Medical Sciences, Surgery and Neurosciences, Santa Maria alle Scotte University Hospital of Siena, Viale Bracci 1, 53100, Siena, Italy
| | - Antonella Fioravanti
- Clinic for the diagnosis and management of Hand Osteoarthritis, Rheumatology Unit, Department of Medicine, Surgery and Neuroscience, Azienda Ospedaliera Universitaria Senese, Policlinico Le Scotte, Viale Bracci 1, 53100, Siena, Italy.
| | - Anna Coluccia
- Department of Medical Sciences, Surgery and Neurosciences, Santa Maria alle Scotte University Hospital of Siena, Viale Bracci 1, 53100, Siena, Italy
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Burkard T, Rauch M, Spoendlin J, Prieto-Alhambra D, Jick SS, Meier CR. Risk of hand osteoarthritis in new users of hormone replacement therapy: A nested case-control analysis. Maturitas 2019; 132:17-23. [PMID: 31883658 DOI: 10.1016/j.maturitas.2019.11.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 11/12/2019] [Accepted: 11/26/2019] [Indexed: 01/13/2023]
Abstract
OBJECTIVE To estimate the risk of hand osteoarthritis (HOA) associated with hormone replacement therapy (HRT). METHODS We conducted a nested case-control study using data from the UKbased Clinical Practice Research Datalink (1998-2017). In the study inception cohort comprised women at age 45. We matched women with incident HOA during follow-up (cases) to osteoarthritisfree controls on age and calendar date (index date, ID), in a ratio of 1:4. We applied conditional logistic regression to calculate odds ratios (OR) with 95 % confidence intervals (CI) of HOA associated with new HRT use compared with non-use overall, and for women with recorded menopause we calculated separate ORs according to the time between menopause and HRT initiation (current users), and the time between HRT cessation and the ID (past users), versus non-users. RESULTS There were 3440 cases and 13,760 controls (mean age: 50.9 ± 4.1 years). We observed an adjusted OR (aOR) of HOA of 1.32 (95 % CI 1.17-1.48) in HRT users (versus nonusers), which attenuated to 0.98 (95 % CI 0.85-1.14) in women with recorded menopause. Current users (versus nonusers) who initiated HRT 3 months before or after menopause had an aOR of 0.72 (95 % CI 0.55-0.96), while aORs increased with later HRT initiation. Among past users (versus non-users), we observed an aOR of 1.25 (95 % CI 0.86-1.81) when HRT use was stopped ≤18 months before the ID, approaching the null with increasing duration between HRT cessation and the ID. CONCLUSION Current HRT use was associated with a decreased risk of HOA if initiated around menopause, but the risk reduction disappeared after HRT cessation.
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Affiliation(s)
- Theresa Burkard
- Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland; Hospital Pharmacy, University Hospital Basel, Basel, Switzerland
| | - Marlene Rauch
- Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland; Hospital Pharmacy, University Hospital Basel, Basel, Switzerland
| | - Julia Spoendlin
- Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland; Hospital Pharmacy, University Hospital Basel, Basel, Switzerland
| | - Daniel Prieto-Alhambra
- Centre for Statistics in Medicine (CSM), Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Susan S Jick
- Boston Collaborative Drug Surveillance Program, Lexington, MA, United States; Boston University School of Public Health, Boston, MA, United States
| | - Christoph R Meier
- Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland; Hospital Pharmacy, University Hospital Basel, Basel, Switzerland; Boston Collaborative Drug Surveillance Program, Lexington, MA, United States.
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Marshall M, Jonsson H, Helgadottir GP, Nicholls E, Myers H, Jansen V, van der Windt D. Longitudinal validity of using digital hand photographs for assessing hand osteoarthritis progression over 7 years in community-dwelling older adults with hand pain. BMC Musculoskelet Disord 2019; 20:484. [PMID: 31656178 PMCID: PMC6815403 DOI: 10.1186/s12891-019-2829-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 09/12/2019] [Indexed: 11/28/2022] Open
Abstract
Background To determine the longitudinal construct validity of assessing hand OA progression on digital photographs over 7 years compared with progression determined from radiographs, clinical features and change in symptoms. Methods Participants were community-dwelling older adults (≥50 years) in North Staffordshire, UK. Standardized digital hand photographs were taken at baseline and 7 years, and hand joints graded for OA severity using an established photographic atlas. Radiographic hand OA was assessed using the Kellgren and Lawrence grading system. Hand examination determined the presence of nodes, bony enlargement and deformity. Symptoms were reported in self-complete questionnaires. Radiographic and clinical progression and change in symptoms were compared to photographic progression. Differences were examined using analysis of covariance and Chi-Square tests. Results Of 253 individuals (61% women, mean age 63 years) the proportion with photographic progression at the joint and joint group-level was higher in individuals with radiographic or clinical progression compared to those without, although differences were not statistically significant. At the person-level, those with moderate photographic progression over 7 years had significantly higher summed radiographic and clinical scores (adjusted for baseline scores) compared to those with no or mild photographic progression. Similar findings were observed for change in symptoms, although differences were small and not statistically significant. Conclusion Assessing hand OA on photographs shows modest longitudinal construct validity over 7 years compared with change in radiographic and clinical hand OA at the person-level. Using photographs to assess overall long-term change in a person with hand OA may be a reasonable alternative when hand examinations and radiographs are not feasible.
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Affiliation(s)
- Michelle Marshall
- Arthritis Research UK Primary Care Centre, School of Primary, Community and Social Care, Keele University, Keele, Staffordshire, ST5 5BG, UK.
| | - Helgi Jonsson
- Department of Rheumatology, Landspitalinn University Hospital, University of Iceland, IS-108 Fossvogur, Reykjavik, Iceland
| | | | - Elaine Nicholls
- Arthritis Research UK Primary Care Centre, School of Primary, Community and Social Care, Keele University, Keele, Staffordshire, ST5 5BG, UK
| | - Helen Myers
- Arthritis Research UK Primary Care Centre, School of Primary, Community and Social Care, Keele University, Keele, Staffordshire, ST5 5BG, UK
| | - Victoria Jansen
- Pulvertaft Hand Centre, Royal Derby Hospital, Derbyshire, DE22 3NE, UK
| | - Danielle van der Windt
- Arthritis Research UK Primary Care Centre, School of Primary, Community and Social Care, Keele University, Keele, Staffordshire, ST5 5BG, UK
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Spies CK, Langer MF, Löw S, Oppermann J, Hohendorff B, Müller LP, Unglaub F. [Metacarpophalangeal joint replacement]. DER ORTHOPADE 2019; 48:386-393. [PMID: 30915483 DOI: 10.1007/s00132-019-03715-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND Arthroplasty of metacarpophalangeal (MCP) joints is crucial for patients with rheumatoid arthritis. Motion preserving therapies are mandatory for this joint, since loss of function of the MCP joint is detrimental. Many protheses or spacers have been introduced over the last 80 years, but most of them have been dismissed due to major complications. CURRENT PROCEDURES Since the 1960s the Swanson spacer has been established as the reference standard for motion preserving procedures of the finger MCP joints. High fracture rates of the spacer do not seem to limit function and patient satisfaction after all. Current long-term studies show at least promising results for pyrolytic carbon protheses with respect to range of motion, survival, and revision rates in comparison to the Swanson spacer.
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Affiliation(s)
- C K Spies
- Handchirurgie, Vulpius Klinik, Vulpiusstraße 29, 74906, Bad Rappenau, Deutschland.
| | - M F Langer
- Klinik für Unfall‑, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Münster, Münster, Deutschland
| | - S Löw
- Praxis für Handchirurgie und Unfallchirurgie, Bad Mergentheim, Deutschland
| | - J Oppermann
- Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Köln, Köln, Deutschland
| | - B Hohendorff
- Abteilung für Hand‑, Ästhetische und Plastische Chirurgie, Elbe Kliniken Stade-Buxtehude GmbH, Buxtehude, Deutschland
| | - L P Müller
- Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Köln, Köln, Deutschland
| | - F Unglaub
- Handchirurgie, Vulpius Klinik, Vulpiusstraße 29, 74906, Bad Rappenau, Deutschland.,Medizinische Fakultät Mannheim, Universität Heidelberg, Heidelberg, Deutschland
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Boesen M, Roemer FW, Østergaard M, Maas M, Terslev L, Guermazi A. Imaging of Common Rheumatic Joint Diseases Affecting the Upper Limbs. Radiol Clin North Am 2019; 57:1001-1034. [DOI: 10.1016/j.rcl.2019.03.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Hand osteoarthritis: clinical phenotypes, molecular mechanisms and disease management. Nat Rev Rheumatol 2019; 14:641-656. [PMID: 30305701 DOI: 10.1038/s41584-018-0095-4] [Citation(s) in RCA: 98] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Osteoarthritis (OA) is a highly prevalent condition, and the hand is the most commonly affected site. Patients with hand OA frequently report symptoms of pain, functional limitations and frustration in undertaking everyday activities. The condition presents clinically with changes to the bone, ligaments, cartilage and synovial tissue, which can be observed using radiography, ultrasonography or MRI. Hand OA is a heterogeneous disorder and is considered to be multifactorial in aetiology. This Review provides an overview of the epidemiology, presentation and burden of hand OA, including an update on hand OA imaging (including the development of novel techniques), disease mechanisms and management. In particular, areas for which new evidence has substantially changed the way we understand, consider and treat hand OA are highlighted. For example, genetic studies, clinical trials and careful prospective imaging studies from the past 5 years are beginning to provide insights into the pathogenesis of hand OA that might uncover new therapeutic targets in the disease.
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Damman W, Liu R, Kaptein AA, Evers AWM, van Middendorp H, Rosendaal FR, Kloppenburg M. Illness perceptions and their association with 2 year functional status and change in patients with hand osteoarthritis. Rheumatology (Oxford) 2019; 57:2190-2199. [PMID: 30107461 DOI: 10.1093/rheumatology/key231] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Indexed: 11/13/2022] Open
Abstract
Objective To investigate the association between illness perceptions and disability both cross-sectionally and over 2 years in patients with hand OA. Methods Illness perceptions and self-reported disability were assessed at baseline and after 2 years in 384 patients with primary hand OA (mean age 61 years, 84% women, n = 312 with follow-up) with the Illness Perception Questionnaire - Revised (IPQ-R), Functional Index for Hand OA, Australian/Canadian Hand OA Index and HAQ. Risk ratios for high disability (highest quartile) at both time points were estimated for tertiles of IPQ-R dimensions, using Poisson regression. The mean IPQ dimension change difference between patients with and without disability progression (change Functional Index for Hand OA ⩾ 1, Australian/Canadian Hand OA Index > 1.4, HAQ > 0.22) was estimated with linear regression. Analyses were adjusted for age, Doyle index and baseline score. Results At baseline, stronger negative illness perceptions were associated with high disability. Baseline illness perceptions were also associated with high disability after 2 years, although adjustment made apparent that these associations were confounded by baseline disability status. Most illness perceptions changed over 2 years; understanding increased, OA was regarded as more chronic and fewer emotions and consequences and less personal and treatment control were experienced. The 2 year change in disability was different between patients with and without progression for the illness perceptions of more perceived consequences, symptoms, treatment control and emotions. Conclusion Illness perceptions seemed to be implicated in disability and its progression. Our results suggest that interventions could focus on improving baseline disability, potentially using illness perceptions to accomplish this goal.
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Affiliation(s)
- Wendy Damman
- Department of Rheumatology, Leiden University Medical Center, The Netherlands
| | - Rani Liu
- Department of Rheumatology, Leiden University Medical Center, The Netherlands
| | - Ad A Kaptein
- Department of Medical Psychology, Leiden University Medical Center, The Netherlands
| | - Andrea W M Evers
- Health, Medical and Neuropsychology Unit, Institute of Psychology, Leiden University, The Netherlands.,Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
| | - Henriët van Middendorp
- Health, Medical and Neuropsychology Unit, Institute of Psychology, Leiden University, The Netherlands
| | - Frits R Rosendaal
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Margreet Kloppenburg
- Department of Rheumatology, Leiden University Medical Center, The Netherlands.,Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
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van Beest S, Damman W, Liu R, Reijnierse M, Rosendaal FR, Kloppenburg M. In finger osteoarthritis, change in synovitis is associated with change in pain on a joint-level; a longitudinal magnetic resonance imaging study. Osteoarthritis Cartilage 2019; 27:1048-1056. [PMID: 30978394 DOI: 10.1016/j.joca.2019.03.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 02/06/2019] [Accepted: 03/28/2019] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To investigate determinants of decrease and increase in joint pain in symptomatic finger osteoarthritis (OA) on magnetic resonance (MR) imaging over 2 years. DESIGN Eighty-five patients (81.2% women, mean age 59.2 years) with primary hand OA (89.4% fulfilling American College of Rheumatology (ACR) classification criteria) from a rheumatology outpatient clinic received contrast-enhanced MR imaging (1.5T) and physical examination of the right interphalangeal finger joints 2-5 at baseline and at follow-up 2 years later. MR images were scored paired in unknown time order, following the Hand OA MRI scoring system (HOAMRIS). Joint pain upon palpation was assessed by research nurses. Odds ratios (ORs; 95% confidence intervals) were estimated on joint level (n = 680), using generalized estimating equations (GEE) to account for the within patient effects. Additional adjustments were made for change in MR-defined osteophytes, synovitis, and bone marrow lesions (BMLs). RESULTS Of 116 painful joints at baseline, at follow-up: 76 had less pain, 21 less synovitis, and 13 less BMLs. A decrease in synovitis (OR = 5.9; 1.12─31.0), but not in BMLs (OR = 0.39; 0.10─1.50), was associated with less pain. Of 678 joints without maximum baseline pain, at follow-up: 115 had increased pain, 132 increased synovitis, 96 increased BMLs, and 44 increased osteophytes. Increased synovitis (OR = 1.81; 1.11─2.94), osteophytes (OR = 2.75; 1.59─4.8), but not BMLs (OR = 1.14; 0.81─1.60), was associated with increased pain. Through stratification it became apparent that BMLs were mainly acting as effect modifier of the synovitis-pain association. CONCLUSION Decrease in MR-defined synovitis is associated with reduced joint pain, identifying synovitis as a possible target for treatment of finger OA.
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Affiliation(s)
- S van Beest
- Departments of Rheumatology, Leiden University Medical Center (LUMC), Leiden, the Netherlands.
| | - W Damman
- Departments of Rheumatology, Leiden University Medical Center (LUMC), Leiden, the Netherlands.
| | - R Liu
- Departments of Rheumatology, Leiden University Medical Center (LUMC), Leiden, the Netherlands.
| | - M Reijnierse
- Radiology, Leiden University Medical Center (LUMC), Leiden, the Netherlands.
| | - F R Rosendaal
- Clinical Epidemiology, Leiden University Medical Center (LUMC), Leiden, the Netherlands.
| | - M Kloppenburg
- Departments of Rheumatology, Leiden University Medical Center (LUMC), Leiden, the Netherlands; Clinical Epidemiology, Leiden University Medical Center (LUMC), Leiden, the Netherlands.
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Loef M, Kroon FPB, Bergstra SA, van der Pol JA, Lems WF, Kerstens PJSM, Allaart CF, Kloppenburg M. TNF inhibitor treatment is associated with a lower risk of hand osteoarthritis progression in rheumatoid arthritis patients after 10 years. Rheumatology (Oxford) 2019; 57:1917-1924. [PMID: 29471377 DOI: 10.1093/rheumatology/key016] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Indexed: 01/14/2023] Open
Abstract
Objective To investigate the effect of TNF inhibitors (TNFis) on incidental and progressive hand OA in recent-onset RA patients after a 10 year follow-up. Methods Radiographs of 262 RA patients (mean age 52 years, 66% women) from the BeSt study were scored for osteophytes in DIP/PIP joints using the Osteoarthritis Research Society International atlas (0-3; summed score 0-54) and according to the Kellgren-Lawrence (KL) score (0-4; summed score 0-72) at baseline and 10 year follow-up. TNFi treatment was assessed on visits every 3 months. Associations between TNFi treatment and hand OA were analysed on the patient and joint level using generalized linear models and generalized estimating equations, respectively. Results Fifty-eight percent of the patients were treated with TNFi, with a median duration of 42 months. A total of 143 patients (55%) had hand OA in any IP joint at baseline based on the Osteoarthritis Research Society International osteophyte score. On the patient level, TNFi treatment duration did not affect incidental hand OA. However, every month of TNFi treatment resulted in a reduced relative risk (RR) of hand OA progression in DIP joints [relative risk (RR) 0.987 (95% CI 0.978, 0.996)] but not in PIP joints. On the joint level, the effect on hand OA progression was observed in DIP joints [RR 0.996 (95% CI 0.991, 1.000)] but not in PIP joints. The results from the KL score analyses were comparable to the osteophyte score. Conclusion TNFi treatment was associated with a reduced risk on radiographic hand OA progression in DIP joints but not in PIP joints after 10 years. Although the effect sizes are small, these results provide evidence for influence of TNF-α in hand OA pathogenesis.
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Affiliation(s)
- Marieke Loef
- Department of Rheumatology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Féline P B Kroon
- Department of Rheumatology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Sytske Anne Bergstra
- Department of Rheumatology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Joy A van der Pol
- Department of Rheumatology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Willem F Lems
- Department of Rheumatology, VU Medical Centre, Amsterdam, The Netherlands
| | | | - Cornelia F Allaart
- Department of Rheumatology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Margreet Kloppenburg
- Department of Rheumatology, Leiden University Medical Centre, Leiden, The Netherlands.,Department of Epidemiology, Leiden University Medical Centre, Leiden, The Netherlands
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78
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Deveza LA, Robbins SR, Duong V, Wajon A, Riordan EA, Fu K, Jongs R, Oo WM, Hunter DJ. Association of Comorbid Interphalangeal Joint Pain and Erosive Osteoarthritis With Worse Hand Function in Individuals With Symptomatic Thumb Base Osteoarthritis. Arthritis Care Res (Hoboken) 2019; 72:685-691. [PMID: 30980506 DOI: 10.1002/acr.23902] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 04/09/2019] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Hand osteoarthritis (OA) trials often target exclusively the thumb base joint, although concomitant widespread interphalangeal (IP) joint involvement is frequent. We aimed to compare hand strength and function between individuals with isolated thumb base OA and those with coexistent IP joint pain and erosive OA. METHODS Baseline data from a thumb base OA trial were analyzed (n = 204). Participants were age ≥40 years with symptomatic and radiographic thumb base OA. Only the index hand was included. Self-reported IP joint pain (in any proximal, distal, or thumb IP joint), hand function score (Functional Index for Hand Osteoarthritis questionnaire [range 0-30]), and hand grip and tip-pinch strength test results were obtained at baseline. Radiographs were scored for OA severity at each joint (Kellgren/Lawrence grade) and for the presence of erosive OA at the thumb base or IP joints. Multiple linear regression was used adjusting for age, sex, body mass index, and radiographic thumb base OA severity. RESULTS Compared to individuals with isolated thumb base OA (62%), those with concomitant IP joint pain (17%) and erosive OA (21%) had significantly worse hand function (β = 1.82 [95% confidence interval (95% CI) 0.36, 3.28] and β = 1.47 [95% CI 0.74, 2.88], respectively). In addition, coexistence of erosive OA was independently associated with lower grip and tip-pinch strength (β = -5.14 [95% CI -7.58, -2.70] and β = -0.61 [95% CI -1.05, -0.17], respectively). CONCLUSION Concomitant IP joint pain and erosive OA are associated with worse hand function in individuals with thumb base OA. Patient stratification based on these characteristics may improve the design of future thumb base OA trials.
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Affiliation(s)
| | - Sarah R Robbins
- The University of Sydney, Sydney, New South Wales, Australia
| | - Vicky Duong
- The University of Sydney, Sydney, New South Wales, Australia
| | - Anne Wajon
- Macquarie University, New South Wales, Sydney, Australia
| | | | - Kai Fu
- The University of Sydney, Sydney, New South Wales, Australia
| | - Ray Jongs
- Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - Win Min Oo
- The University of Sydney, Sydney, New South Wales, Australia
| | - David J Hunter
- The University of Sydney, Sydney, New South Wales, Australia
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79
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Arnold JB, Marshall M, Thomas MJ, Redmond AC, Menz HB, Roddy E. Midfoot osteoarthritis: potential phenotypes and their associations with demographic, symptomatic and clinical characteristics. Osteoarthritis Cartilage 2019; 27:659-666. [PMID: 30660723 DOI: 10.1016/j.joca.2018.12.022] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 12/20/2018] [Accepted: 12/23/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To investigate the demographic, symptomatic, clinical and structural foot characteristics associated with potential phenotypes of midfoot osteoarthritis (OA). DESIGN Cross-sectional study of 533 community-dwelling adults aged ≥50 years with foot pain in the past year. Health questionnaires and clinical assessments of symptoms, foot structure and function were undertaken. Potential midfoot OA phenotypes were defined by the pattern of radiographic joint involvement affecting either the medial midfoot (talonavicular, navicular-1st cuneiform, or cuneiform-1st metatarsal joint), central midfoot (2nd cuneiform-metatarsal joint), or both medial and central midfoot joints. Multivariable regression models with generalised estimating equations were used to investigate the associations between patterns of midfoot joint involvement and symptomatic, clinical and structural characteristics compared to those with no or minimal midfoot OA. RESULTS Of 879 eligible feet, 168 had medial midfoot OA, 103 central midfoot OA, 76 both medial and central midfoot OA and 532 no/minimal OA. Having both medial and central midfoot OA was associated with higher pain scores, dorsally-located midfoot pain (OR 2.54, 95%CI 1.45, 4.45), hallux valgus (OR 1.76, 95%CI 1.02, 3.05), flatter foot posture (β 0.44, 95%CI 0.12, 0.77), lower medial arch height (β 0.02, 95%CI 0.01, 0.03) and less subtalar inversion and 1st MTPJ dorsiflexion. Isolated medial midfoot OA and central midfoot OA had few distinguishing clinical characteristics. CONCLUSIONS Distinct phenotypes of midfoot OA appear challenging to identify, with substantial overlap in symptoms and clinical characteristics. Phenotypic differences in symptoms, foot posture and function were apparent in this study only when both the medial and central midfoot were involved.
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Affiliation(s)
- J B Arnold
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK; National Institute for Health Research (NIHR), Leeds Biomedical Research Centre, Leeds, UK; Alliance for Research in Exericse, Nutrition & Activity (ARENA) and School of Health Sciences, University of South Australia, Adelaide, Australia.
| | - M Marshall
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University, Staffordshire, UK
| | - M J Thomas
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University, Staffordshire, UK; Haywood Academic Rheumatology Centre, Midlands Partnership NHS Foundation Trust, Haywood Hospital, Staffordshire, UK
| | - A C Redmond
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK; National Institute for Health Research (NIHR), Leeds Biomedical Research Centre, Leeds, UK
| | - H B Menz
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University, Staffordshire, UK; Discipline of Podiatry and La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Melbourne, Australia
| | - E Roddy
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University, Staffordshire, UK; Haywood Academic Rheumatology Centre, Midlands Partnership NHS Foundation Trust, Haywood Hospital, Staffordshire, UK
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80
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Sanchez-Santos MT, Judge A, Gulati M, Spector TD, Hart DJ, Newton JL, Arden NK, Kluzek S. Association of metabolic syndrome with knee and hand osteoarthritis: A community-based study of women. Semin Arthritis Rheum 2019; 48:791-798. [DOI: 10.1016/j.semarthrit.2018.07.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 06/28/2018] [Accepted: 07/23/2018] [Indexed: 01/03/2023]
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81
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Gløersen M, Steen Pettersen P, Kvien TK, Haugen IK. Validation of the Intermittent and Constant Osteoarthritis Pain Questionnaire in Patients with Hand Osteoarthritis: Results from the Nor-Hand Study. J Rheumatol 2019; 46:645-651. [PMID: 30877221 DOI: 10.3899/jrheum.180835] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/03/2018] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To examine the validity of a modified Intermittent and Constant Osteoarthritis Pain (ICOAP) questionnaire for assessment of pain in hand osteoarthritis (OA). METHODS The modified ICOAP-hand questionnaire was administered to 300 patients [89% female, median (interquartile range) age: 61 (57-66) yrs] in the Nor-Hand observational cohort study. The questionnaire was completed twice by 31 patients and test-retest reliability was assessed by intraclass correlation coefficients (ICC) for sum scores and weighted κ scores for individual items. Internal consistency was assessed by Cronbach's alpha coefficient and item-total correlations. Correlations between the ICOAP-hand questionnaire, the Australian/Canadian Hand OA Index (AUSCAN) hand pain subscale, and pain on a numerical rating scale (NRS) were analyzed using Spearman correlation analyses. RESULTS We found a substantial overlap between constant and intermittent pain (46% reporting constant + intermittent pain and 33% reporting no pain). Test-retest reliability analysis of ICOAP-hand showed an ICC of 0.89 for the total scale and weighted κ values between 0.39-0.70 for the individual items. Principal component analysis revealed one component with an eigenvalue of 7.9, explaining 72% of the total variance. Cronbach's alpha coefficient values > 0.93 and strong item-total correlations proved high internal consistency. ICOAP-hand was strongly correlated with NRS hand pain and the AUSCAN pain subscale. CONCLUSION ICOAP-hand is a reliable pain index that correlates with other available pain questionnaires. However, our results indicate that constant and intermittent pain do not represent separate constructs in hand OA, questioning the usefulness of the 2 subscales. [ClinicalTrials.gov: NCT03083548].
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Affiliation(s)
- Marthe Gløersen
- From the Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway. .,M. Gløersen, Medical Student, Department of Rheumatology, Diakonhjemmet Hospital; P. Steen Pettersen, MD, Department of Rheumatology, Diakonhjemmet Hospital; T.K. Kvien, MD, PhD, Professor of Rheumatology, Department of Rheumatology, Diakonhjemmet Hospital; I.K. Haugen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital.
| | - Pernille Steen Pettersen
- From the Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.,M. Gløersen, Medical Student, Department of Rheumatology, Diakonhjemmet Hospital; P. Steen Pettersen, MD, Department of Rheumatology, Diakonhjemmet Hospital; T.K. Kvien, MD, PhD, Professor of Rheumatology, Department of Rheumatology, Diakonhjemmet Hospital; I.K. Haugen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital
| | - Tore K Kvien
- From the Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.,M. Gløersen, Medical Student, Department of Rheumatology, Diakonhjemmet Hospital; P. Steen Pettersen, MD, Department of Rheumatology, Diakonhjemmet Hospital; T.K. Kvien, MD, PhD, Professor of Rheumatology, Department of Rheumatology, Diakonhjemmet Hospital; I.K. Haugen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital
| | - Ida K Haugen
- From the Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.,M. Gløersen, Medical Student, Department of Rheumatology, Diakonhjemmet Hospital; P. Steen Pettersen, MD, Department of Rheumatology, Diakonhjemmet Hospital; T.K. Kvien, MD, PhD, Professor of Rheumatology, Department of Rheumatology, Diakonhjemmet Hospital; I.K. Haugen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital
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82
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Exploring the Involvement of NLRP3 and IL-1 β in Osteoarthritis of the Hand: Results from a Pilot Study. Mediators Inflamm 2019; 2019:2363460. [PMID: 30983879 PMCID: PMC6431515 DOI: 10.1155/2019/2363460] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 12/04/2018] [Accepted: 12/19/2018] [Indexed: 12/27/2022] Open
Abstract
Hand osteoarthritis (HOA) includes different subsets; a particular and uncommon form is erosive HOA (EHOA). Interleukin- (IL-) 1β plays a crucial role in the pathogenesis of osteoarthritis (OA); it is synthesized as an inactive precursor which requires the intervention of a cytosolic multiprotein complex, named inflammasome, for its activation. The aim of this study was to investigate the involvement of IL-1β and the NOD-like receptor pyrin domain containing 3 (NLRP3) inflammasome in patients with EHOA and nonerosive HOA (NEHOA) compared to healthy controls. In particular, we evaluated the gene expression of IL-1β and NLRP3, the serum levels of IL-1β, IL-6, IL-17, and tumor necrosis factor- (TNF-) α, and the protein levels of IL-1β and NLRP3. We also assessed the relationships between IL-1β and NLRP3 and clinical, laboratory, and radiological findings. Fifty-four patients with HOA (25 EHOA and 29 NEHOA) and 20 healthy subjects were included in the study. Peripheral blood mononuclear cell (PBMC) gene and protein expressions of IL-1β and NLRP3 were quantified by quantitative real-time PCR and western blot. IL-1β, IL-6, IL-17, and TNF-α serum levels were determined by ELISA. IL-1β gene expression was significantly reduced (p = 0.0208) in EHOA compared to healthy controls. NLRP3 protein levels were significantly increased in the NEHOA group versus the control (p = 0.0063) and EHOA groups (p = 0.0038). IL-1β serum levels were not significantly different across the groups; IL-6, IL-17, and TNF-α were not detectable in any sample. IL-1β concentrations were negatively correlated with the Kellgren-Lawrence score in the whole population (r = −0.446; p = 0.0008) and in NEHOA (r = −0.608; p = 0.004), while IL-1β gene expression was positively correlated with the number of joint swellings in the EHOA group (r = 0.512; p = 0.011). Taken together, our results, showing poorly detectable IL-1β concentrations and minimal inflammasome activity in the PBMCs of HOA patients, suggest a low grade of systemic inflammation in HOA. This evidence does not preclude a possible involvement of these factors at the local level.
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83
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van Beest S, Kroon FPB, Kroon HM, Damman W, Liu R, Bloem JL, Reijnierse M, Kloppenburg M. Assessment of osteoarthritic features in the thumb base with the newly developed OMERACT magnetic resonance imaging scoring system is a valid addition to standard radiography. Osteoarthritis Cartilage 2019; 27:468-475. [PMID: 30508599 DOI: 10.1016/j.joca.2018.11.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 10/30/2018] [Accepted: 11/19/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To investigate the construct validity of the new thumb base OA magnetic resonance imaging (MRI) scoring system (TOMS) by comparing TOMS scores with radiographic scores in patients with primary hand OA. DESIGN In 200 patients (83.5% women, mean (SD) age 61.0 (8.4) years), postero-anterior radiographs and MR scans (1.5 T) of the right first carpometacarpal (CMC-1) and scaphotrapeziotrapezoid (STT) joints, were scored using the OARSI atlas and TOMS, respectively. The distributions of the TOMS scores (specified in results section) were stratified for the OARSI scores of corresponding radiographic features and investigated using boxplots and non-parametric tests. Furthermore, Spearman's rank or Phi correlation coefficients (ρ/φ) were calculated. RESULTS For all features, especially for erosions and osteophytes, the prevalence found with MRI was higher than with radiography. TOMS osteophyte and cartilage loss scores differed statistically significant between corresponding OARSI scores in CMC-1 (0 vs 1; 1 vs 2). TOMS scores were positively correlated with radiographic scores in CMC-1 for osteophytes (coefficient [95% confidence interval], ρ = 0.75 [0.69; 0.81]), cartilage loss/joint space narrowing (ρ = 0.70 [0.62; 0.76]), subchondral bone defects (SBDs)/erosion-cyst (ρ = 0.41 [0.29; 0.52]), bone marrow lesions (BMLs)/subchondral sclerosis (ρ = 0.65 [0.56; 0.73]) and subluxation (φ = 0.65 [0.57; 0.73]); and in STT for osteophytes (ρ = 0.30 [0.17; 0.42]) and cartilage loss/joint space narrowing (ρ = 0.53 [0.42; 0.62]). CONCLUSIONS In patients with hand OA, TOMS scores positively correlated with radiographic scores, indicating good construct validity. However, the prevalence of features on MR images was higher compared to radiographs, suggesting that TOMS might be more sensitive than radiography. The clinical meaning of these extra MR detected cases is currently still unknown.
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Affiliation(s)
- S van Beest
- Department of Rheumatology, Leiden University Medical Center (LUMC), Leiden, the Netherlands.
| | - F P B Kroon
- Department of Rheumatology, Leiden University Medical Center (LUMC), Leiden, the Netherlands.
| | - H M Kroon
- Department of Radiology, Leiden University Medical Center (LUMC), Leiden, the Netherlands.
| | - W Damman
- Department of Rheumatology, Leiden University Medical Center (LUMC), Leiden, the Netherlands.
| | - R Liu
- Department of Rheumatology, Leiden University Medical Center (LUMC), Leiden, the Netherlands.
| | - J L Bloem
- Department of Radiology, Leiden University Medical Center (LUMC), Leiden, the Netherlands.
| | - M Reijnierse
- Department of Radiology, Leiden University Medical Center (LUMC), Leiden, the Netherlands.
| | - M Kloppenburg
- Department of Rheumatology, Leiden University Medical Center (LUMC), Leiden, the Netherlands; Department of Clinical Epidemiology, Leiden University Medical Center (LUMC), Leiden, the Netherlands.
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84
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Differentiating Bilateral Symptomatic Hand Osteoarthritis From Rheumatoid Arthritis Using Sonography When Clinical and Radiographic Features Are Nonspecific: A Case Report. J Chiropr Med 2019; 18:56-60. [DOI: 10.1016/j.jcm.2018.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 07/24/2018] [Accepted: 07/31/2018] [Indexed: 11/17/2022] Open
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85
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The ultrasonographic study of the nail reveals differences in patients affected by inflammatory and degenerative conditions. Clin Rheumatol 2019; 38:913-920. [DOI: 10.1007/s10067-019-04437-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 12/31/2018] [Accepted: 01/07/2019] [Indexed: 10/27/2022]
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86
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Wittoek R, Kroon FP, Kundakci B, Abhishek A, Haugen IK, Berenbaum F, Conaghan PG, Ishimori ML, Smeets W, van der Heijde D, Kloppenburg M. Report from the Hand Osteoarthritis Working Group at OMERACT 2018: Update on Core Instrument Set Development. J Rheumatol 2019; 46:1183-1187. [DOI: 10.3899/jrheum.181003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2018] [Indexed: 12/18/2022]
Abstract
Objective.To evaluate hand osteoarthritis tools for core instrument set development.Methods.For OMERACT 2018, a systematic literature review and advances in instrument validation were presented.Results.Visual analog and numerical rating scales were considered valuable for pain and patient’s global assessment, despite heterogeneous phrasing and missing psychometric evidence for some aspects. The Modified Intermittent and Constant Osteoarthritis Pain scale was lacking evidence. The Michigan Hand Outcomes Questionnaire had advantages above other pain/function questionnaires. The Hand Mobility in Scleroderma scale was valid, although responsiveness was questioned. Potential joint activity instruments were evaluated.Conclusion.The development of the core instrument set is progressing, and a research agenda was also developed.
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87
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Kloppenburg M, Kroon FP, Blanco FJ, Doherty M, Dziedzic KS, Greibrokk E, Haugen IK, Herrero-Beaumont G, Jonsson H, Kjeken I, Maheu E, Ramonda R, Ritt MJ, Smeets W, Smolen JS, Stamm TA, Szekanecz Z, Wittoek R, Carmona L. 2018 update of the EULAR recommendations for the management of hand osteoarthritis. Ann Rheum Dis 2019; 78:16-24. [PMID: 30154087 DOI: 10.1136/annrheumdis-2018-213826] [Citation(s) in RCA: 234] [Impact Index Per Article: 46.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 06/28/2018] [Accepted: 08/01/2018] [Indexed: 01/08/2023]
Abstract
Since publication of the European League Against Rheumatism (EULAR) recommendations for management of hand osteoarthritis (OA) in 2007 new evidence has emerged. The aim was to update these recommendations. EULAR standardised operating procedures were followed. A systematic literature review was performed, collecting the evidence regarding all non-pharmacological, pharmacological and surgical treatment options for hand OA published to date. Based on the evidence and expert opinion from an international task force of 19 physicians, healthcare professionals and patients from 10 European countries formulated overarching principles and recommendations. Level of evidence, grade of recommendation and level of agreement were allocated to each statement. Five overarching principles and 10 recommendations were agreed on. The overarching principles cover treatment goals, information provision, individualisation of treatment, shared decision-making and the need to consider multidisciplinary and multimodal (non-pharmacological, pharmacological, surgical) treatment approaches. Recommendations 1-3 cover different non-pharmacological treatment options (education, assistive devices, exercises and orthoses). Recommendations 4-8 describe the role of different pharmacological treatments, including topical treatments (preferred over systemic treatments, topical non-steroidal anti-inflammatory drugs (NSAIDs) being first-line choice), oral analgesics (particularly NSAIDs to be considered for symptom relief for a limited duration), chondroitin sulfate (for symptom relief), intra-articular glucocorticoids (generally not recommended, consider for painful interphalangeal OA) and conventional/biological disease-modifying antirheumatic drugs (discouraged). Considerations for surgery are described in recommendation 9. The last recommendation relates to follow-up. The presented EULAR recommendations provide up-to-date guidance on the management of hand OA, based on expert opinion and research evidence.
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Affiliation(s)
- Margreet Kloppenburg
- Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Féline Pb Kroon
- Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
| | - Francisco J Blanco
- Department of Rheumatology, INIBIC-Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain
| | - Michael Doherty
- Division of Rheumatology, Orthopaedics and Dermatology, School of Medicine, University of Nottingham, Nottingham City Hospital, Nottingham, UK
| | - Krysia S Dziedzic
- Institute for Primary Care and Health Sciences, Arthritis Research UK Primary Care Centre, Keele University, Keele, UK
| | - Elsie Greibrokk
- National Advisory Unit on Rehabilitation in Rheumatology, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
| | - Ida K Haugen
- National Advisory Unit on Rehabilitation in Rheumatology, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
| | - Gabriel Herrero-Beaumont
- Department of Rheumatology, Instituto de Investigación Sanitaria Fundación Jimenez Díaz, Universidad Autónoma de Madrid, Madrid, Spain
| | - Helgi Jonsson
- Department of Rheumatology, Landspitalinn University Hospital, University of Iceland, Reykjavik, Iceland
| | - Ingvild Kjeken
- National Advisory Unit on Rehabilitation in Rheumatology, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
| | - Emmanuel Maheu
- Department of Rheumatology, AP-HP, St Antoine Hospital, Paris, France
| | - Roberta Ramonda
- Rheumatology Unit, Department of Medicine DIMED, University of Padova, Padova, Italy
| | - Marco Jpf Ritt
- Department of Plastic Surgery, VU University Medical Center, Amsterdam, The Netherlands
| | - Wilma Smeets
- Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Rheumatology, INIBIC-Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain
| | - Josef S Smolen
- Division of Rheumatology, Department of Medicine 3, Medical University of Vienna, Vienna, Austria
| | - Tanja A Stamm
- Section for Outcomes Research, Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria
| | - Zoltan Szekanecz
- Department of Rheumatology, University of Debrecen, Faculty of Medicine, Debrecen, Hungary
| | - Ruth Wittoek
- Department of Rheumatology, University Hospital Ghent, Ghent, Belgium
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Kroon FP, van Beest S, Gandjbakhch F, Peterfy CG, Chen S, Conaghan PG, Eshed I, Foltz V, Genant HK, Haugen IK, Medema JK, Østergaard M, Zhang L, Levesque MC, Kloppenburg M. Longitudinal Reliability of the OMERACT Thumb Base Osteoarthritis Magnetic Resonance Imaging Scoring System (TOMS). J Rheumatol 2018; 46:1228-1231. [DOI: 10.3899/jrheum.180949] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2018] [Indexed: 11/22/2022]
Abstract
Objective.To assess the longitudinal reliability of the Outcome Measures in Rheumatology (OMERACT) Thumb base Osteoarthritis Magnetic resonance imaging (MRI) Scoring system (TOMS).Methods.Paired MRI of patients with hand osteoarthritis were scored in 2 exercises (6-mo and 2-yr followup) for synovitis, subchondral bone defects (SBD), osteophytes, cartilage assessment, bone marrow lesions (BML), and subluxation. Interreader reliability of delta scores was assessed.Results.Little change occurred. Average-measure intraclass correlation coefficients were good-excellent (≥ 0.71), except synovitis (0.55–0.83) and carpometacarpal-1 osteophytes/cartilage assessment (0.47/0.39). Percentage exact/close agreement was 52–92%/68–100%, except BML in 2 years (28%/64–76%). Smallest detectable change was below the scoring increment, except in SBD and BML.Conclusion.TOMS longitudinal reliability was moderate-good. Limited change hampered assessment.
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Kroon FPB, Boersma A, Boonen A, van Beest S, Damman W, van der Heijde D, Rosendaal FR, Kloppenburg M. Performance of the Michigan Hand Outcomes Questionnaire in hand osteoarthritis. Osteoarthritis Cartilage 2018; 26:1627-1635. [PMID: 30099114 DOI: 10.1016/j.joca.2018.07.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 06/27/2018] [Accepted: 07/26/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To investigate the performance of the Michigan Hand Outcomes Questionnaire (MHQ) in hand osteoarthritis (OA) by evaluating truth, discrimination and feasibility. DESIGN Symptomatic hand OA patients from the Hand Osteoarthritis in Secondary Care (HOSTAS) cohort completed questionnaires (demographics, MHQ, Australian/Canadian Hand Osteoarthritis Index [AUSCAN], Functional Index for Hand Osteoarthritis [FIHOA] and visual analogue scale [VAS] pain) at baseline (n = 383), 1- and 2-year follow-up (n = 312, n = 293). Anchor questions at follow-up assessed whether pain/function levels were (un)acceptable and had changed compared to baseline. Correlations between MHQ and other pain/function questionnaires were calculated. Validity of unique MHQ domains (work performance, aesthetics, satisfaction), discrimination across disease stages, and responsiveness were assessed by categorizing patients by external anchors (employment, joint deformities, erosions, and anchor questions). Between-group differences were assessed with linear regression, probability plots and comparison of medians. RESULTS MHQ pain and function subscales correlated moderately-to-good with other instruments (rs 0.63-0.81). Work performance scores were worse in patients with reduced working capacity than in employed patients. Aesthetics scores were worse in patients with more deformities. Patients with unacceptable complaints had worse satisfaction scores. All pain/function instruments discriminated between patients with acceptable vs unacceptable pain/function, while only MHQ activities of daily living (ADL), FIHOA, and MHQ aesthetics could discriminate between erosive and non-erosive disease. MHQ and AUSCAN were most responsive. CONCLUSIONS MHQ has several unique aspects and advantages justifying its use in hand OA, including the unique assessment of work performance, aesthetics, and satisfaction. However, MHQ, AUSCAN and FIHOA appear to measure different aspects of pain and function.
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Affiliation(s)
- F P B Kroon
- Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands.
| | - A Boersma
- Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
| | - A Boonen
- Department of Rheumatology, Maastricht University Medical Center, Maastricht, The Netherlands; Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - S van Beest
- Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
| | - W Damman
- Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
| | - D van der Heijde
- Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
| | - F R Rosendaal
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - M Kloppenburg
- Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands; Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
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90
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Burkard T, Hügle T, Layton JB, Glynn RJ, Bloechliger M, Frey N, Jick SS, Meier CR, Spoendlin J. Risk of Incident Osteoarthritis of the Hand in Statin Initiators: A Sequential Cohort Study. Arthritis Care Res (Hoboken) 2018; 70:1795-1805. [PMID: 29885074 DOI: 10.1002/acr.23616] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Accepted: 06/05/2018] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To investigate the association between statin therapy initiation and incident hand osteoarthritis (OA). METHODS We performed a propensity score-matched cohort study using data from the UK-based Clinical Practice Research Datalink. Statin initiators had ≥1 statin prescription between 1996 and 2015 and were matched 1:1 on their propensity score to noninitiators within 10 sequential 2-year cohort entry blocks. After a 180-day run-in period, patients were followed in an as-treated approach until a recorded diagnosis of hand OA or until censoring (change in exposure status, development of an exclusion criterion, or maximum follow-up of 5.5 years). We applied Cox proportional hazard regression to calculate hazard ratios (HRs) with 95% confidence intervals (95% CIs) overall and in subgroups of sex, age, statin dose, statin agent, preexisting dyslipidemia, and treatment duration. To compare results, we ran all analyses with negative and positive control outcomes and assessed generalized OA as a secondary outcome. We further performed the overall analysis with an active comparator (topical glaucoma therapy initiators). RESULTS Among 233,608 statin initiators and the same number of noninitiators, we observed an overall HR for hand OA of 0.98 (95% CI 0.88-1.09). The observed null result remained unchanged in all subgroups. Results were highly similar for generalized OA and negative control outcomes. In addition, the active comparator analysis showed a null result with an HR for hand OA of 0.85 (95% CI 0.56-1.29). Previously known associations with positive control outcomes were observed. CONCLUSION There was no association between statin initiation and incident hand OA in this study.
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Affiliation(s)
- Theresa Burkard
- University of Basel and University Hospital Basel, Basel, Switzerland
| | | | - J Bradley Layton
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill
| | - Robert J Glynn
- Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | | | - Noel Frey
- University of Basel and University Hospital Basel, Basel, Switzerland
| | - Susan S Jick
- Boston Collaborative Drug Surveillance Program, Lexington, Massachusetts
| | - Christoph R Meier
- University of Basel and University Hospital Basel, Basel, Switzerland, and Boston Collaborative Drug Surveillance Program, Lexington, Massachusetts
| | - Julia Spoendlin
- University of Basel and University Hospital Basel, Basel, Switzerland
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van Delft MAM, van Beest S, Kloppenburg M, Trouw LA, Ioan-Facsinay A. Presence of Autoantibodies in Erosive Hand Osteoarthritis and Association with Clinical Presentation. J Rheumatol 2018; 46:101-105. [PMID: 30219766 DOI: 10.3899/jrheum.180256] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/05/2018] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To investigate whether 3 rheumatoid arthritis-associated antibodies [rheumatoid factor (RF) and anticitrullinated protein antibodies (ACPA) or anticarbamylated protein (anti-CarP) antibodies] are present in hand osteoarthritis (HOA) and associate with erosive OA (EOA). METHODS Anti-CarP IgG was measured by ELISA in baseline sera of patients with HOA from 3 cohorts: HOSTAS (n = 510, 27.2% EOA), ECHO (n = 47), and EHOA (n = 23), and in sera of healthy controls (HC; n = 196, mean age 44.1 yrs, 51.0% women). Moreover, ACPA-IgG and RF-IgM were additionally determined in HOSTAS and HC. The prevalence of autoantibodies was compared between HOA and HC and between erosive and nonerosive HOA. In HOSTAS, hand radiographs were scored (Kellgren-Lawrence, Osteoarthritis Research Society International osteophyte and joint space narrowing) and C-reactive protein (CRP) levels, representing inflammation, were assessed. Groups were compared using nonparametric tests. RESULTS The prevalence of anti-CarP was low and not significantly different between the total HOA group and HC (6.6% vs 3.6%, p = 0.12). In HOSTAS, the prevalence of all tested autoantibodies was low (anti-CarP 7.1%, ACPA 0.8%, RF 6.1%), and there were no significant differences observed between HOA patients and HC or between erosive and nonerosive HOA. Further, radiographic damage and CRP levels were similar in anti-CarP+ and anti-CarP-, and RF+ and RF- HOSTAS patients. CONCLUSION The prevalence of autoantibodies is similar in HOA patients and HC, and these autoantibodies are not associated with erosive disease, structural damage, or inflammation in patients with HOA, indicating that another mechanism is driving erosive disease.
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Affiliation(s)
- Myrthe Alexandra Maria van Delft
- From the Department of Rheumatology, Department of Clinical Epidemiology, and Department of Immunohematology and Blood Transfusion, Leiden University Medical Center, Leiden, the Netherlands.,M.A. van Delft, MSc, PhD student, Department of Rheumatology, Leiden University Medical Center; S. van Beest, MD, PhD student, Department of Rheumatology, Leiden University Medical Center; M. Kloppenburg, Professor, MD, PhD, Department of Rheumatology, Leiden University Medical Center, and Department of Clinical Epidemiology, Leiden University Medical Center; L.A. Trouw, Associate Professor, PhD, Department of Rheumatology, Leiden University Medical Center, and Department of Immunohematology and Blood Transfusion, Leiden University Medical Center; A. Ioan-Facsinay, Assistant Professor, PhD, Department of Rheumatology, Leiden University Medical Center. M.A. van Delft and S. van Beest contributed equally to this work
| | - Sjoerd van Beest
- From the Department of Rheumatology, Department of Clinical Epidemiology, and Department of Immunohematology and Blood Transfusion, Leiden University Medical Center, Leiden, the Netherlands.,M.A. van Delft, MSc, PhD student, Department of Rheumatology, Leiden University Medical Center; S. van Beest, MD, PhD student, Department of Rheumatology, Leiden University Medical Center; M. Kloppenburg, Professor, MD, PhD, Department of Rheumatology, Leiden University Medical Center, and Department of Clinical Epidemiology, Leiden University Medical Center; L.A. Trouw, Associate Professor, PhD, Department of Rheumatology, Leiden University Medical Center, and Department of Immunohematology and Blood Transfusion, Leiden University Medical Center; A. Ioan-Facsinay, Assistant Professor, PhD, Department of Rheumatology, Leiden University Medical Center. M.A. van Delft and S. van Beest contributed equally to this work
| | - Margreet Kloppenburg
- From the Department of Rheumatology, Department of Clinical Epidemiology, and Department of Immunohematology and Blood Transfusion, Leiden University Medical Center, Leiden, the Netherlands.,M.A. van Delft, MSc, PhD student, Department of Rheumatology, Leiden University Medical Center; S. van Beest, MD, PhD student, Department of Rheumatology, Leiden University Medical Center; M. Kloppenburg, Professor, MD, PhD, Department of Rheumatology, Leiden University Medical Center, and Department of Clinical Epidemiology, Leiden University Medical Center; L.A. Trouw, Associate Professor, PhD, Department of Rheumatology, Leiden University Medical Center, and Department of Immunohematology and Blood Transfusion, Leiden University Medical Center; A. Ioan-Facsinay, Assistant Professor, PhD, Department of Rheumatology, Leiden University Medical Center. M.A. van Delft and S. van Beest contributed equally to this work
| | - Leendert Adrianus Trouw
- From the Department of Rheumatology, Department of Clinical Epidemiology, and Department of Immunohematology and Blood Transfusion, Leiden University Medical Center, Leiden, the Netherlands.,M.A. van Delft, MSc, PhD student, Department of Rheumatology, Leiden University Medical Center; S. van Beest, MD, PhD student, Department of Rheumatology, Leiden University Medical Center; M. Kloppenburg, Professor, MD, PhD, Department of Rheumatology, Leiden University Medical Center, and Department of Clinical Epidemiology, Leiden University Medical Center; L.A. Trouw, Associate Professor, PhD, Department of Rheumatology, Leiden University Medical Center, and Department of Immunohematology and Blood Transfusion, Leiden University Medical Center; A. Ioan-Facsinay, Assistant Professor, PhD, Department of Rheumatology, Leiden University Medical Center. M.A. van Delft and S. van Beest contributed equally to this work
| | - Andreea Ioan-Facsinay
- From the Department of Rheumatology, Department of Clinical Epidemiology, and Department of Immunohematology and Blood Transfusion, Leiden University Medical Center, Leiden, the Netherlands. .,M.A. van Delft, MSc, PhD student, Department of Rheumatology, Leiden University Medical Center; S. van Beest, MD, PhD student, Department of Rheumatology, Leiden University Medical Center; M. Kloppenburg, Professor, MD, PhD, Department of Rheumatology, Leiden University Medical Center, and Department of Clinical Epidemiology, Leiden University Medical Center; L.A. Trouw, Associate Professor, PhD, Department of Rheumatology, Leiden University Medical Center, and Department of Immunohematology and Blood Transfusion, Leiden University Medical Center; A. Ioan-Facsinay, Assistant Professor, PhD, Department of Rheumatology, Leiden University Medical Center. M.A. van Delft and S. van Beest contributed equally to this work.
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Kroon FPB, van Beest S, Ermurat S, Kortekaas MC, Bloem JL, Reijnierse M, Rosendaal FR, Kloppenburg M. In thumb base osteoarthritis structural damage is more strongly associated with pain than synovitis. Osteoarthritis Cartilage 2018; 26:1196-1202. [PMID: 29709499 DOI: 10.1016/j.joca.2018.04.009] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 03/15/2018] [Accepted: 04/11/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Osteoarthritis in thumb base joints (first carpometacarpal (CMC-1), scaphotrapeziotrapezoid (STT)) is prevalent and disabling, yet focussed studies are scarce. Our aim was to investigate associations between ultrasonographic and magnetic resonance imaging (MRI) inflammatory features, radiographic osteophytes, and thumb base pain in hand osteoarthritis patients. DESIGN Cross-sectional analyses were performed in cohorts with MRI (n = 202) and ultrasound measurements (n = 87). Pain upon thumb base palpation was assessed. Radiographs were scored for CMC-1/STT osteophytes. Synovial thickening, effusion and power Doppler signal in CMC-1 joints were assessed with ultrasound. MRIs were scored for synovitis and bone marrow lesions (BMLs) in CMC-1 and STT joints using OMERACT-TOMS. Associations between ultrasound/MRI features, osteophytes, and thumb base pain were assessed. Interaction between MRI features and osteophytes was explored. RESULTS In 289 patients (mean age 60.2, 83% women) 139/376 thumb bases were painful. Osteophyte presence was associated with pain (MRI cohort: odds ratio (OR) 5.1 (2.7-9.8)). Ultrasound features were present in 25-33% of CMC-1 joints, though no associations were seen with pain. MRI-synovitis and BMLs grade ≥2 were scored in 25% and 43% of thumb bases, and positively associated with pain (OR 3.6 (95% CI 1.7-7.6) and 3.0 (1.6-5.5)). Associations attenuated after adjustment for osteophyte presence. Combined presence of osteophytes and MRI-synovitis had an additive effect. CONCLUSIONS Ultrasonographic and MRI inflammatory features were often present in the thumb base. Osteophytes were more strongly associated with thumb base pain than inflammatory features, in contrast to findings in finger OA studies, supporting thumb base osteoarthritis as a distinct phenotype.
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Affiliation(s)
- F P B Kroon
- Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands.
| | - S van Beest
- Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
| | - S Ermurat
- Department of Rheumatology, Uludag University Medical Faculty, Bursa, Turkey
| | - M C Kortekaas
- Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
| | - J L Bloem
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - M Reijnierse
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - F R Rosendaal
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - M Kloppenburg
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
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93
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Silva PG, Jones A, Fernandes ADRC, Natour J. Moberg Picking-Up Test in patients with hand osteoarthritis. J Hand Ther 2018; 30:522-528. [PMID: 27863736 DOI: 10.1016/j.jht.2016.10.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Revised: 09/01/2016] [Accepted: 10/12/2016] [Indexed: 02/09/2023]
Abstract
STUDY DESIGN Clinical measurement. INTRODUCTION The Moberg Pick-up Test (MPUT) was previously used to evaluate functional performance in patients with hand inflammatory disease. This is the first study using the MPUT in hand osteoarthritis (OA). PURPOSE OF THE STUDY Compare the functional performance (MPUT) in hand OA patients and healthy controls. METHODS Fifty hand OA patients and 50 controls were assessed using the MPUT, AUSCAN and Cochin questionnaires, grip and pinch strength, pain using a visual analog scale and a Likert scale regarding difficulty to perform MPUT. RESULTS In the MPUT evaluation, the OA group presented a statistically significant difference from the control group. The OA group spent more time executing test. The grip and pinch strength measurements showed higher values for the control group. The OA group reported a greater difficulty than the control group in performing the test. CONCLUSION The MPUT is a short and easy to apply test, which can be safely used to assess the functional performance of the hand OA. LEVEL OF EVIDENCE II.
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Affiliation(s)
- Paula Gabriel Silva
- Division of Rheumatology, Department of Medicine, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Anamaria Jones
- Division of Rheumatology, Department of Medicine, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | | | - Jamil Natour
- Division of Rheumatology, Department of Medicine, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
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Shabestari M, Kise NJ, Landin MA, Sesseng S, Hellund JC, Reseland JE, Eriksen EF, Haugen IK. Enhanced angiogenesis and increased bone turnover characterize bone marrow lesions in osteoarthritis at the base of the thumb. Bone Joint Res 2018; 7:406-413. [PMID: 30034794 PMCID: PMC6035357 DOI: 10.1302/2046-3758.76.bjr-2017-0083.r3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Objectives Little is known about tissue changes underlying bone marrow lesions (BMLs) in non-weight-bearing joints with osteoarthritis (OA). Our aim was to characterize BMLs in OA of the hand using dynamic histomorphometry. We therefore quantified bone turnover and angiogenesis in subchondral bone at the base of the thumb, and compared the findings with control bone from hip OA. Methods Patients with OA at the base of the thumb, or the hip, underwent preoperative MRI to assess BMLs, and tetracycline labelling to determine bone turnover. Three groups were compared: trapezium bones removed by trapeziectomy from patients with thumb base OA (n = 20); femoral heads with (n = 24); and those without (n = 9) BMLs obtained from patients with hip OA who underwent total hip arthroplasty. Results All trapezium bones demonstrated MRI-defined BMLs. Compared with femoral heads without BMLs, the trapezia demonstrated significantly higher bone turnover (mean sd 0.2 (0.1) versus 0.01 (0.01) µm3/µm2/day), mineralizing surface (18.5% (13.1) versus 1.4% (1.3)) and vascularity (5.2% (1.1) versus 1.2% (0.6)). Femoral heads with BMLs exhibited higher bone turnover (0.3 (0.2) versus 0.2 (0.1) µm3/µm2/day), a higher mineralization rate (26.6% (10.6) versus 18.6% (11.9)) and greater trabecular thickness (301.3 µm (108) versus 163.6 µm (24.8)) than the trapezia. Conclusion Bone turnover and angiogenesis were enhanced in BMLs of both the thumb base and hip OA, of which the latter exhibited the highest bone turnover. Thus, the increase in bone turnover in weight-bearing joints like the hip may be more pronounced than less mechanically loaded osteoarthritic joints demonstrating BMLs. The histological changes observed may explain the water signal from BMLs on MRI.Cite this article: M. Shabestari, N. J. Kise, M. A. Landin, S. Sesseng, J. C. Hellund, J. E. Reseland, E. F. Eriksen, I. K. Haugen. Enhanced angiogenesis and increased bone turnover characterize bone marrow lesions in osteoarthritis at the base of the thumb. Bone Joint Res 2018;7:406-413. DOI: 10.1302/2046-3758.76.BJR-2017-0083.R3.
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Affiliation(s)
- M Shabestari
- Department of Biomaterials, Faculty of Dentistry, Institute of Clinical Dentistry, University of Oslo, Oslo, Norway
| | - N J Kise
- Department of Orthopaedic Surgery, Martina Hansens Hospital, Akershus, Norway
| | - M A Landin
- Department of Oral Biology, Faculty of Dentistry University of Oslo, Oslo, Norway
| | - S Sesseng
- Department of Radiology,Diakonhjemmet Hospital, Oslo, Norway
| | - J C Hellund
- Department of Radiology and Nuclear Medicine, Oslo University Hospital, Ullevål, Oslo, Norway
| | - J E Reseland
- Department of Biomaterials, Faculty of Dentistry University of Oslo, Oslo, Norway
| | - E F Eriksen
- Department of Endocrinology, Oslo University Hospital, Ullevål, Oslo, Norway and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - I K Haugen
- Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
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Moon DK, Park YJ, Song SY, Kim MJ, Park JS, Nam DC, Kim DH, Na JB, Lee SI, Hwang SC, Park KS. Common Upper Extremity Disorders and Function Affect Upper Extremity-Related Quality of Life: A Community-Based Sample from Rural Areas. Yonsei Med J 2018; 59:669-676. [PMID: 29869465 PMCID: PMC5990682 DOI: 10.3349/ymj.2018.59.5.669] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 05/03/2018] [Accepted: 05/03/2018] [Indexed: 11/27/2022] Open
Abstract
PURPOSE Upper extremity musculoskeletal disorders (UEMDs), such as rotator cuff tear, epicondylitis, and hand osteoarthritis, have a negative impact on quality of life (QOL). In this study, we evaluated the prevalence of rotator cuff tear, lateral and medial epicondylitis, and hand osteoarthritis in the dominant side and the impact of these UEMDs on the disabilities of the arm, shoulder, and hand (DASH) outcome measure, which assesses upper extremity-related QOL. MATERIALS AND METHODS In 2013-2015, 987 participants from rural areas completed a questionnaire and underwent physical examinations, laboratory tests, simple radiographic evaluations of bilateral upper extremities, and magnetic resonance imaging studies of bilateral shoulders. Based on data from these participants, researchers evaluated DASH and performed a functional assessment of each region of the dominant side and related UEMDs. RESULTS The prevalences of epicondylitis, rotator cuff tear, and hand osteoarthritis were 33.7%, 53.4%, and 44.6%, respectively. Univariate regression analysis results revealed that epicondylitis, epicondylitis+rotator cuff tear, epicondylitis+hand osteoarthritis, and epicondylitis+rotator cuff tear+hand osteoarthritis were significantly associated with DASH score. Multiple regression analysis, including DASH, UEMD, and regional functional assessments, showed that only epicondylitis and epicondylitis+rotator cuff tear were associated with DASH score. CONCLUSION Epicondylitis significantly affected QOL, while other UEMDs, such as hand osteoarthritis and rotator cuff tear, had no significant impact. When a patient's QOL is affected by a UEMD, there is an increased possibility of the simultaneous presence of other UEMDs.
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Affiliation(s)
- Dong Kyu Moon
- Department of Orthopedic Surgery, Institute of Health Sciences, Gyeongsang National University School of Medicine, Gyeongsang National University Hospital, Jinju, Korea
| | - Young Jin Park
- Department of Orthopedic Surgery, Institute of Health Sciences, Gyeongsang National University School of Medicine, Gyeongsang National University Hospital, Jinju, Korea
| | - Sang Youn Song
- Department of Orthopedic Surgery, Institute of Health Sciences, Gyeongsang National University School of Medicine, Gyeongsang National University Hospital, Jinju, Korea
| | - Mi Ji Kim
- Department of Preventive Medicine, Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Jin Sung Park
- Department of Orthopedic Surgery, Institute of Health Sciences, Gyeongsang National University School of Medicine, Gyeongsang National University Hospital, Jinju, Korea
| | - Dae Cheol Nam
- Department of Orthopedic Surgery, Institute of Health Sciences, Gyeongsang National University School of Medicine, Gyeongsang National University Hospital, Jinju, Korea
| | - Dong Hee Kim
- Department of Orthopedic Surgery, Institute of Health Sciences, Gyeongsang National University School of Medicine, Gyeongsang National University Hospital, Jinju, Korea
| | - Jae Boem Na
- Department of Radiology, Institute of Health Sciences, Gyeongsang National University School of Medicine, Gyeongsang National University Hospital, Jinju, Korea
| | - Sang Il Lee
- Department of Internal Medicine, Institute of Health Sciences, Gyeongsang National University School of Medicine, Gyeongsang National University Hospital, Jinju, Korea
| | - Sun Chul Hwang
- Department of Orthopedic Surgery, Institute of Health Sciences, Gyeongsang National University School of Medicine, Gyeongsang National University Hospital, Jinju, Korea.
| | - Ki Soo Park
- Department of Preventive Medicine, Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea.
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96
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Marshall M, Peat G, Nicholls E, Myers HL, Mamas MA, van der Windt DA. Metabolic risk factors and the incidence and progression of radiographic hand osteoarthritis: a population-based cohort study. Scand J Rheumatol 2018; 48:52-63. [PMID: 29952684 PMCID: PMC6319183 DOI: 10.1080/03009742.2018.1459831] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To determine whether selected metabolic factors are associated with greater amounts of radiographic hand osteoarthritis (OA) incidence and progression. METHODS The study identified 706 adults, aged 50-69 years, with hand pain and hand radiographs at baseline, from two population-based cohorts. Metabolic factors (body mass index, hypertension, dyslipidaemia, and diabetes) were ascertained at baseline by direct measurement and medical records. Analyses were undertaken following multiple imputation of missing data, and in complete cases (sensitivity analyses). Multivariable regression models estimated associations between metabolic factors and two measures of radiographic change at 7 years for all participants, individuals free of baseline radiographic OA, and in baseline hand OA subsets. Estimates were adjusted for baseline values and other covariates. RESULTS The most consistent and strong associations observed were between the presence of diabetes and the amount of radiographic progression in individuals with nodal OA [adjusted mean differences in Kellgren-Lawrence summed score of 4.50 (-0.26, 9.25)], generalized OA [3.27 (-2.89, 9.42)], and erosive OA [3.05 (-13.56, 19.67)]. The remaining associations were generally weak or inconsistent, although numbers were limited for analyses of incident radiographic OA and erosive OA in particular. CONCLUSION Overall metabolic risk factors were not independently or collectively associated with greater amounts of radiographic hand OA incidence or progression over 7 years, but diabetes was associated with radiographic progression in nodal, and possibly generalized and erosive OA. Diabetes has previously been associated with prevalent but not incident hand OA. Further investigation in hand OA subsets using objective measures accounting for disease duration and control is warranted.
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Affiliation(s)
- M Marshall
- a Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences , Keele University , Staffordshire , UK
| | - G Peat
- a Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences , Keele University , Staffordshire , UK
| | - E Nicholls
- b Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences and Keele Clinical Trials Unit , Keele University , Staffordshire , UK
| | - H L Myers
- b Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences and Keele Clinical Trials Unit , Keele University , Staffordshire , UK
| | - M A Mamas
- c Keele Cardiovascular Research Group, Guy Hilton Research Centre , Keele University , Stoke-on-Trent , UK
| | - D A van der Windt
- a Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences , Keele University , Staffordshire , UK
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Karl Spies C, Langer M, Hahn P, Peter Müller L, Unglaub F. The Treatment of Primary Arthritis of the Finger and Thumb Joint. DEUTSCHES ARZTEBLATT INTERNATIONAL 2018; 115:269-275. [PMID: 29739493 PMCID: PMC5954171 DOI: 10.3238/arztebl.2018.0269] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Revised: 08/15/2017] [Accepted: 01/31/2018] [Indexed: 02/05/2023]
Abstract
BACKGROUND Primary finger and thumb joint arthritis is common, with a markedly rising prevalence from age 50 onward. As the population as a whole ages, the need for effective, stage-appropriate treatment of this condition is increasing. METHODS This review is based on pertinent publications retrieved by a selective search in the PubMed and Cochrane Library databases. RESULTS Pain on movement and morning stiffness are commonly reported symptoms. Thorough physical examination and plain x-rays are mandatory. In the early stages of primary finger and thumb joint arthritis, a conservative, multimodal treatment approach involving the use of splints, physiotherapy, and non-steroidal anti-inflammatory drugs can be helpful. The intraarticular injection of hyaluronic acid or cortisone seems to relieve pain in the short term, but its long-term efficacy in primary finger and thumb joint arthritis is questionable. Arthrodesis (joint fusion) is a reliable surgical treatment option for arthritis of the metacarpophalangeal and interphalangeal joints of the thumb. For mobility-preserving surgery of the metacarpophalangeal joints of the second through fifth fingers, silicone implant arthroplasty remains the gold standard. Symptomatic, advanced arthritis of the distal interphalangeal joint is most effectively treated with arthrodesis. CONCLUSION The efficacy of conservative treatment has been documented in high-quality clinical trials, while that of surgical treatment has not. The various surgical methods have yielded benefits in routine clinical use, but these remain to be assessed in randomized and controlled trials.
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Affiliation(s)
| | - Martin Langer
- Department of Trauma, Hand, and Plastic Surgery, Münster University Hospital, Münster
| | - Peter Hahn
- Department of Hand Surgery, Vulpius Hospital, Bad Rappenau
| | - Lars Peter Müller
- Department of Orthopedics and Trauma Surgery, Cologne University Hospital, Cologne
| | - Frank Unglaub
- Department of Hand Surgery, Vulpius Hospital, Bad Rappenau
- Medical Faculty Mannheim, University of Heidelberg, Mannheim
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98
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Kroon FPB, Damman W, Liu R, Bijsterbosch J, Meulenbelt I, van der Heijde D, Kloppenburg M. Validity, reliability, responsiveness and feasibility of four hand mobility measures in hand osteoarthritis. Rheumatology (Oxford) 2018; 57:525-532. [PMID: 29253246 DOI: 10.1093/rheumatology/kex438] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Indexed: 11/13/2022] Open
Abstract
Objectives To investigate metric properties of four hand mobility tests in hand OA patients, using the OMERACT filter. Methods Trained assessors examined the Hand Mobility in Scleroderma test (HAMIS), fingertip-to-palm distance (FPD), modified Kapandji index (MKI) and number of hand joints with limited mobility in participants from two cohorts [Genetics ARthrosis and Progression (n = 207) and Hand OSTeoArthritis in Secondary care (n = 174)]. Validity was appraised by assessment of correlations with other outcome measures, and ability to measure thumb vs finger mobility specifically, using cumulative probability plots. The proportion of participants changing in hand mobility based on the smallest detectable difference was calculated for responsiveness. Intraclass correlation coefficients (ICCs) for intra- and interobserver reliability, and feasibility (time to perform tests) were studied in a random sample (n = 20). Results Participants displayed large variation in mobility scores. Strongest correlations were observed with structural damage (rs = 0.43-0.52) and bony swelling (rs = 0.46-0.58); correlation patterns were similar among tests. HAMIS, FPD and MKI could all measure finger mobility specifically, but only HAMIS measured thumb mobility particularly. Interobserver reliability was best for HAMIS, ICC 0.90 (95% CI: 0.76, 0.96); intraobserver reliability was excellent for all (ICCs 0.94-0.97). In 2 years, little change was observed; HAMIS was the most sensitive-to-change (smallest detectable difference 3.7% of maximum score). The mean performance time ranged from 0.7 (s.d. 0.5, for FPD) to 5.7 (s.d. 1.3, for HAMIS) min. Conclusion HAMIS, FPD, MKI and number of joints with limited mobility are all valid, reliable and feasible measures for assessing hand mobility in hand OA, although HAMIS had slightly more favourable properties. Studies assessing sensitivity-to-change in a clinical trial setting are warranted.
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Affiliation(s)
- Féline P B Kroon
- Department of Rheumatology, Leiden University Medical Center, Leiden, the Netherlands
| | - Wendy Damman
- Department of Rheumatology, Leiden University Medical Center, Leiden, the Netherlands
| | - Rani Liu
- Department of Rheumatology, Leiden University Medical Center, Leiden, the Netherlands
| | - Jessica Bijsterbosch
- Department of Rheumatology, Leiden University Medical Center, Leiden, the Netherlands
| | - Ingrid Meulenbelt
- Department of Molecular Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | | | - Margreet Kloppenburg
- Department of Rheumatology, Leiden University Medical Center, Leiden, the Netherlands.,Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
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99
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Reginster JYL, Arden NK, Haugen IK, Rannou F, Cavalier E, Bruyère O, Branco J, Chapurlat R, Collaud Basset S, Al-Daghri NM, Dennison EM, Herrero-Beaumont G, Laslop A, Leeb BF, Maggi S, Mkinsi O, Povzun AS, Prieto-Alhambra D, Thomas T, Uebelhart D, Veronese N, Cooper C. Guidelines for the conduct of pharmacological clinical trials in hand osteoarthritis: Consensus of a Working Group of the European Society on Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO). Semin Arthritis Rheum 2017; 48:1-8. [PMID: 29287769 DOI: 10.1016/j.semarthrit.2017.12.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Revised: 11/09/2017] [Accepted: 12/05/2017] [Indexed: 02/06/2023]
Abstract
OBJECTIVES To gather expert opinion on the conduct of clinical trials that will facilitate regulatory review and approval of appropriate efficacious pharmacological treatments for hand osteoarthritis (OA), an area of high unmet clinical need. METHODS The European Society on Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal diseases (ESCEO) organized a working group under the auspices of the International Osteoporosis Foundation (IOF) and the World Health Organization (WHO). RESULTS This consensus guideline is intended to provide a reference tool for practice, and should allow for better standardization of the conduct of clinical trials in hand OA. Hand OA is a heterogeneous disease affecting different, and often multiple, joints of the thumb and fingers. It was recognized that the various phenotypes and limitations of diagnostic criteria may make the results of hand OA trials difficult to interpret. Nonetheless, practical recommendations for the conduct of clinical trials of both symptom and structure modifying drugs are outlined in this consensus statement, including guidance on study design, execution, and analysis. CONCLUSIONS While the working group acknowledges that the methodology for performing clinical trials in hand OA will evolve as knowledge of the disease increases, it is hoped that this guidance will support the development of new pharmacological treatments targeting hand OA.
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Affiliation(s)
- Jean-Yves L Reginster
- Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - Nigel K Arden
- Arthritis Research UK Centre for Sport, Exercise and Osteoarthritis, University of Oxford, Oxford, UK; MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
| | - Ida K Haugen
- Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
| | - Francois Rannou
- Division of Physical Medicine and Rehabilitation, AP-HP Cochin Hospital, Université Paris Descartes Sorbonne Paris Cité, Paris, France
| | - Etienne Cavalier
- Department of Clinical Chemistry, University of Liège, CHU Sart-Tilman, Route 52, Porte 53, Domaine du Sart-Tilman, Liège, Belgium
| | - Olivier Bruyère
- Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - Jaime Branco
- Department of Rheumatology, CEDOC, NOVA Medical School, Universidade Nova de Lisboa, CHLO, Hospital Egas Moniz, Lisbon, Portugal
| | - Roland Chapurlat
- Division of Rheumatology, INSERM UMR 1033, Université de Lyon, Hôpital E Herriot, Lyon, France
| | | | - Nasser M Al-Daghri
- Biochemistry Department, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - Elaine M Dennison
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
| | - Gabriel Herrero-Beaumont
- Department of Rheumatology, Bone and Joint Research Unit, Fundación Jiménez Diaz, Universidad Autonoma, Madrid, Spain
| | - Andrea Laslop
- Scientific Office, Austrian Medicines and Medical Devices Agency, AGES, Vienna, Austria
| | - Burkhard F Leeb
- Second Department of Medicine, Centre for Rheumatology Lower Austria, State Hospital Stockerau, Stockerau, Austria
| | | | - Ouafa Mkinsi
- Rheumatology Department, IBN ROCHD University Hospital, Casablanca, Morocco
| | - Anton S Povzun
- Scientific Research Institute of Emergency Care n.a. l.l. Dzhanelidze, Saint-Petersburg, Russia
| | - Daniel Prieto-Alhambra
- Musculoskeletal Pharmaco and Device Epidemiology, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, UK; NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK
| | - Thierry Thomas
- Department of Rheumatology, Hôpital Nord, CHU de St-Etienne & INSERM 1059, Université de Lyon, Saint-Etienne, France
| | - Daniel Uebelhart
- Division of Musculoskeletal, Internal Medicine and Oncological Rehabilitation, Department of Orthopaedics and Traumatology, Hôpital du Valais (HVS), Centre Hospitalier du Valais Romand (CHVR), CVP, Crans-Montana, Switzerland
| | | | - Cyrus Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK; NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK.
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Fioravanti A, Cheleschi S, De Palma A, Addimanda O, Mancarella L, Pignotti E, Pulsatelli L, Galeazzi M, Meliconi R. Can adipokines serum levels be used as biomarkers of hand osteoarthritis? Biomarkers 2017; 23:265-270. [PMID: 29105498 DOI: 10.1080/1354750x.2017.1401665] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
PURPOSE To evaluate serum levels of visfatin, resistin and adiponectin in patients with erosive (E) and non-erosive (NE) osteoarthritis (OA) of the hand (HOA) compared to normal controls (NC). METHODS 94 outpatients with E HOA and NE HOA and 21 NC were enrolled. The radiological assessment of both hands was performed according to the Kellgren-Lawrence and Kallman score. Patients were divided into two subsets (lone HOA or generalized OA) based on clinically OA involvement of knee and hip. Serum visfatin, resistin and adiponectin levels were determined by ELISA assay. RESULTS Visfatin was significantly higher in E HOA patients in comparison to NC and NE HOA group. Resistin showed a significant increase in both E HOA and NE HOA groups versus NC, in particular in generalized OA. No significant differences among groups were found in adiponectin. The Kallman score was more severe in the two subsets of E HOA patients compared to NE HOA. CONCLUSIONS This study showed increased levels of resistin in erosive and non-erosive HOA, and higher visfatin levels in E HOA in comparison to NE HOA. These data suggest the adipokines possible role in the pathogenesis of HOA and their potential usefulness as biomarkers of the disease.
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Affiliation(s)
- A Fioravanti
- a Department of Medicine, Surgery and Neuroscience, Rheumatology Unit , University of Siena, Policlinico Le Scotte , Siena , Italy
| | - S Cheleschi
- a Department of Medicine, Surgery and Neuroscience, Rheumatology Unit , University of Siena, Policlinico Le Scotte , Siena , Italy
| | - A De Palma
- a Department of Medicine, Surgery and Neuroscience, Rheumatology Unit , University of Siena, Policlinico Le Scotte , Siena , Italy.,b Department of Medical Biotechnologies , University of Siena, Policlinico Le Scotte , Siena , Italy
| | - O Addimanda
- c Medicine and Rheumatology Unit , Rizzoli Orthopaedic Institute , Bologna , Italy.,d Department of Biomedical and Neuromotor Sciences , University of Bologna , Italy
| | - L Mancarella
- c Medicine and Rheumatology Unit , Rizzoli Orthopaedic Institute , Bologna , Italy
| | - E Pignotti
- c Medicine and Rheumatology Unit , Rizzoli Orthopaedic Institute , Bologna , Italy
| | - L Pulsatelli
- e Laboratory of Immunorheumatology and Tissue Regeneration , Rizzoli Orthopaedic Institute , Bologna , Italy
| | - M Galeazzi
- a Department of Medicine, Surgery and Neuroscience, Rheumatology Unit , University of Siena, Policlinico Le Scotte , Siena , Italy
| | - R Meliconi
- c Medicine and Rheumatology Unit , Rizzoli Orthopaedic Institute , Bologna , Italy.,d Department of Biomedical and Neuromotor Sciences , University of Bologna , Italy
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