Risk Factors For Hand Osteoarthritis Research Articles

Causality between Ankylosing Spondylitis and osteoarthritis in European ancestry: a bidirectional Mendelian randomization study.

To explore the bidirectional causal relationship between Ankylosing Spondylitis (AS) and Osteoarthritis (OA) at the genetic level within the European ancestry. We implemented a series of quality control steps to select instrumental variables (IVs) related to the exposure. We conducted two-sample Mendelian randomization (MR) using the inverse-variance weighted method as the primary approach. We adjusted significance levels using Bonferroni correction, assessed heterogeneity using Cochrane's Q test. Sensitivity analysis was conducted through leave-one-out method. Additionally, external datasets and relaxed IV selection criteria were employed, and multivariate MR analyses were performed for validation purposes. Finally, Bayesian colocalization (COLOC) analysis identified common genes, validating the MR results. The investigation focused on the correlation between OA and AS in knee, hip, and hand joints. MR results revealed that individuals with AS exhibit a decreased risk of knee OA (OR = 0.9882, 95% CI: 0.9804-0.9962) but no significant increase in the risk of hip OA (OR = 0.9901, 95% CI: 0.9786-1.0018). Conversely, AS emerged as a risk factor for hand OA (OR = 1.0026, 95% CI: 1.0015-1.0036). In reverse-direction MR analysis, OA did not significantly influence the occurrence of AS. Importantly, minimal heterogeneity was observed in our MR analysis results (p > 0.05), and the robustness of these findings was confirmed through sensitivity analysis and multivariate MR analysis. COLOC analysis identified four colocalized variants for AS and hand OA (rs74707996, rs75240935, rs181468789, and rs748670681). In European population, individuals with AS have a relatively lower risk of knee OA, whereas AS serves as a risk factor for hand OA. However, no significant causal relationship was found between AS and hip OA. Additionally, it offers novel insights into genetic research on AS and OA.

Demographic Characteristics and Clinical Factors of the Patients Suffering from Osteoarthritis of Hand – A Study Done in A Tertiary Specialized Hospital in Bangladesh

Background: Osteoarthritis (OA) is one of the most common forms of arthritis. Hand OA is a heterogeneous, age and gender-dependent disorder, occurring more frequently in postmenopausal women over 50 years of age. Objective: This study aims to identify demographic patterns and factors associated with osteoarthritis of the hand among patients attending a tertiary-level hospital in Bangladesh. Methods: This cross-sectional study was done in the Department of Orthopedics, Shaheed Ziaur Rahman Medical College Hospital, Bogura, Bangladesh, between January and December of 2021. A total of 90 patients with OA of hands were included in this study. All patients were selected conveniently and informed written consent of the patients was taken. Participant data were collected through face-to-face interviews using a semi-structured questionnaire. Statistical analyses were done with Statistical Package for Social Science (SPSS) version 25.0. Quantitative variables were analyzed by mean and standard deviation while qualitative variables were summarized by percentage. Results: In this study, the age distribution of the patients ranges from e”40 years to d”75 years irrespective of sex. The mean age of the patients of both sexes was 56.6±8.72 years. Among those 90 patients, 35 persons (38.9%) were male and 55 (61.1%) were female. Most of the patients are housewives 38 (42.22%). Most of the women (87.27%) are menopausal among the total 55 female patients. Only 13 (14.45%) persons had a previous history of a hand injury, and 20 (22.22%) persons had a habit of smoking or previously smokers. Most of the subjects 78 (86.67%) were right-hand dominant and a maximum of 67 (74.45%) persons enrolled in this study showed priority affected CMC1 OA to the dominant hand. Most of them (75.55%) took medications for treatment for arthritis. Conclusion: Our study revealed that osteoarthritis of the hands is predominant in females and affects mostly the right hand. Further high-quality studies examining the risk factors for hand osteoarthritis are needed to replicate these findings and determine modifiable factors in symptomatic patients. Mugda Med Coll J. 2023; 6(2): 77-82

The proportion of hand and knee osteoarthritis and its associated risk factors among an urban diabetic population

Introduction: Osteoarthritis (OA) is found to be a leading cause of disability in people with diabetes mellitus (DM). This study aimed to find the proportion of knee OA and hand OA and its risk determinants among people with DM. Materials and Methods: A cross-sectional study was conducted among 258 diabetic subjects attending the general outpatient department of a tertiary care hospital over 4 months. A predesigned case record form was used to collect details on sociodemographic profiles and various factors related to OA. The American College of Rheumatology criteria were used for the diagnosis of both knee and hand OA. Data analysis was done using the SPSS version 16. Chi-square/Fisher's exact test was used wherever applicable to find the association of various factors with OA. Results: The overall proportion of OA in diabetic subjects was 48.4%. The proportion of only hand OA was 25.2%, only knee OA was 14.3%, and both hand OA and knee OA were 8.9%. Age, female sex, duration of DM, irregularity in taking diabetic medications, hypertension, menopause, and body mass index were found to be significantly associated with both hand and knee OA. Physical inactivity and previous joint injury were found to be associated with knee OA. An inverse association with alcohol consumption was found. On logistic regression, we found irregularity in taking diabetic medication to be a significant risk factor for hand and knee OA. The duration of DM and taking alternate medications for DM were also found to be significant risk factors for hand OA. Prior knee injury is a significant risk factor for knee OA. Conclusion: There exists an association between OA and DM, and this suggests the need for early diagnosis, good disease management, and medication adherence and to implement preventive strategies so as to prevent further disabilities and improve quality of life. The following core competencies are addressed in this article: Patient care and procedural skills, Medical knowledge, Systems-based practice, Practice-based learning and improvement.

Association Between Race and Radiographic, Symptomatic, and Clinical Hand Osteoarthritis: A Propensity Score-Matched Study Using Osteoarthritis Initiative Data.

To determine the associations between Black race and the presence of radiographic, symptomatic, and clinical hand osteoarthritis (OA). Using available hand radiographs from the Osteoarthritis Initiative cohort (total 4,699; n=849 Black subjects [18.1%], n=3,850 non-Black subjects [81.9%]), a propensity score-matching method was used to match Black subjects with non-Black subjects for known potential risk factors of hand OA (age, sex, body mass index, smoking status, cardiovascular disease, osteoporosis, excessive occupation- or recreation-related hand use, and knee OA). Posteroanterior radiographs of subjects' dominant hands were reviewed by a musculoskeletal radiologist in a blinded manner. To assess the severity of hand OA, the modified Kellgren/Lawrence (K/L) radiographic OA scoring scale (grades 0-4) was used, and the presence of erosive OA in the hand joints was recorded. Associations between race and the severity of hand OA (measured as the summed modified K/L grade), presence of radiographic hand OA (modified K/L grade ≥2), presence of erosive hand OA, presence of symptomatic hand OA (radiographic OA with hand pain), and presence of clinical hand OA (indicated by clinical findings of Heberden's nodes in the hands) were studied using regression models. In these models, beta coefficients or odds ratios (ORs) with 95% confidence intervals (95% CIs) were calculated for the associations between Black race and any of these radiographic and symptomatic hand OA phenotypes. Black subjects had less severe hand OA (β=-1.93 [95% CI -2.53, -1.34]), as well as a lower risk of developing radiographic hand OA (OR 0.79 [95% CI 0.66, 0.94]), erosive hand OA (OR 0.23 [95% CI 0.11, 0.47]), symptomatic hand OA (OR 0.63 [95% CI 0.49, 0.82]), and clinical hand OA (OR 0.49 [95% CI 0.41, 0.60]), as compared to non-Black subjects. In contrast to the well-established association between Black race and knee or hip OA, the findings of this study suggest that the risk of hand OA is lower in Black subjects compared to non-Black subjects, which is not mediated by known hand OA risk factors. Future studies are warranted to determine the mediating protective factors for hand OA among Black subjects.

Radiographic hand osteoarthritis in women farmers: characteristics and risk factors.

BackgroundRepetitive hand use increases the risk of hand osteoarthritis (OA). This study aimed to investigate characteristics of and risk factors for hand OA in Korean women farmers.MethodsThis cross-sectional study included women farmers resident in Jeollanam-do, Korea. The participants were interviewed, and radiographs were taken of both hands. Radiological hand OA was defined based on the Osteoarthritis Research Society International imaging criteria of joint space narrowing or the presence of osteophytes. The participants were divided into age groups of < 60 and ≥ 60 years. Obesity was defined as body mass index of > 25 kg/m2. Annual working time was divided into < 2,000, 2,000–2,999, and ≥ 3,000 hours. Agricultural working type was divided into rice farming and field farming. Robust Poisson regression was used to identify factors associated with radiographic hand OA, with adjustment for age, obesity, annual working time, and agricultural classification.ResultsA total of 310 participants with a mean age of 58.1 ± 7.6 years, were enrolled. The prevalence of radiologically confirmed OA was 49.0%, with an OA prevalence of 39.4% the interphalangeal joint in the thumb (IP1). The prevalence of OA was higher in the distal interphalangeal joint than in the proximal interphalangeal, metacarpophalangeal, and carpometacarpal joints. The prevalence of OA varied by age, annual working time, and agriculture type.ConclusionsKorean women farmers have a high prevalence of OA, particularly in the IP1 joints. OA is associated with age, working hours, and agriculture type.

Development and validation of a prediction model for incident radiographic finger interphalangeal joint osteoarthritis

Purpose: Joints in the hand are those most commonly affected by osteoarthritis. Within the hand, osteoarthritis at the base of thumb and at the fingers are often considered to be different subsets of disease. Although there have been a number of studies assessing risk factors for hand osteoarthritis, most of these have focussed on the base of thumb. Further, risk factors have typically been analysed in isolation, whereas patients are likely to have multiple risk factors with complex interactions.

Blame it on the knee: the association of hand osteoarthritis and obesity

Purpose: Obesity and overweight are recognized risk factors for osteoarthritis (OA). There is a strong and consistently found relationship between high body mass index (BMI) and knee OA, but there is ongoing uncertainty as to whether higher BMI is a risk factor for hand OA. As with most OA research, the studies on hand OA consider this joint in isolation (i.e. without consideration of other joints). Given that hand OA often occurs in conjunction with OA of other joints, a failure to consider other joints could lead to misleading results. The Canadian Longitudinal Study on Aging (CLSA) asked separately about the presence of knee, hip, and hand OA, providing the opportunity to investigate whether there is an independent association between hand OA and BMI, accounting for the association of BMI with other concurrent joints, particularly the knee. Methods: The CLSA began in 2013 and is following a representative sample of respondents aged 45-85 years at baseline to gain insight into the development of disease and disability through the aging process. Respondents in the baseline assessment were asked separately about OA in the knee, in the hip, and in the hand, with the lead-in question, “Has a doctor ever told you that you have⋯” Participant height and weight was measured and BMI (kg/m2) calculated, and sociodemographic information was collected. Participants reporting arthritis other than OA or without information on OA or BMI were excluded from the present study. Descriptive analyses compared BMI distributions between those without OA, and those with OA of the knee, hip and hand, individually and with each possible combination of OA at these joint sites. Visual inspection was used to determine whether the shape of the BMI distributions differed for combinations of hand OA with knee and hip OA. The relationship between BMI and joint site was quantified by linear regression, adjusted for age and sex. The relationship between obesity and joint site was quantified by logistic regression, adjusted for age and sex. Results: The analytic sample included 25,459 individuals. Overall, 24.9% of the sample reported OA at any site. Among these, 56.6% reported knee OA, 31.2% hip OA and 46.9% hand OA. Forty-seven percent of individuals reporting hand OA also reported knee and/or hip OA. There was minimal difference in mean BMI between the OA groups (Table, Column A), but the percent obese, especially for the combinations of individual joint sites, showed greater differences across groups (Table, Column B). The distributions of BMI for the hand OA and hand and hip OA groups were similar, but distinct from the distributions that included knee OA, which were likewise similar but had a higher proportion of individuals in the obese I and II/III categories (Figure). Findings for males and females and different age groups were similar. Regression results for OA overall and for OA at individual joint sites (without consideration of other joints), showed a positive and significant association between each joint group and higher BMI and, in particular, likelihood of being obese (Table, Columns C and D). However, when all combinations of joint sites were simultaneously considered, neither hand OA alone nor hand and hip OA together were significantly associated with higher BMI or obesity, whereas any combinations that included knee OA were significantly associated with higher BMI and, in particular, likelihood of being obese (Table, Column C and D). Conclusions: Hand OA assessed without regard to the involvement of other joints appears to be significantly associated with higher BMI and obesity. However, when considering OA in other joints, and in particular knee OA, an independent association between hand OA and BMI/obesity was not found. This suggests that positive associations seen in previous studies are likely due to the presence, but lack of consideration, of concomitant knee OA. Furthermore, the results suggest that a simple comparison of mean BMI values, even when age and sex adjusted, between OA groups may miss important differences that exist in the upper tails of the BMI distribution (i.e. the obese portion of the distribution) where there is greater risk for OA. The findings also raise questions as to whether obesity is a risk factor for OA in general, or only for knee OA.View Large Image Figure ViewerDownload Hi-res image Download (PPT)

Prevalence and risk factors for hand osteoarthritis

IntroductionHand osteoarthritis (OA) is a highly prevalent disease with a significant physical and social burden. Thus we decided to find out prevalence of hand OA in the patients above 40 year of age who presented to us with either hand symptoms or knee OA. MethodsPostero-anterior hand radiographs were taken of both hands to confirm the diagnosis of hand OA. Fifteen joints were evaluated for the presence of osteophytes, joint space narrowing, sclerosis, and cysts. 358 patients attending Rheumatology OPD of two tertiary care centers in Eastern India in one year participated in study. ResultsNinety nine (27.65%) of 358 subjects had radiological hand OA. Among the 222 patients with knee OA 90 (40.5%) patients had hand OA. Nine (6.6%) of 136 patients with hand symptoms alone had hand OA. Overall 212 (59.21%) of 358 patients had symptoms in hand joints and of them 49 (23.2%) patients had hand OA positive. Female sex, older age, BMI >25, family history of OA or diabetes mellitus increased the risk of radiological hand OA. Knee OA increased the risk of hand OA both symptomatic and asymptomatic. ConclusionHand OA is common and a good quality X ray of hand is an initial investigation to diagnose hand OA. Presence of Knee OA increases risk of hand OA.

Adiposity and hand osteoarthritis: the Netherlands Epidemiology of Obesity study

IntroductionObesity, usually characterized by the body mass index (BMI), is a risk factor for hand osteoarthritis (OA). We investigated whether adipose tissue and abdominal fat distribution are associated with hand OA.MethodsThe Netherlands Epidemiology of Obesity (NEO) study is a population-based cohort aged 45 to 65 years, including 5315 participants (53% women, median BMI 29.9 kg/m2). Fat percentage and fat mass (FM) (kg) were estimated using bioelectrical impedance analysis. The waist-to-hip ratio (WHR) was calculated. In 1721 participants, visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) (cm2) were assessed using abdominal MR imaging. Hand OA was defined according to the ACR criteria.Odds ratios (OR) with 95% confidence intervals (CI) were calculated for the association of fat percentage, FM, WHR, VAT and SAT with hand OA using logistic regression analyses per standard deviation, stratified by sex and adjusted for age.ResultsHand OA was present in 8% of men and 20% of women. Fat percentage was associated with hand OA in men (OR 1.34 (95% CI 1.11 to 1.61)) and women (OR 1.26 (1.05 to 1.51)), as was FM. WHR was associated with hand OA in men (OR 1.45 (1.13 to 1.85)), and to a lesser extent in women (OR 1.17 (1.00 to 1.36)). Subgroup analysis revealed that VAT was associated with hand OA in men (OR1.33 (1.01 to 1.75)). This association increased after additional adjustment for FM (OR 1.51 (1.13 to 2.03)).ConclusionsFat percentage, FM and WHR were associated with hand OA. VAT was associated with hand OA in men, suggesting involvement of visceral fat in hand OA.

Quantification of finger joint loadings using musculoskeletal modelling clarifies mechanical risk factors of hand osteoarthritis

Owing to limited quantitative data related to the loadings (forces and pressures) acting upon finger joints, several clinical observations regarding mechanical risk factors of hand osteoarthritis remain misunderstood. To improve the knowledge of this pathology, the present study used musculoskeletal modelling to quantify the forces and pressures acting upon hand joints during two grasping tasks.Kinematic and grip force data were recorded during both a pinch and a power grip tasks. Three-dimensional magnetic resonance imaging measurements were conducted to quantify joint contact areas. Using these datasets as input, a musculoskeletal model of the hand and wrist, including twenty-three degrees of freedom and forty-two muscles, has been developed to estimate joint forces and joint pressures.When compared with the power grip task, the pinch grip task resulted in two to eight times higher joint loadings whereas the grip forces exerted on each finger were twice lower. For both tasks, joint forces and pressures increased along a disto-proximal direction for each finger.The quantitative dataset provided by the present hand model clarified two clinical observations about osteoarthritis development which were not fully understood, i.e., the strong risk associated to pinch grip tasks and the high frequency of thumb-base osteoarthritis.

FRI0316 Prevalence of clinical digital osteoarthritis (heberden and bouchard nodes) in a selected population of patients with severe obesity: A prospective study

BackgroundHand osteoarthritis (HOA) is the most frequent form of osteoarthritis (60%). The main risk factors of hand osteoarthritis are: age above 40, women, obesity, heredity and work. A recent meta-analysis...

Radiographic assessment of the severity of thumb carpometacarpal osteoarthritis in the dominant and non-dominant hand: a descriptive, cross-sectional study

a. Purpose: thumb carpometacarpal osteoarthritis is a disabling condition that can lead to pain at the base of the thumb and impairment of hand function. Considering that usage of the hand is within the risk factors for hand osteoarthritis and that the dominant hand is more demanded in occupational activities, especially during tasks that require precision pinches, the purpose of this study was to compare the radiographic changes at the carpometacarpal (CMC) thumb in the dominant and non-dominant hand. b. Methods: we studied 108 (19 male and 89 female) subjects, between 40 and 80 years old, with radiographic changes of the thumb CMC joint. The individuals represented 65% of the participants enrolled in a group education programme for patients with knee osteoarthritis (OA) in the Institute of Orthopaedics and Traumatology of Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. Patterns of the use of the hand was varied among the subjects, including occupations such as housekeepers, secretaries, seamstress, teachers, nursing assistants, workers of metallurgical plant, etc. Two orthopedic surgeons assessed bilateral thumb CMC joint radiographs according to Kellgren and Lawrence (KL) scale. The participants were asked by telephone call or in their follow up visit which was their dominant hand and what was the main occupational activity they did most during the last years. We examined the data for correlation between the grades of severity of osteoarthritis in the thumb CMC, handedness and occupational usage of the hand. c. Results: 25% (95% CI: 18-33) of the 108 subjects had a higher KL grade in the thumb CMC of the dominant hand comparing with the non-dominant (dominant KL mean: 2; non-dominant KL mean: 0,75; range1 to 4) ; 18% (95% CI:10-25) had a higher KL grade in the thumb CMC of the non-dominant hand (non-dominant KL mean: 2,35; dominant KL mean: 1; range 1 to 4); and 55% (95% CI: 45-64) had no difference in the severity of the thumb CMC comparing the dominant with non-dominant hand (KL mean 1,7; range 1-4). We did not find an association between occupational use of the hand and severity OA of the thumb CMC joint because there were too many subgroups of occupational activities and patterns of use of the hand. d. Conclusion: The results suggest that there is no association between joint destruction and the overuse of the thumb CMC of the dominant hand comparing with the non-dominant hand in individuals with thumb CMC and knee osteoarthritis. In this sense, our initial hypothesis seems to be not true. Comparison and analysis of pain and hand function in dominant and non-dominant hand will possibly show different findings. Correlation between occupational use of the hand (work activities) and thumb CMC severity OA should be done with a bigger or more homogenous sample.

Knuckle Cracking and Hand Osteoarthritis

Previous studies have not shown a correlation between knuckle cracking (KC) and hand osteoarthritis (OA). However, one study showed an inverse correlation between KC and metacarpophalangeal joint OA. We conducted a retrospective case-control study among persons aged 50 to 89 years who received a radiograph of the right hand during the last 5 years. Patients had radiographically proven hand OA, and controls did not. Participants indicated frequency, duration, and details of their KC behavior and known risk factors for hand OA. The prevalence of KC among 215 respondents (135 patients, 80 controls) was 20%. When examined in aggregate, the prevalence of OA in any joint was similar among those who crack knuckles (18.1%) and those who do not (21.5%; P = .548). When examined by joint type, KC was not a risk for OA in that joint. Total past duration (in years) and volume (daily frequency × years) of KC of each joint type also was not significantly correlated with OA at the respective joint. A history of habitual KC-including the total duration and total cumulative exposure-does not seem to be a risk factor for hand OA.

EULAR evidence-based recommendations for the diagnosis of hand osteoarthritis: report of a task force of ESCISIT

Objectives:To develop evidence-based recommendations for the diagnosis of hand osteoarthritis (OA).Methods:The multidisciplinary guideline development group, representing 15 European countries, generated 10 key propositions regarding diagnosis using a Delphi consensus approach....

Hand osteoarthritis – an increasing need for treatment and rehabilitation

This review describes advances in our knowledge on the clinical burden of hand osteoarthritis, its relation to radiographic signs of osteoarthritis and potential targets for therapy. Treatments and trial methodology for hand osteoarthritis are critically reviewed. Recent studies have shown that there is an association between radiographic hand osteoarthritis and hand pain, and that symptomatic hand osteoarthritis leads to substantial disability. Some risk factors for hand osteoarthritis have been described but the development of hand osteoarthritis is still unclear. Unfortunately, pharmacological therapies for hand osteoarthritis are lacking and have been investigated little. Only a few studies on other treatment modalities are available. Surgical treatments are not covered in this review. Advances have been made in our understanding of symptomatic hand osteoarthritis. Potential targets for therapy are recognized. The challenge for the coming years is to conduct clinical trials of high quality in hand osteoarthritis.

Finger Osteoarthritis and Differences in Dental Work Tasks

Mechanical load has been proposed as a risk factor for hand osteoarthritis. Dentists produce high manual forces in their work tasks. We studied whether the pattern of dental work tasks was associated with finger osteoarthritis. Radiographs of both hands of 291 middle-aged female dentists were examined for the presence of osteoarthritis. Patterns of dental work tasks during work history were empirically defined by cluster analysis. Three patterns emerged reflecting high, moderate, and mild task variation. Age, specialization, years in clinical work, various activities requiring hand use, family history of Heberden's nodes, body mass index, and smoking were accounted for in logistic regression analyses. The dentists with a history of low task variation had a greater prevalence of osteoarthritis in the thumb, index, and middle fingers compared with dentists with high variation (OR 2.22; 95%CI 1.04-4.91). The pattern of dental work task history is associated with the localization of osteoarthritis in the fingers.

Session 1: Epidemiology and genetics of hand osteoarthritis

The aim of this session was to identify current issues and problems relating to risk factors for hand osteoarthritis (OA). The following important factors were discussed: Genetics, Age, Gender, Obesity, HRT (hormone replacement therapy), Physical activity/trauma.