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Giulini M, Brinks R, Vordenbäumen S, Acar H, Richter JG, Baraliakos X, Ostendorf B, Schneider M, Sander O, Sewerin P. High Frequency of Osteophytes Detected by High-Resolution Ultrasound at the Finger Joints of Asymptomatic Factory Workers. J Pers Med 2023; 13:1343. [PMID: 37763111 PMCID: PMC10532985 DOI: 10.3390/jpm13091343] [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: 08/14/2023] [Revised: 08/28/2023] [Accepted: 08/30/2023] [Indexed: 09/29/2023] Open
Abstract
Hand Osteoarthritis (HOA) is a frequently occurring musculoskeletal disease that impacts health. Diagnostic criteria often incorporate osteophytes documented through imaging procedures. Radiographic imaging is considered the gold standard; however, more sensitive and safer methods like ultrasound imaging are becoming increasingly important. We conducted a population-based cross-sectional study to examine the prevalence, grade, and pattern of osteophytes using high-resolution ultrasound investigation. Factory workers were recruited on-site for the study. Each participant had 26 finger joints examined using ultrasonography to grade the occurrence of osteophytes on a semi-quantitative scale ranging from 0-3, where higher scores indicate larger osteophytes. A total of 427 participants (mean age 53.5 years, range 20-79 years) were included, resulting in 11,000 joints scored. At least one osteophyte was found in 4546 out of 11,000 (41.3%) joints or in 426 out of 427 (99.8%) participants, but only 5.0% (553) of the joints showed grade 2 or 3 osteophytes. The total osteophyte sum score increased by 0.18 per year as age increased (p < 0.001). The distal interphalangeal joints were the most commonly affected, with 61%, followed by the proximal interphalangeal joints with 48%, carpometacarpal joint 1 with 39%, and metacarpophalangeal joints with 16%. There was no observed impact of gender or workload. In conclusion, ultrasound imaging proves to be a practical screening tool for osteophytes and HOA. Grade 1 osteophytes are often detected in the working population through ultrasound assessments and their incidence increases with age. The occurrence of grade 2 or 3 osteophytes is less frequent and indicates the clinical presence of HOA. Subsequent evaluations are imperative to ascertain the predictive significance of early osteophytes.
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Affiliation(s)
- Mario Giulini
- Department and Hiller-Research-Unit for Rheumatology, Medical Faculty, Heinrich-Heine-University Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany
| | - Ralph Brinks
- Department and Hiller-Research-Unit for Rheumatology, Medical Faculty, Heinrich-Heine-University Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany
| | - Stefan Vordenbäumen
- Department and Hiller-Research-Unit for Rheumatology, Medical Faculty, Heinrich-Heine-University Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany
| | - Hasan Acar
- Department and Hiller-Research-Unit for Rheumatology, Medical Faculty, Heinrich-Heine-University Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany
| | - Jutta G. Richter
- Department and Hiller-Research-Unit for Rheumatology, Medical Faculty, Heinrich-Heine-University Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany
| | - Xenofon Baraliakos
- Rheumazentrum Ruhrgebiet, Ruhr University Bochum, Claudiusstrasse 45, 44649 Herne, Germany
| | - Benedikt Ostendorf
- Department and Hiller-Research-Unit for Rheumatology, Medical Faculty, Heinrich-Heine-University Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany
| | - Matthias Schneider
- Department and Hiller-Research-Unit for Rheumatology, Medical Faculty, Heinrich-Heine-University Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany
| | - Oliver Sander
- Department and Hiller-Research-Unit for Rheumatology, Medical Faculty, Heinrich-Heine-University Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany
| | - Philipp Sewerin
- Department and Hiller-Research-Unit for Rheumatology, Medical Faculty, Heinrich-Heine-University Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany
- Rheumazentrum Ruhrgebiet, Ruhr University Bochum, Claudiusstrasse 45, 44649 Herne, Germany
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Prevalence and associated factors of osteoarthritis in the Ural Eye and Medical Study and the Ural Very Old Study. Sci Rep 2022; 12:12607. [PMID: 35871091 PMCID: PMC9308808 DOI: 10.1038/s41598-022-16925-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Accepted: 07/18/2022] [Indexed: 11/26/2022] Open
Abstract
To determine the prevalence of osteoarthritis and its associated factors in populations from Russia. The population-based Ural Eye and Medical Study (UEMS) and the population-based Ural Very Old Study (UVOS) were conducted in a rural and urban region in Bashkortostan/Russia and included participants aged 40+ and 85+ years, respectively. As part of a detailed systematic examination, we assessed the osteoarthritis prevalence in an interview including questions on the self-reported presence of osteoarthritis, the joints affected and osteoarthritis-related pain-relieving therapy taken. Out of 5898 participants of the UEMS, 1636 individuals had osteoarthritis [prevalence: 27.7%; 95% confidence interval (CI) 26.7, 28.7], with 816 individuals (13.8%; 95% CI 12.8, 14.8) taking pain-relieving medication. A higher osteoarthritis prevalence was associated (multivariable analysis) with older age [odds ratio (OR 1.04; 95% confidence interval (CI) 1.03, 1.05], urban region of residence (OR 1.25; 95% CI 1.07, 1.45), higher body mass index (BMI) (OR 1.04; 95% CI 1.03, 1.06), lower monthly income (OR 0.78; 95% CI 0.68, 0.90), higher physical activity score (OR 1.02, 95% CI 1.01, 1.03), higher prevalence of a history of cardiovascular disease including stroke (OR 1.55; 95% CI 1.33, 1.81), previous bone fractures (OR 1.20; 95% CI 1.04, 1.40) and previous falls (OR 1.22; 95% CI 1.03, 1.45), higher hearing loss score (OR 1.01; 95% CI 1.01, 1.02), and less alcohol consumption (OR 0.78; 95% CI 0.65, 0.93). Out of 1526 UVOS participants, 567 individuals had osteoarthritis (prevalence: 37.2%; 95% CI 35.0, 40.0), with 195 (12.8%; 95% CI 11.3, 14.3) individuals taking pain-relieving medication. Higher osteoarthritis prevalence was associated with rural region of habitation (OR 1.69; 95% CI 1.20, 2.38), lower monthly income (OR 0.62; 95% CI 0.46, 0.84), higher prevalence of cardiovascular disease (OR 1.75; 95% CI 1.30, 2.36), and higher anxiety score (OR 1.04; 95% CI 1.03, 1.06). Osteoarthritis and use of pain-relieving medication are common in these populations in Russia. Main associated factors were older age and lower monthly income in both study populations, female sex, higher BMI, urban region, and previous falls and bone fractures in the UEMS population, and rural region and a higher anxiety score in the UVOS study population.
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Auroux M, Merle B, Fontanges E, Duvert F, Lespessailles E, Chapurlat R. The disability associated with hand osteoarthritis is substantial in a cohort of post-menopausal women: the QUALYOR study. Osteoarthritis Cartilage 2022; 30:1526-1535. [PMID: 35995128 DOI: 10.1016/j.joca.2022.07.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 06/10/2022] [Accepted: 07/14/2022] [Indexed: 02/02/2023]
Abstract
OBJECTIVES Our primary aims were to assess current prevalence of HOA and the disability associated with this condition, in the group usually most affected, i.e., women older than 55. METHODS We performed hand radiographs, clinical examination, grip strength measurement, AUSCAN and COCHIN questionnaires in a cohort of postmenopausal women aged at least 55. Radiographic hand OA (RHOA) was defined as at least 2 affected joints among 30, grading 2 or more using the Kellgren Lawrence score but without any HOA symptom. Symptomatic HOA (OA ACR) was defined according to ACR criteria for hand OA. Moderate to severe symptomatic HOA was defined as having OA ACR and AUSCAN total score of >43/100. RESULTS We enrolled 1,189 participants. The mean age was 71.7 years. Inter-reader reliability of radiographs reading was good (ICC = 0.86) and intra-reader reliability was excellent (ICC = 0.97). Among the 1,189 women, 333 (28.0%) had RHOA, 482 (40.5%) patients fulfilled the ACR criteria for symptomatic HOA and 82 of these (17% of OA ACR population) had moderate to severe symptomatic HOA. The prevalence of symptomatic erosive osteoarthritis was 11.8%. Mean AUSCAN and Cochin scores were higher and grip strength lower in patients with symptomatic HOA compared to patient without HOA. Differences were more noticeable in patients with moderate to severe HOA. CONCLUSIONS We have assessed disability associated with HOA in greater detail than previously and found that a third of postmenopausal women had RHOA, two fifths had symptomatic HOA and one sixth of symptomatic patients had moderate to severe HOA related disability and a tenth had symptomatic erosive osteoarthritis, representing a substantial burden of disease in our population-based cohort.
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Affiliation(s)
- M Auroux
- Hôpital E Herriot, Hospices Civils de Lyon, 69437 Lyon Cedex 03 Lyon, France.
| | - B Merle
- INSERM UMR 1033, Université de Lyon, Hôpital E Herriot, 69437 Lyon Cedex 03, France
| | - E Fontanges
- Hôpital E Herriot, Hospices Civils de Lyon, 69437 Lyon Cedex 03 Lyon, France
| | - F Duvert
- Hôpital E Herriot, Hospices Civils de Lyon, 69437 Lyon Cedex 03 Lyon, France
| | - E Lespessailles
- Centre Hospitalier Régional d'Orléans, Université d'Orléans, Orléans, France
| | - R Chapurlat
- Hôpital E Herriot, Hospices Civils de Lyon, 69437 Lyon Cedex 03 Lyon, France; INSERM UMR 1033, Université de Lyon, Hôpital E Herriot, 69437 Lyon Cedex 03, France
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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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Luo W, Lei GH, He HB, Li YS. Does the prevalence of radiographic hand osteoarthritis in patients with HIV-1 infection increase or not? Ann Rheum Dis 2016; 75:e51. [PMID: 27221692 DOI: 10.1136/annrheumdis-2016-209808] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2016] [Indexed: 11/04/2022]
Affiliation(s)
- Wei Luo
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Guang-Hua Lei
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Hong-Bo He
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yu-Sheng Li
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
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Aksoy A, Solmaz D, Can G, Cetin P, Balci A, Akar S, Birlik M, Akkoc N, Onen F. Increased Frequency of Hand Osteoarthritis in Patients with Primary Sjögren Syndrome Compared with Systemic Lupus Erythematosus. J Rheumatol 2016; 43:1068-71. [PMID: 27036385 DOI: 10.3899/jrheum.150841] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/19/2016] [Indexed: 11/22/2022]
Abstract
OBJECTIVE In daily practice, we noticed that hand osteoarthritis (OA) was commonly associated with primary Sjögren syndrome (pSS). Therefore, we aimed to investigate its prevalence in patients with pSS in a controlled study. METHODS The study included patients with pSS and controls with systemic lupus erythematosus (SLE). Standard hand/wrist radiographs were obtained and classified according to the Kellgren-Lawrence system. "Erosive hand OA" was defined according to the Verbruggen-Veys classification. RESULTS There were 114 patients with pSS (110 women, 51.0 yrs) and 34 patients with SLE (33 women, 42.4 yrs). Among 114 patients with pSS, 42.7% had radiographic, 30.3% symptomatic, and 16.0% erosive hand OA. The prevalences of radiographic (45.5%) and erosive hand OA (14.4%) in 90 patients with pSS with age- and sex-matched patients with SLE were significantly higher than those in patients with SLE (14.7% and 0.0%, p = 0.007 and p = 0.012, respectively). Interobserver reliabilities for diagnosing radiographic and erosive OA were found to be good (ĸ = 0.780 and ĸ = 0.788, respectively). Intraobserver reliabilities for diagnosing radiographic and erosive OA were also good (ĸ = 0.784 and ĸ = 0.825 for FO, and ĸ = 0.722 and ĸ = 0.800 for AB, respectively). The frequency of hand OA in patients with pSS was found to be increased with increasing age (r = 0.513). The mean age of those with erosive hand OA was significantly higher than those without erosive OA (p < 0.001). CONCLUSION This study suggests that pSS, conversely to SLE, is more frequently associated with hand OA.
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Affiliation(s)
- Adem Aksoy
- From the Department of Internal Medicine, and Division of Rheumatology, and Department of Radiology, Dokuz Eylul University School of Medicine, Izmir, Turkey.A. Aksoy, MD, Department of Internal Medicine, Dokuz Eylul University School of Medicine; D. Solmaz, MD, Department of Internal Medicine, Division of Rheumatology, Dokuz Eylul University School of Medicine; G. Can, MD, Department of Internal Medicine, Division of Rheumatology, Dokuz Eylul University School of Medicine; P. Cetin, MD, Department of Internal Medicine, Division of Rheumatology, Dokuz Eylul University School of Medicine; A. Balci, MD, Department of Radiology, Dokuz Eylul University School of Medicine; S. Akar, MD, Department of Internal Medicine, Division of Rheumatology, Dokuz Eylul University School of Medicine; M. Birlik, MD, Department of Internal Medicine, Division of Rheumatology, Dokuz Eylul University School of Medicine; N. Akkoc, MD, Professor, Department of Internal Medicine, Division of Rheumatology, Dokuz Eylul University School of Medicine; F. Onen, MD, Department of Internal Medicine, Division of Rheumatology, Dokuz Eylul University School of Medicine
| | - Dilek Solmaz
- From the Department of Internal Medicine, and Division of Rheumatology, and Department of Radiology, Dokuz Eylul University School of Medicine, Izmir, Turkey.A. Aksoy, MD, Department of Internal Medicine, Dokuz Eylul University School of Medicine; D. Solmaz, MD, Department of Internal Medicine, Division of Rheumatology, Dokuz Eylul University School of Medicine; G. Can, MD, Department of Internal Medicine, Division of Rheumatology, Dokuz Eylul University School of Medicine; P. Cetin, MD, Department of Internal Medicine, Division of Rheumatology, Dokuz Eylul University School of Medicine; A. Balci, MD, Department of Radiology, Dokuz Eylul University School of Medicine; S. Akar, MD, Department of Internal Medicine, Division of Rheumatology, Dokuz Eylul University School of Medicine; M. Birlik, MD, Department of Internal Medicine, Division of Rheumatology, Dokuz Eylul University School of Medicine; N. Akkoc, MD, Professor, Department of Internal Medicine, Division of Rheumatology, Dokuz Eylul University School of Medicine; F. Onen, MD, Department of Internal Medicine, Division of Rheumatology, Dokuz Eylul University School of Medicine
| | - Gercek Can
- From the Department of Internal Medicine, and Division of Rheumatology, and Department of Radiology, Dokuz Eylul University School of Medicine, Izmir, Turkey.A. Aksoy, MD, Department of Internal Medicine, Dokuz Eylul University School of Medicine; D. Solmaz, MD, Department of Internal Medicine, Division of Rheumatology, Dokuz Eylul University School of Medicine; G. Can, MD, Department of Internal Medicine, Division of Rheumatology, Dokuz Eylul University School of Medicine; P. Cetin, MD, Department of Internal Medicine, Division of Rheumatology, Dokuz Eylul University School of Medicine; A. Balci, MD, Department of Radiology, Dokuz Eylul University School of Medicine; S. Akar, MD, Department of Internal Medicine, Division of Rheumatology, Dokuz Eylul University School of Medicine; M. Birlik, MD, Department of Internal Medicine, Division of Rheumatology, Dokuz Eylul University School of Medicine; N. Akkoc, MD, Professor, Department of Internal Medicine, Division of Rheumatology, Dokuz Eylul University School of Medicine; F. Onen, MD, Department of Internal Medicine, Division of Rheumatology, Dokuz Eylul University School of Medicine
| | - Pinar Cetin
- From the Department of Internal Medicine, and Division of Rheumatology, and Department of Radiology, Dokuz Eylul University School of Medicine, Izmir, Turkey.A. Aksoy, MD, Department of Internal Medicine, Dokuz Eylul University School of Medicine; D. Solmaz, MD, Department of Internal Medicine, Division of Rheumatology, Dokuz Eylul University School of Medicine; G. Can, MD, Department of Internal Medicine, Division of Rheumatology, Dokuz Eylul University School of Medicine; P. Cetin, MD, Department of Internal Medicine, Division of Rheumatology, Dokuz Eylul University School of Medicine; A. Balci, MD, Department of Radiology, Dokuz Eylul University School of Medicine; S. Akar, MD, Department of Internal Medicine, Division of Rheumatology, Dokuz Eylul University School of Medicine; M. Birlik, MD, Department of Internal Medicine, Division of Rheumatology, Dokuz Eylul University School of Medicine; N. Akkoc, MD, Professor, Department of Internal Medicine, Division of Rheumatology, Dokuz Eylul University School of Medicine; F. Onen, MD, Department of Internal Medicine, Division of Rheumatology, Dokuz Eylul University School of Medicine
| | - Ali Balci
- From the Department of Internal Medicine, and Division of Rheumatology, and Department of Radiology, Dokuz Eylul University School of Medicine, Izmir, Turkey.A. Aksoy, MD, Department of Internal Medicine, Dokuz Eylul University School of Medicine; D. Solmaz, MD, Department of Internal Medicine, Division of Rheumatology, Dokuz Eylul University School of Medicine; G. Can, MD, Department of Internal Medicine, Division of Rheumatology, Dokuz Eylul University School of Medicine; P. Cetin, MD, Department of Internal Medicine, Division of Rheumatology, Dokuz Eylul University School of Medicine; A. Balci, MD, Department of Radiology, Dokuz Eylul University School of Medicine; S. Akar, MD, Department of Internal Medicine, Division of Rheumatology, Dokuz Eylul University School of Medicine; M. Birlik, MD, Department of Internal Medicine, Division of Rheumatology, Dokuz Eylul University School of Medicine; N. Akkoc, MD, Professor, Department of Internal Medicine, Division of Rheumatology, Dokuz Eylul University School of Medicine; F. Onen, MD, Department of Internal Medicine, Division of Rheumatology, Dokuz Eylul University School of Medicine
| | - Servet Akar
- From the Department of Internal Medicine, and Division of Rheumatology, and Department of Radiology, Dokuz Eylul University School of Medicine, Izmir, Turkey.A. Aksoy, MD, Department of Internal Medicine, Dokuz Eylul University School of Medicine; D. Solmaz, MD, Department of Internal Medicine, Division of Rheumatology, Dokuz Eylul University School of Medicine; G. Can, MD, Department of Internal Medicine, Division of Rheumatology, Dokuz Eylul University School of Medicine; P. Cetin, MD, Department of Internal Medicine, Division of Rheumatology, Dokuz Eylul University School of Medicine; A. Balci, MD, Department of Radiology, Dokuz Eylul University School of Medicine; S. Akar, MD, Department of Internal Medicine, Division of Rheumatology, Dokuz Eylul University School of Medicine; M. Birlik, MD, Department of Internal Medicine, Division of Rheumatology, Dokuz Eylul University School of Medicine; N. Akkoc, MD, Professor, Department of Internal Medicine, Division of Rheumatology, Dokuz Eylul University School of Medicine; F. Onen, MD, Department of Internal Medicine, Division of Rheumatology, Dokuz Eylul University School of Medicine
| | - Merih Birlik
- From the Department of Internal Medicine, and Division of Rheumatology, and Department of Radiology, Dokuz Eylul University School of Medicine, Izmir, Turkey.A. Aksoy, MD, Department of Internal Medicine, Dokuz Eylul University School of Medicine; D. Solmaz, MD, Department of Internal Medicine, Division of Rheumatology, Dokuz Eylul University School of Medicine; G. Can, MD, Department of Internal Medicine, Division of Rheumatology, Dokuz Eylul University School of Medicine; P. Cetin, MD, Department of Internal Medicine, Division of Rheumatology, Dokuz Eylul University School of Medicine; A. Balci, MD, Department of Radiology, Dokuz Eylul University School of Medicine; S. Akar, MD, Department of Internal Medicine, Division of Rheumatology, Dokuz Eylul University School of Medicine; M. Birlik, MD, Department of Internal Medicine, Division of Rheumatology, Dokuz Eylul University School of Medicine; N. Akkoc, MD, Professor, Department of Internal Medicine, Division of Rheumatology, Dokuz Eylul University School of Medicine; F. Onen, MD, Department of Internal Medicine, Division of Rheumatology, Dokuz Eylul University School of Medicine
| | - Nurullah Akkoc
- From the Department of Internal Medicine, and Division of Rheumatology, and Department of Radiology, Dokuz Eylul University School of Medicine, Izmir, Turkey.A. Aksoy, MD, Department of Internal Medicine, Dokuz Eylul University School of Medicine; D. Solmaz, MD, Department of Internal Medicine, Division of Rheumatology, Dokuz Eylul University School of Medicine; G. Can, MD, Department of Internal Medicine, Division of Rheumatology, Dokuz Eylul University School of Medicine; P. Cetin, MD, Department of Internal Medicine, Division of Rheumatology, Dokuz Eylul University School of Medicine; A. Balci, MD, Department of Radiology, Dokuz Eylul University School of Medicine; S. Akar, MD, Department of Internal Medicine, Division of Rheumatology, Dokuz Eylul University School of Medicine; M. Birlik, MD, Department of Internal Medicine, Division of Rheumatology, Dokuz Eylul University School of Medicine; N. Akkoc, MD, Professor, Department of Internal Medicine, Division of Rheumatology, Dokuz Eylul University School of Medicine; F. Onen, MD, Department of Internal Medicine, Division of Rheumatology, Dokuz Eylul University School of Medicine
| | - Fatos Onen
- From the Department of Internal Medicine, and Division of Rheumatology, and Department of Radiology, Dokuz Eylul University School of Medicine, Izmir, Turkey.A. Aksoy, MD, Department of Internal Medicine, Dokuz Eylul University School of Medicine; D. Solmaz, MD, Department of Internal Medicine, Division of Rheumatology, Dokuz Eylul University School of Medicine; G. Can, MD, Department of Internal Medicine, Division of Rheumatology, Dokuz Eylul University School of Medicine; P. Cetin, MD, Department of Internal Medicine, Division of Rheumatology, Dokuz Eylul University School of Medicine; A. Balci, MD, Department of Radiology, Dokuz Eylul University School of Medicine; S. Akar, MD, Department of Internal Medicine, Division of Rheumatology, Dokuz Eylul University School of Medicine; M. Birlik, MD, Department of Internal Medicine, Division of Rheumatology, Dokuz Eylul University School of Medicine; N. Akkoc, MD, Professor, Department of Internal Medicine, Division of Rheumatology, Dokuz Eylul University School of Medicine; F. Onen, MD, Department of Internal Medicine, Division of Rheumatology, Dokuz Eylul University School of Medicine.
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Kodama R, Muraki S, Oka H, Iidaka T, Teraguchi M, Kagotani R, Asai Y, Yoshida M, Morizaki Y, Tanaka S, Kawaguchi H, Nakamura K, Akune T, Yoshimura N. Prevalence of hand osteoarthritis and its relationship to hand pain and grip strength in Japan: The third survey of the ROAD study. Mod Rheumatol 2016; 26:767-73. [PMID: 26882012 DOI: 10.3109/14397595.2015.1130673] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES To examine the prevalence and pattern of hand osteoarthritis (HOA), and determine its relationship with grip strength and hand pain. METHODS Among the participants of the third survey of the Research on Osteoarthritis/Osteoporosis Against Disability (ROAD) study, 507 Japanese men and 1028 Japanese women were included. Radiographs of both hands were graded for osteoarthritis (OA) using the modified Kellgren-Lawrence (KL) scale. HOA was defined as the presence of at least one affected joint. The absence or presence of subchondral erosion was also scored. RESULTS The prevalence of HOA (KL grade ≥2) was 89.9% in men and 92.3% in women (p = 0.11), and it was significantly associated with age. OA in the distal interphalangeal (DIP) joint was the highest overall. After adjusting for age, sex, body mass index, and the residing area, both severity (KL grade ≥3) and erosion were significantly related to low grip strength and hand pain. With regard to the joint groups, severe OA in the DIP and first carpometacarpal joints were related to hand pain. CONCLUSION This study showed a high prevalence of radiographic HOA and a significant relationship between hand pain and the severity of HOA, in addition to erosion.
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Affiliation(s)
- Rie Kodama
- a Department of Orthopedic Surgery, Graduate School of Medicine , The University of Tokyo , Tokyo , Japan
| | | | - Hiroyuki Oka
- c Department of Medical Research and Management for Musculoskeletal Pain
| | - Toshiko Iidaka
- d Department of Joint Disease Research, 22nd Century Medical and Research Center, Faculty of Medicine , The University of Tokyo , Tokyo , Japan
| | - Masatoshi Teraguchi
- e Department of Orthopedic Surgery , Wakayama Medical University , Wakayama , Japan
| | - Ryohei Kagotani
- e Department of Orthopedic Surgery , Wakayama Medical University , Wakayama , Japan
| | - Yoshiki Asai
- e Department of Orthopedic Surgery , Wakayama Medical University , Wakayama , Japan
| | - Munehito Yoshida
- e Department of Orthopedic Surgery , Wakayama Medical University , Wakayama , Japan
| | - Yutaka Morizaki
- a Department of Orthopedic Surgery, Graduate School of Medicine , The University of Tokyo , Tokyo , Japan
| | - Sakae Tanaka
- a Department of Orthopedic Surgery, Graduate School of Medicine , The University of Tokyo , Tokyo , Japan
| | - Hiroshi Kawaguchi
- f Department of Orthopedic Surgery , Japan Community Health care Organization Tokyo Shinjuku Medical Center , Tokyo , Japan , and
| | - Kozo Nakamura
- g National Rehabilitation Center for Persons with Disabilities , Saitama , Japan
| | - Toru Akune
- g National Rehabilitation Center for Persons with Disabilities , Saitama , Japan
| | - Noriko Yoshimura
- d Department of Joint Disease Research, 22nd Century Medical and Research Center, Faculty of Medicine , The University of Tokyo , Tokyo , Japan
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Marshall M, Jonsson H, Helgadottir GP, Nicholls E, van der Windt D, Myers H, Dziedzic K. Reliability of Assessing Hand Osteoarthritis on Digital Photographs and Associations With Radiographic and Clinical Findings. Arthritis Care Res (Hoboken) 2015; 66:828-36. [PMID: 26259552 PMCID: PMC4153954 DOI: 10.1002/acr.22225] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2013] [Accepted: 10/22/2013] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To investigate the reliability and construct validity of an atlas for grading hand osteoarthritis (OA) on photographs in a separate younger community-dwelling population than the development cohort. METHODS Participants were community-dwelling adults (ages ≥50 years) in North Staffordshire, UK with hand pain or hand problems in the last year who attended a research clinic. High-quality photographs were taken in a standardized position. A photographic atlas was used to score hand joints (second and third distal interphalangeal [DIP], second and third proximal interphalangeal [PIP], and first carpometacarpal [CMC] joints) and joint groups (DIP, PIP, and CMC joints) for OA on a 0-3 scale. Hand radiographs were graded for OA using the Kellgren/Lawrence (K/L) grading system. Clinical features (nodes, bony enlargement, and deformity) were determined by physical examination. Associations of photographic hand OA grades with radiographic OA and clinical features were determined to assess construct validity. RESULTS In total, 558 participants (mean age 64 years, 62% women) were included in the analyses. Reliability for scoring OA on the photographs was good (mean intrarater intraclass correlation coefficient [ICC] 0.77 and mean interrater ICC 0.71). At the joint level, photographic hand OA grade was positively associated with radiographic OA grade (Spearman's ρ = 0.19-0.57, P < 0.001) and the number of clinical features (Spearman's ρ = 0.36-0.59, P < 0.001). At the person level, individuals with higher global photographic OA scores had higher summed K/L scores and higher percentages meeting the American College of Rheumatology clinical hand OA criteria. CONCLUSION This photographic scoring system was reliable and a good indicator of hand OA in a separate younger community-dwelling population than the development cohort. This method of data collection offers researchers a feasible alternative to physical examination and radiography.
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Affiliation(s)
- Michelle Marshall
- Arthritis Research UK Primary Care Centre, Primary Care Sciences, Keele University, Staffordshire, UK
| | - Helgi Jonsson
- Landspitalinn University Hospital and University of Iceland, Reykjavik, Iceland
| | | | - Elaine Nicholls
- Arthritis Research UK Primary Care Centre, Primary Care Sciences, Keele University, Staffordshire, UK
| | - Danielle van der Windt
- Arthritis Research UK Primary Care Centre, Primary Care Sciences, Keele University, Staffordshire, UK
| | - Helen Myers
- Arthritis Research UK Primary Care Centre, Primary Care Sciences, Keele University, Staffordshire, UK
| | - Krysia Dziedzic
- Arthritis Research UK Primary Care Centre, Primary Care Sciences, Keele University, Staffordshire, UK
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Fu Q, Cao J, Renner JB, Jordan JM, Caterson B, Duance V, Luo M, Kraus VB. Radiographic features of hand osteoarthritis in adult Kashin-Beck Disease (KBD): the Yongshou KBD study. Osteoarthritis Cartilage 2015; 23:868-73. [PMID: 25623625 PMCID: PMC4769644 DOI: 10.1016/j.joca.2015.01.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Revised: 01/13/2015] [Accepted: 01/17/2015] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Kashin-Beck Disease (KBD) is a rare and severe osteoarthropathy endemic to China. We evaluated the frequency and patterns of hand radiographic osteoarthritis (rOA) in adults with and without KBD. METHODS Han Chinese (N = 438) from Yongshou County of central China underwent right hand radiography for determining case status. Presence of KBD was based on characteristic radiographic deformities of articular ends of bones including articular surface depression, carpal crowding, any subchondral bone deformities in the proximal end of phalanges or first metacarpal bone, or the distal ends of metacarpal bones 2-5, and any bony enlargement with deformity of the distal ends of phalanges. Hand rOA severity was determined by osteophyte (OST), joint space narrowing (JSN), and Kellgren and Lawrence (KL) grades. RESULTS This study included 127 KBD and 311 non-KBD adults of similar mean age (39 years) and body mass index (BMI) (21 kg/m(2)). Inter- and intra-rater reliability for radiographic determination of case status and rOA features was high (kappa 0.72-0.96). Compared to non-KBD, KBD adults had significantly more severe hand rOA of the thumb, distal interphalangeal (DIP), proximal interphalangeal (PIP) and metacarpophalangeal (MCP) joints. Only KBD adults had end-stage carpometacapal (CMC) disease. In KBD, DIPs and PIPs were more affected than MCPs and the frequency of OSTs was significantly higher in PIPs than DIPs. CONCLUSIONS Compared with age-matched adults from the same area and farming occupation, KBD hand rOA was more widespread and severe, particularly of PIPs and CMCs. The ability to differentiate adult KBD from non-KBD hand rOA will facilitate genetic analyses of the vast majority of affected individuals.
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Affiliation(s)
- Qiang Fu
- Institute of Endemic Diseases, School of Public Health, Xi'an Jiaotong University Medical Center, Xi’an, Shaanxi, P.R. China,Key Laboratory of Environment and Genes Related to Diseases, Xi’an Jiaotong University Medical Center, Ministry of Education, Xi’an, Shaanxi, P.R. China,Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, NC, USA,Address correspondence and reprint requests to: Qiang Fu, Institute of Endemic Diseases, Division of Public Health, School of Medicine, Xi'an Jiaotong University, 76 West Yanta Road, Xi’an, Shaanxi, 710061, P.R. China. Tel: 86-29-8265 5193; Fax: 86-29-8265 5032; , or Junling Cao, MD, Institute of Endemic Diseases, Division of Public Health, School of Medicine, Xi’an Jiaotong University, 76 West Yanta Road, Xi’an, Shaanxi, 710061, P.R. China. Tel: 86-29-8265 5193; Fax: 86-29-8265 5032; , or Virginia Byers Kraus, MD, PhD, Department of Medicine, Duke University Medical Center, Box 3416, GSRB1 Building, Durham, NC, 27710, USA. Tel: 1-919-681 6652; Fax: 1-919-684 8907;
| | - Junling Cao
- Institute of Endemic Diseases, School of Public Health, Xi'an Jiaotong University Medical Center, Xi’an, Shaanxi, P.R. China,Key Laboratory of Environment and Genes Related to Diseases, Xi’an Jiaotong University Medical Center, Ministry of Education, Xi’an, Shaanxi, P.R. China,Address correspondence and reprint requests to: Qiang Fu, Institute of Endemic Diseases, Division of Public Health, School of Medicine, Xi'an Jiaotong University, 76 West Yanta Road, Xi’an, Shaanxi, 710061, P.R. China. Tel: 86-29-8265 5193; Fax: 86-29-8265 5032; , or Junling Cao, MD, Institute of Endemic Diseases, Division of Public Health, School of Medicine, Xi’an Jiaotong University, 76 West Yanta Road, Xi’an, Shaanxi, 710061, P.R. China. Tel: 86-29-8265 5193; Fax: 86-29-8265 5032; , or Virginia Byers Kraus, MD, PhD, Department of Medicine, Duke University Medical Center, Box 3416, GSRB1 Building, Durham, NC, 27710, USA. Tel: 1-919-681 6652; Fax: 1-919-684 8907;
| | - Jordan B. Renner
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA,Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Joanne M. Jordan
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA,Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA,Department of Medicine and Orthopaedics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Bruce Caterson
- Connective Tissue Biology Laboratories, School of Biosciences, Cardiff University, UK
| | - Victor Duance
- Connective Tissue Biology Laboratories, School of Biosciences, Cardiff University, UK
| | - Mingxiu Luo
- Institute of Endemic Diseases, School of Public Health, Xi'an Jiaotong University Medical Center, Xi’an, Shaanxi, P.R. China,Key Laboratory of Environment and Genes Related to Diseases, Xi’an Jiaotong University Medical Center, Ministry of Education, Xi’an, Shaanxi, P.R. China
| | - Virginia Byers Kraus
- Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, NC, USA,Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA,Address correspondence and reprint requests to: Qiang Fu, Institute of Endemic Diseases, Division of Public Health, School of Medicine, Xi'an Jiaotong University, 76 West Yanta Road, Xi’an, Shaanxi, 710061, P.R. China. Tel: 86-29-8265 5193; Fax: 86-29-8265 5032; , or Junling Cao, MD, Institute of Endemic Diseases, Division of Public Health, School of Medicine, Xi’an Jiaotong University, 76 West Yanta Road, Xi’an, Shaanxi, 710061, P.R. China. Tel: 86-29-8265 5193; Fax: 86-29-8265 5032; , or Virginia Byers Kraus, MD, PhD, Department of Medicine, Duke University Medical Center, Box 3416, GSRB1 Building, Durham, NC, 27710, USA. Tel: 1-919-681 6652; Fax: 1-919-684 8907;
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Hoeven TA, Kavousi M, Ikram MA, van Meurs JB, Bindels PJ, Hofman A, Franco OH, Bierma-Zeinstra SM. Markers of atherosclerosis in relation to presence and progression of knee osteoarthritis: a population-based cohort study. Rheumatology (Oxford) 2015; 54:1692-8. [DOI: 10.1093/rheumatology/kev106] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Indexed: 11/12/2022] Open
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11
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Nelson AE, Jordan JM. Defining osteoarthritis: a moving target. Osteoarthritis Cartilage 2012; 20:1-3. [PMID: 22063368 DOI: 10.1016/j.joca.2011.10.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2011] [Revised: 10/12/2011] [Accepted: 10/17/2011] [Indexed: 02/02/2023]
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Abstract
Hand osteoarthritis (OA) is a prevalent disorder. Hand OA is not one single disease, but a heterogeneous group of disorders. Radiographic signs of hand OA, such as osteophytes or joint space narrowing, can be found in up to 81% of the elderly population. Several hand OA subsets--such as nodal interphalangeal OA, thumb base OA and erosive OA--can be discriminated. Furthermore, the experience of symptoms and the course of the disease differ between patients. Studies that used well-defined study populations with longitudinal follow-up have shown that similarities and differences can be observed in the pathogenesis, epidemiology and risk factors of the various hand OA subsets. Erosive OA in particular, characterized by erosive lesions on radiographical images, has a higher clinical burden and worse outcome than nonerosive hand OA. Imaging modalities (such as ultrasonography) have increased our knowledge of the role of inflammation of the disease. Our understanding of the heterogeneous nature of hand OA can eventually lead to increased knowledge of the pathogenesis of, and ultimately new treatment modalities for, this complex disease.
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Affiliation(s)
- Margreet Kloppenburg
- Department of Rheumatology, Leiden University Medical Center, Albinusdreef 2, PO Box 9600, 2300 RC Leiden, The Netherlands.
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Pereira D, Peleteiro B, Araújo J, Branco J, Santos RA, Ramos E. The effect of osteoarthritis definition on prevalence and incidence estimates: a systematic review. Osteoarthritis Cartilage 2011; 19:1270-85. [PMID: 21907813 DOI: 10.1016/j.joca.2011.08.009] [Citation(s) in RCA: 505] [Impact Index Per Article: 38.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2010] [Revised: 07/31/2011] [Accepted: 08/17/2011] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To understand the differences in prevalence and incidence estimates of osteoarthritis (OA), according to case definition, in knee, hip and hand joints. METHOD A systematic review was carried out in PUBMED and SCOPUS databases comprising the date of publication period from January 1995 to February 2011. We attempted to summarise data on the incidence and prevalence of OA according to different methods of assessment: self-reported, radiographic and symptomatic OA (clinical plus radiographic). Prevalence estimates were combined through meta-analysis and between-study heterogeneity was quantified. RESULTS Seventy-two papers were reviewed (nine on incidence and 63 on prevalence). Higher OA prevalences are seen when radiographic OA definition was used for all age groups. Prevalence meta-analysis showed high heterogeneity between studies even in each specific joint and using the same OA definition. Although the knee is the most studied joint, the highest OA prevalence estimates were found in hand joints. OA of the knee tends to be more prevalent in women than in men independently of the OA definition used, but no gender differences were found in hip and hand OA. Insufficient data for incidence studies didn't allow us to make any comparison according to joint site or OA definition. CONCLUSIONS Radiographic case definition of OA presented the highest prevalences. Within each joint site, self-reported and symptomatic OA definitions appear to present similar estimates. The high heterogeneity found in the studies limited further conclusions.
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Affiliation(s)
- D Pereira
- Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Portugal
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Nelson AE, DeVellis RF, Renner JB, Schwartz TA, Conaghan PG, Kraus VB, Jordan JM. Quantification of the whole-body burden of radiographic osteoarthritis using factor analysis. Arthritis Res Ther 2011; 13:R176. [PMID: 22027269 PMCID: PMC3308111 DOI: 10.1186/ar3501] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2011] [Revised: 07/05/2011] [Accepted: 10/25/2011] [Indexed: 11/30/2022] Open
Abstract
Introduction Although osteoarthritis (OA) commonly involves multiple joints, no widely accepted method for quantifying whole-body OA burden exists. Therefore, our aim was to apply factor analytic methods to radiographic OA (rOA) grades across multiple joint sites, representing both presence and severity, to quantify the burden of rOA. Methods We used cross-sectional data from the Johnston County Osteoarthritis Project. The sample (n = 2092) had a mean age of 65 ± 11 years, body mass index (BMI) 31 ± 7 kg/m2, with 33% men and 34% African Americans. A single expert reader (intra-rater κ = 0.89) provided radiographic grades based on standard atlases for the hands (30 joints, including bilateral distal and proximal interphalangeal [IP], thumb IP, metacarpophalangeal [MCP] and carpometacarpal [CMC] joints), knees (patellofemoral and tibiofemoral, 4 joints), hips (2 joints), and spine (5 levels [L1/2 to L5/S1]). All grades were entered into an exploratory common factor analysis as continuous variables. Stratified factor analyses were used to look for differences by gender, race, age, and cohort subgroups. Results Four factors were identified as follows: IP/CMC factor (20 joints), MCP factor (8 joints), Knee factor (4 joints), Spine factor (5 levels). These factors had high internal consistency reliability (Cronbach's α range 0.80 to 0.95), were not collapsible into a single factor, and had moderate between-factor correlations (Pearson correlation coefficient r = 0.24 to 0.44). There were no major differences in factor structure when stratified by subgroup. Conclusions The 4 factors obtained in this analysis indicate that the variables contained within each factor share an underlying cause, but the 4 factors are distinct, suggesting that combining these joint sites into one overall measure is not appropriate. Using such factors to reflect multi-joint rOA in statistical models can reduce the number of variables needed and increase precision.
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Affiliation(s)
- Amanda E Nelson
- Thurston Arthritis Research Center, University of North Carolina, 3300 Thurston Building CB 7280, Chapel Hill, NC, 27599, USA.
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Abstract
BACKGROUND AND AIMS Previous studies have reported that centenarians escape the major agerelated diseases. No studies on prevalence and severity of osteoarthritis (OA) in longevity population have previously been reported. Because OA is associated with morbidity and mortality, we hypothesized that radiographic hand OA would generally be less prevalent and would develop at a later age in longevity populations vs non-longevity populations. Aim was to evaluate the prevalence and mode of development of radiographic hand OA in three longevity populations (Abkhazians, Azerbaijanis and Georgians) and in one non-longevity population (Russians). METHODS Crosssectional observational study. Longevity index was calculated as a ratio of the number of individuals aged >90 years vs the number of people aged >60, expressed per mil (‰). A population with longevity index >40‰was considered as a longevity population. Radiographic hand OA was evaluated using the left hand radiograms in 14 joints according to Kellgren and Lawrence's (K-L) grading system. Each individual was characterized by the total number of affected (K-L≥2) joints (NAJ). Prevalence of hand OA was defined as the presence of at least one affected joint. Statistical analyses included prevalence estimation, linear, logistic and polynomial regressions, and ANOVA. RESULTS A significant difference (p<0.003) in age standardized prevalence of hand OA was found between each pair of studied samples, except between Russians and Georgians and between Azerbaijanis and Abkhazians (p>0.05). The lowest age-standardized prevalence was found in Abkhazians, followed by Azerbaijanis and Georgians. The highest prevalence was found in Russians. ANOVA showed significant differences (p<0.01) between the age-adjusted means of NAJs. The lowest age-adjusted NAJ was found in the Abkhazian population, followed by Azerbaijanis and Georgians. The highest NAJ was found in Russians. CONCLUSIONS We observed that the pattern of radiographic hand OA in longevity populations differs from the pattern in non-longevity populations. On average, first joints with OA appear at an older age, and progression of hand OA, measured by NAJ, is slower.
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Current world literature. Curr Opin Rheumatol 2011; 23:497-503. [PMID: 21844756 DOI: 10.1097/bor.0b013e32834a96c0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Haugen IK, Englund M, Aliabadi P, Niu J, Clancy M, Kvien TK, Felson DT. Prevalence, incidence and progression of hand osteoarthritis in the general population: the Framingham Osteoarthritis Study. Ann Rheum Dis 2011; 70:1581-6. [PMID: 21622766 DOI: 10.1136/ard.2011.150078] [Citation(s) in RCA: 333] [Impact Index Per Article: 25.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
OBJECTIVES To describe the prevalence and longitudinal course of radiographic, erosive and symptomatic hand osteoarthritis (HOA) in the general population. METHODS Framingham osteoarthritis (OA) study participants obtained bilateral hand radiographs at baseline and 9-year follow-up. The authors defined radiographic HOA at joint level as Kellgren-Lawrence grade (KLG)≥2, erosive HOA as KLG≥2 plus erosion and symptomatic HOA as KLG≥2 plus pain/aching/stiffness. Presence of HOA at individual level was defined as ≥1 affected joint. The prevalence was age-standardised (US 2000 Population 40-84 years). RESULTS Mean (SD) baseline age was 58.9 (9.9) years (56.5% women). The age-standardised prevalence of HOA was only modestly higher in women (44.2%) than men (37.7%), whereas the age-standardised prevalence of erosive and symptomatic OA was much higher in women (9.9% vs 3.3%, and 15.9% vs 8.2%). The crude incidence of HOA over 9-year follow-up was similar in women (34.6%) and men (33.7%), whereas the majority of those women (96.4%) and men (91.4%) with HOA at baseline showed progression during follow-up. Incident metacarpophalangeal and wrist OA were rare, but occurred more frequently and from an earlier age in men than women. Development of erosive disease occurred mainly in those with non-erosive HOA at baseline (as opposed to those without HOA), and was more frequent in women (17.3%) than men (9.6%). CONCLUSIONS The usual female predominance of prevalent and incident HOA was less clear for radiographic HOA than for symptomatic and erosive HOA. With an ageing population, the impact of HOA will further increase.
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Affiliation(s)
- Ida K Haugen
- Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.
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Abstract
BACKGROUND Osteoarthritis (OA), the most common form of arthritis, often affects hands, hips, and knees and involves an estimated 26.9 million US adults. Women have a higher prevalence of OA, and the risk of developing OA increases with age, obesity, and joint malalignment. OA typically presents with pain and reduced function. Therapeutic programs are often multimodal and must take into account pharmaceutical toxicities and patient comorbidities. For example, nonsteroidal anti-inflammatory drugs (NSAIDs) are associated with cardiovascular, gastrointestinal, and renal adverse events. Topical NSAIDs offer efficacy with reduced systemic drug exposure. RESEARCH DESIGN AND METHODS This is a review of current guideline recommendations regarding the use of topical NSAIDs in OA of the hand and knee. Articles were identified by PubMed search (January 1, 2000 to May 21, 2010). RESULTS Several current guidelines for management of OA recommend topical NSAIDs, indicating them as a safe and effective treatment. One guideline recommends that topical NSAIDs be considered as first-line pharmacologic therapy. A US guideline for knee OA recommends topical NSAIDs in older patients and in patients with increased gastrointestinal risk. CONCLUSIONS The consensus across US and European OA guidelines is that topical NSAIDs are a safe and effective treatment for OA. Because the research base on topical NSAIDs for OA is small, guidelines will continue to evolve.
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Affiliation(s)
- Roy D Altman
- David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
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Radiographic hand osteoarthritis in two ethnic groups living in the same geographic area. Rheumatol Int 2010; 30:1533-6. [PMID: 20372909 DOI: 10.1007/s00296-010-1494-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2010] [Accepted: 03/27/2010] [Indexed: 10/19/2022]
Abstract
The aim of the study was to compare the prevalence of radiographic hand osteoarthritis (OA) and its association with age, sex, body mass index in two ethnic groups, Russian and Buryats who reside in the same geographic area. It was a cross-sectional observational study. The study population comprised ethnic Russians (N = 572) and Buryats (N = 327) from the Barguzinsky District of the Buryat Republic, Russian Federation. OA was evaluated in 14 joints of the left hand according to Kellgren and Lawrence's grading system. A diagnosis of OA was determined by the number of affected joints and by the presence of at least one affected joint. Statistical analyses included prevalence estimation, linear and logistic regressions, and chi(2) tests. Our major finding was that individuals of different ethnic groups, residing in the same location, have similar prevalence and severity of radiographic hand OA. Considering the results of our previous study, where we found significant differences in the prevalence and severity of hand OA between the Russian samples (same ethnicity) with diverse places of residence, we conclude that environmental factors play an important role in the development of hand OA.
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