To evaluate, by means of a longitudinal study, radiographic involvement of metacarpophalangeal and radio-carpal joints in hand osteoarthritis, its relationship with erosive disease and its progression, 368 patients with hand osteoarthritis were enrolled. All patients underwent hand X-rays. On the basis of the presence of central erosions in interphalangeal joints, patients were divided into three groups: 0—no central erosions, 1—one joint with central erosion, and 2—two or more joints with central erosions. A longitudinal study on 44 patients and nine normal controls, whose X-rays were available after 3.9 years, was performed. The radiological involvement of metacarpophalangeal and radio-carpal joints was evaluated using Kellgren-Lawrence and OARSI scores. Low number of joints showed Kellgren-Lawrence values ≥2 group 0, 42/1290 (3.3%); group 1, 10/410 (2.4%); and group 2, 36/1980 (1.8%). Low score values were obtained for all radiographic items. Only metacarpophalangeal joint space narrowing score showed significant increase from groups 0 to 2. Subsequent adjustment for age, gender, and BMI did not confirm the statistical significance. Marginal erosions were rarely found (6.7% of joints). Metacarpophalangeal and radio-carpal radiographic per patient scores significantly worsened at follow-up, but no significant increase in joints with Kellgren-Lawrence score ≥2 was found. In normal controls, no significant radiographic worsening was found. Only a minority of metacarpophalangeal joints shows a Kellgren-Lawrence value ≥2. Metacarpophalangeal and to lesser extent radiocarpal joints had significant worsening at follow-up. Metacarpophalangeal joint involvement in hand osteoarthritis is mild but progressive. Radiocarpal involvement is negligible.
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The authors thank Ms. Alexandra Teff for her linguistic assistance.
Compliance with ethical standards
This study was partially supported by grants from Fondazione del Monte di Bologna e Ravenna, (Bologna), Rizzoli Orthopedic Institute/Italian Ministry of Health (Ricerca Corrente), and the University of Bologna (RFO). The study sponsor was not involved in the study design, collection, analysis and interpretation of data, in the writing of the manuscript, or in the decision to submit the manuscript for publication.
Reginster JY, Reiter-Niesert S, Bruyère O, Berenbaum F, Brandi ML, Branco J et al (2015) Recommendations for an update of the 2010 European regulatory guideline on clinical investigation of medicinal products used in the treatment of osteoarthritis and reflections about related clinically relevant outcomes: expert consensus statement. Osteoarthr Cartil 23:2086–2093CrossRefPubMedGoogle Scholar
De Filippis L, Gulli S, Caliri A, Romano C, Munaò F, Trimarchi G et al (2004) Gruppo OASIS (osteoarthritis South Italy study). [epidemiology and risk factors in osteoarthritis: literature review data from “OASIS” study]. Reumatismo 56:169–184PubMedGoogle Scholar
Kalichman L, Cohen Z, Kobyliansky E, Livshits G (2004) Patterns of joint distribution in hand osteoarthritis: contribution of age, sex and handedness. Am J Hum Biol 16:125–134CrossRefPubMedGoogle Scholar
Oliviero F, Ramonda R, Punzi L (2010) New horizons in osteoarthritis. Swiss Med Wkly 140:w13098PubMedGoogle Scholar
Haugen IK, Englund M, Aliabadi P, Niu J, Clancy M, Kvien TK et al (2011) Prevalence, incidence and progression of hand osteoarthritis in the general population: the Framingham osteoarthritis study. Ann Rheum Dis 70:1581–1586CrossRefPubMedGoogle Scholar
Dahaghin S, Bierma-Zeinstra SM, Ginai AZ, Pols HA, Hazes JM, Koes BW (2005) Prevalence and pattern of radiographic hand osteoarthritis and association with pain and disability (the Rotterdam study). Ann Rheum Dis 64:682–687CrossRefPubMedGoogle Scholar
Kwok WY, Vliet Vlieland TP, Rosendaal FR, Huizinga TW, Kloppenburg M (2011) Limitations in daily activities are the major determinant of reduced health-related quality of life in patients with hand osteoarthritis. Ann Rheum Dis 70:334–336CrossRefPubMedGoogle Scholar
Addimanda O, Mancarella L, Dolzani P, Punzi L, Fioravanti A, Pignotti E et al (2012) Clinical and radiographic distribution of structural damage in erosive and non erosive hand osteoarthritis. Arthritis Care Res (Hoboken) 64:1046–1053CrossRefGoogle Scholar
Verbruggen G, Wittoek R, Cruyssen BV, Elewaut D (2010) Morbid anatomy of ‘erosive osteoarthritis’ of the interphalangeal finger joints: an optimised scoring system to monitor disease progression in affected joints. Ann Rheum Dis 69:862–867CrossRefPubMedGoogle Scholar
Addimanda O, Mancarella L, Dolzani P, Ramonda R, Fioravanti A, Brusi V et al (2012) Clinical associations in patients with hand osteoarthritis. Scand J Rheumatol 41:310–313CrossRefPubMedGoogle Scholar
Altman R, Alarcòn G, Appelrouth D, Bloch D, Borenstein D, Brandt K et al (1990) The American College of Rheumatology Criteria for the classification and reporting of osteoarthritis of the hand. Arthritis Rheum 33:1601–1610CrossRefPubMedGoogle Scholar
Kallman DA, Wiglet FM, Scott WW, Hochberg MC, Tobin JD (1989) New radiographic grading scales for osteoarthritis of the hand. Reliability for determining prevalence and progression. Arthr Rheum 32:1584–1591CrossRefGoogle Scholar
Altman RD, Gold GE (2007) Atlas of individual radiographic features in osteoarthritis, revised. Osteoarthr Cartil 15(Suppl A):A1–56CrossRefPubMedGoogle Scholar
Marshall M, van der Windt D, Nicholls E, Myers H, Hay E, Dziedzic K (2009) Radiographic hand osteoarthritis: patterns and associations with hand pain and function in a community-dwelling sample. Osteoarthr Cartil 17:1440–1447CrossRefPubMedGoogle Scholar
Slatkowsky-Christensen B, Haugen I, Kvien TK (2010) Distribution of joint involvement in women with hand osteoarthritis and associations between joint counts and patient-reported outcome measures. Ann Rheum Dis 69:198–201CrossRefPubMedGoogle Scholar
Smolen SJ, van der Heijde DM, Keystone EC, van Vollenhoven RF, Goldring MB, Guérette B et al (2013) Association of joint space narrowing with impairment of physical function and work ability in patients with early rheumatoid arthritis: protection beyond disease control by adalimumab plus methotrexate. Ann Rheum Dis 72:1156–1162CrossRefPubMedGoogle Scholar
Aletaha D, Funovitis J, Smolen JS (2011) Physical disability in rheumatoid arthritis is associated with cartilage damage rather than bone destruction. Ann Rheum Dis 70:733–739CrossRefPubMedGoogle Scholar