Erosive osteoarthritis: a more severe form of radiographic hand osteoarthritis rather than a distinct entity?

Marshall, Michelle; Nicholls, Elaine; Kwok, Wing-Yee; Peat, George; Kloppenburg, Margreet; Van Der Windt, Danielle; Myers, Helen; Dziedzic, Krysia

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.

Citation

Marshall, M., Nicholls, E., Kwok, W., Peat, G., Kloppenburg, M., Van Der Windt, D., …Dziedzic, K. (2014). Erosive osteoarthritis: a more severe form of radiographic hand osteoarthritis rather than a distinct entity?. Annals of the Rheumatic Diseases, 74(1), 136 - 141. https://doi.org/10.1136/annrheumdis-2013-203948

• Journal Article Type: Article
• Acceptance Date: Sep 20, 2013
• Publication Date: Dec 4, 2014
• Journal: Annals of the Rheumatic Diseases
• Print ISSN: 0003-4967
• Publisher: BMJ Publishing Group
• Peer Reviewed: Peer Reviewed
• Volume: 74
• Issue: 1
• Pages: 136 - 141
• DOI: https://doi.org/10.1136/annrheumdis-2013-203948
• Keywords: Aged, Aged, 80 and over, Comorbidity, Dyslipidemias, Epidemiology, Female, Finger Joint, Hand Joints, Hand Osteoarthritis, Humans, Logistic Models, Male, Metabolic Syndrome, Middle Aged, Osteoarthritis, Radiography, Severity of Illness Index
• Publisher URL: https://ard.bmj.com/content/74/1/136