Progression Of Hand Osteoarthritis Research Articles

Accelerated metacarpal bone mineral density loss is associated with radiographic progressive hand osteoarthritis

ObjectiveTo study the association between metacarpal bone mineral density (BMD) loss and progressive hand osteoarthritis (OA) over 2 years.MethodsUsing the Kellgren–Lawrence (KL) grading scale and the Osteoarthritis Research Society International...

Association between leptin, adiponectin and resistin and long-term progression of hand osteoarthritis

ObjectiveTo investigate the association between baseline serum adipokines levels—leptin, adiponectin and resistin—and long-term progression of hand osteoarthritis (HOA).MethodsBaseline and 6-year radiographs of 164 patients (mean age 60 years, 81% women)...

Natural history of radiographic features of hand osteoarthritis over 10 years

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.

Progression of hand osteoarthritis over 2 years: a clinical and radiological follow-up study

Objectives:To investigate the course of hand osteoarthritis over 2 years by currently available outcome measures.Methods:189 participants of the Genetics, Arthrosis and Progression (GARP) study with hand osteoarthritis were followed for...

Epiphyseal expansion in hand bones: association with age, sex, and hand osteoarthritis

Previous studies showed increased femoral, neck, and tibial plateau with age in individuals with and without osteoarthritis (OA) at adjacent joints. However, the question whether epiphyseal bone enlargement is a natural phenomenon of aging or associated with OA remains open. The aim of the present study was to evaluate age- and sex-related changes in the relative size of epiphyses of long hand bones and their association with radiographic OA. The data were collected from a population-based European sample in 1994 (557 individuals) and in 2002 (513 individuals). The latter sample included 253 individuals who were previously investigated in 1994. The epiphyseal index (EI), reflecting the relative size of bone epiphyses and hand OA, was evaluated from hand radiographs. Statistical analyses included multiple regression analyses and a maximum likelihood-based model-fitting technique. Hand bone epiphyses increased with age and with OA. In males, the EI gradually increased during their entire life span. In females, the EI remained almost unchanged up to the age of 40, after which, it increased more rapidly than in males. Individuals with OA had higher values of EI at any age. In both sexes, epiphyseal enlargement is a predisposing factor for hand OA progression in adjacent joints. This was clearly seen in males, where old individuals with high EI values had much higher OA scores in comparison with age-matched individuals. Enlargement of long bone epiphyses with age appears to be a general tendency in the human skeleton. Our study shows that the enlargement of epiphyses may also be related to OA.

Repeated measurement study of hand osteoarthritis in an apparently healthy Caucasian population

The rate of hand osteoarthritis (OA) progression remains controversial due to a shortage of longitudinal studies. We performed a longitudinal, 8-year follow-up study to evaluate the rate of hand OA progression in men and women. This analysis included the influence of age, sex, anthropometric traits, baseline level of hand OA, smoking, alcohol consumption, and familial effects on the progression rate of hand OA. The collected data included information on 263 (127 males and 136 females) Chuvashians (Russian Federation) who had been assessed in 1994 and 2002 by the same investigators. The Kellgren-Lawrence (K-L) grading system was applied to assess the extent of OA development from hand radiographs for various joints and for the hand as a whole. We found high and statistically significant correlations between initial and repeated OA scores but no association between the rate of hand OA progression and anthropometric features, life-style factors, or familial effects. A positive correlation was observed between baseline levels of OA in distal interphalangeal (DIP) joints and the rate of its progression in postmenopausal women. Our results showed a significant difference between the sexes in sum K-L score of metacarpophalangeal (MP) joints in a young (<47) population and in a score of affected DIP joints (K-L > or = 2) in the population over the age of 47 (i.e., most of females were postmenopausal). Our data also suggest a weak but significant correlation in the rate of OA progression in DIP and proximal interphalangeal (PIP) joints and weak negative associations between DIP and MP joints, especially in females.

Erosive and non-erosive hand osteoarthritis. Use and limitations of two scoring systems

To assess the evolution and progression of osteoarthritis (OA) in the finger joints using anatomical changes on standard radiographs. Data obtained from 85 patients enrolled in a prospective study were used to evaluate systems to score the morbidity and the progression of the disease over 3 years. Posteroanterior (PA) radiographs of the metacarpophalangeal (MCP) and interphalangeal (IP) joints were obtained at entry and after 3 years. Assessment of the progression of OA over time is based on: (1) the increase in incidence of OA in previously normal joints during the study period, (2) the changes in the OA-associated features (osteophyte growth, loss of joint space, subchondral cysts or sclerosis) in the pathological finger joints (anatomical lesion progression score system), and (3) the recognition of consecutive anatomical phases in the course of 'erosive' OA (anatomical phase progression score system). Almost 80% of the distal IP and 50% of the proximal IP were affected at study entry. In approximately 40% of the patients, the classical picture of OA of the IP joints was complicated by manifest erosive changes, which were followed by a repair phenomenon in the 'eroded' finger joints. MCP were less affected and showed the non-erosive picture of OA. Numbers of affected DIP, PIP and MCP joints per patient at entry did not differ from those after 3 years of follow-up. Two systems to score the progression of OA (anatomical lesion and anatomical phase progression score system) showed definite progression within 3 years of follow-up, especially in the IP joints. Since changes in both non-erosive and erosive joints were recorded by the anatomical lesion progression system, it was found much more sensitive to change than the anatomical phase progression system which principally recorded the progression through the destructive phases of erosive OA. The results of both progression score systems correlated well. Conventional radiographs can be used to assess the morbidity and progression of hand OA. The existence of non-erosive and erosive forms of OA of the finger joints necessitates the use of two scoring systems: the anatomical lesion progression score system and the anatomical phase progression score system.

Session 3: Imaging. Radiological assessment of hand OA

The different radiographic procedures and methods for reading films and assessing the status and progression of hand osteoarthritis (OA) were reviewed. The methods that relate to each of the above procedures were assigned to categories upon which there was or was not general agreement. It was agreed that the radiographic method should use published standardized radiographic protocols; that X-ray features should be graded separately for determining the extent of the disease and that changes in osteophyte size was the most sensitive indicator of progression. For epidemiological studies films should be read blind and randomly, but for assessing progression films should be read in pairs and in sequence. No agreement was obtained on the value of the lateral radiographic view of the hand nor on which radiographic atlas would be best for long-term longitudinal studies. Further work was required to evaluate the role of MRI and scintigraphy in hand OA; radiographic atlases could be improved by incorporating diagrams to illustrate the change in grade for each feature; validation was required for methods of assessment in long-term trials.

The progression of radiological hand osteoarthritis over ten years: a clinical follow-up study

The natural history of hand osteoarthritis (OA) is poorly understood. The aim of the study was to ascertain the extent and pattern of radiological progression of hand OA over a 10-year period. A follow-up study was carried out on 169 consecutive patients who initially presented with OA of the hands or knees between 1975-1977. Fifty-nine subjects (45 women and 14 men) were recontacted who had paired hand radiographs, a mean of 10 years apart, and were a mean 69 (range 53-86) years old at follow-up. X-rays were scored blind, in three joint areas--distal and proximal interphalangeal joints (DIP and PIP) and first carpo-metacarpal (CMC) joints--using the method of Kellgren and Lawrence (K&L) (0-4), and for osteophytes and narrowing (0-3). Using the highest score for right and left hands (N = 118), K&L changes at the three areas were similar with 47-50% deteriorating, 45-46% unchanged, and 6-8% improving. Similar deterioration was seen when scoring the three joint areas for osteophytes (38-39%) and narrowing (39-48%). New osteophytes appeared in 48% of DIP joints during the 10 years. There was a weak correlation between progression at the DIP and PIP joints, but no relationship between DIP and CMC, or CMC and PIP. Virtually all subjects (97%) deteriorated when the total scores of all joints were calculated. No significant differences were seen between 'severe progressors' and 'minor' in terms of age or body mass index (BMI). A nonsignificant increase in the proportion of knee progressors in the severe progressor hand group was seen and there was a higher rate of baseline DIP OA in knee progressors. These results suggest that the majority of patients with OA of the hands attending a rheumatology outpatients clinic deteriorate radiologically over a 10-year period, about half developing new changes in DIP joints. There were no obvious features distinguishing those with rapid deterioration, although DIP OA appears to be a risk factor for knee progression.