Radiographic hand osteoarthritis and worsening of mri-based tibiofemoral osteoarthritis-related structural damage, data from the OAI study

Abstract

Purpose: To determine whether the presence of hand osteoarthritis (OA) is associated with radiographic knee OA progression (over 48-months) and MRI-based knee OA structural damage worsening (over 24-months). Methods: 600 subjects from the Foundation for the National Institute of Health (FNIH) project which is an IRB approved HIPAA compliant study were included (one index knee and hand in each subject). Baseline hand radiography of all subjects was measured for the presence of hand OA. PA radiographs of the dominant hand or the left hand (in case of ambidexterity) of included subjects were assessed by a musculoskeletal radiologist in a blinded fashion. Distal interphalangeal (DIP), proximal interphalangeal (PIP), interphalangeal (IP), metacarpophalangeal (MCP), and the first carpometacarpal (CMC) joints were assessed for the presence of OA (modified Kellgren and Lawrence (mKL) grade >=2) in each hand joint. Baseline and follow-up knee radiographic measurements and MRI OA Knee Score (MOAKS) variables for cartilage damage, bone marrow lesions, osteophytes, effusion, and Hoffa-synovitis as well as MRI-based knee periarticular bone area measurements were extracted. The association between the presence of hand OA (presence vs. absence of hand OA in each hand joint) and 48-months radiographic knee OA progression (defined as >0.7mm reduction in medial tibiofemoral joint space width) as well as 24-months change in knee MOAKS and periarticular bone measurements were analyzed using regression model (adjusted for age and sex). Results: Presence of any carpometacarpal (CMC) OA (OR 95%CI: 1.58(0.96-2.62)) and overall hand OA (prsence of any mKL>=2 in all hand joints) (OR 95%CI: 1.44(0.97-2.07)) was associated increased odds for being a radiographic or composite progressor (approached but not reached significance). In comparison with controls, subjects with hand OA showed higher odds of worsening tibial/femoral cartilage damage (OR 95%CI: 1.38(0.95-2.01) and 1.79(1.24-2.58)) and femoral periarticular bone area expansion (Beta 95%CI: 10.54(1.40-19.69)) over 24-months. CMC OA and 24-months worsening of MRI-based tibiofemoral cartilage damage and periarticular bone area expansion were also showed approached significant associations. Conclusions: Presence of hand OA, especially in CMC joint, is associated with longitudinal MRI-based knee OA-related structural damage worsening including tibial/femoral cartilage damage and periarticular bone area expansion.