Erosive osteoarthritis: a more severe form of radiographic hand osteoarthritis rather than a distinct entity?. Issue 1 (4th October 2013)

• Record Type: Journal Article
• Authors: Marshall, Michelle; Nicholls, Elaine; Kwok, Wing-Yee; Peat, George; Kloppenburg, Margreet; van der Windt, Danielle; Myers, Helen; Dziedzic, Krysia
• Is Part Of: Annals of the rheumatic diseases. Volume 74:Issue 1(2015)
• Page Start: 136
• Page End: 141
• Publication Date: 2013-10-04
• Subjects: Osteoarthritis -- Epidemiology -- Hand Osteoarthritis; Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/annrheumdis-2013-203948
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Objectives: To determine whether erosive osteoarthritis shares the same pattern of joint involvement and risk profile as increasing grades of non-erosive hand osteoarthritis. Methods: Participants were from two population-based cohorts, aged ≥50 years, reporting hand symptoms in the previous month. Interphalangeal joints were assessed for erosive osteoarthritis (Verbruggen–Veys erosive or remodelled phase) and radiographic osteoarthritis (sliding cut-offs of K&L≥2, K&L≥3 and K&L=4). At the joint level, similarities in the frequency and pattern of erosive and non-erosive osteoarthritis were assessed by Spearman's rank correlation coefficients and generalised estimating equations. At the person level, individuals with erosive osteoarthritis were compared to those with non-erosive osteoarthritis using logistic regression, adjusted for age and gender (aOR), for the following exposures: family history, previous injury, overuse and metabolic factors (BMI, dyslipidaemia, hypertension, diabetes). Results: In 1076 symptomatic participants the ranked frequency of involvement for erosive joints was comparable to joints with K&L≥3 and K&L=4 (r>0.95). Patterns of joint involvement in erosive osteoarthritis were strongest for symmetry (aOR=6.5; 95% CI 3.0 to 14.1), followed by row (2.0; 0.8 to 5.0) and ray (0.3; 0.0 to 2.5), which was similar to joints with K&L≥3 and K&L=4. Individuals with erosive osteoarthritis (n=80) had an increased risk of metabolic syndrome (2.7; 1.0 to 7.1), notably dyslipidaemia (4.7; 2.1 to 10.6) compared with non-erosive osteoarthritis classed K&L≥3 (n=193). Conclusions: The similar frequency of radiographic joint involvement and patterning in erosive osteoarthritis and more severe non-erosive osteoarthritis is consistent with prevalent erosive osteoarthritis being a severe form of hand osteoarthritis rather than a distinct entity. Metabolic exposures, dyslipidaemia in particular, may be implicated in erosive osteoarthritis.