Natural history of radiographic features of hand osteoarthritis over 10 years

Abstract

To evaluate the natural history of radiographic hand osteoarthritis (OA) over 10 years. We assessed 118 subjects (30 women) twice (X-ray A and B) with mean (SD) follow-up time of 9.6 (0.4) years. Subjects were of mean (SD) age 52 (10) years at X-ray A and had undergone prior knee meniscectomy. Radiographs of the distal interphalangeal (DIP) and proximal interphalangeal (PIP) joints, and the first interphalangeal (IP1) and first carpometacarpal (CMC1) joints of both hands were read for joint space narrowing (JSN) and osteophytes according to the OARSI atlas. Radiographic progression was evaluated both at joint and subject level. At the time of X-ray A, we found radiographic OA (approximating Kellgren and Lawrence grade 2 or worse) in at least one hand joint in 42 (36%) subjects, and in 62 (53%) at X-ray B (P<0.001). At X-ray A, 21 subjects (18%) were classified as having primary hand OA vs 35 (30%) at X-ray B (P<0.001). Increase in JSN and osteophyte grade occurred most frequently in the DIP joints. OA at X-ray B was most frequently found in subjects' CMC1 (29%), DIP (14-27%), and IP1 joints (19%). Fifty-nine percent of subjects progressed radiographically (increase in total radiographic score by at least 2). However, the progression of the radiographic changes was mostly minor. In subjects with prior meniscectomy, CMC1, DIP, and IP1 joint OA is common. However, further hand OA progression over 10 years, as detected by plain radiography, is relatively modest. More sensitive imaging techniques may be preferable for clinical trials to evaluate structural hand OA progression.