scholarly journals 395 OSTEOPHYTES AND JOINT SPACE NARROWING ARE INDEPENDENTLY ASSOCIATED WITH PAIN IN FINGER JOINTS IN HAND OSTEOARTHRITIS

2011 ◽  
Vol 19 ◽  
pp. S182-S183
Author(s):  
M. Kortekaas ◽  
W.-Y. Kwok ◽  
M. Reijnierse ◽  
T. Huizinga ◽  
M. Kloppenburg
Keyword(s):  
Joint Space Narrowing ◽  
Joint Space ◽  
Hand Osteoarthritis ◽  
Finger Joints

Osteophytes and joint space narrowing are independently associated with pain in finger joints in hand osteoarthritis

2011 ◽  
Vol 70 (10) ◽  
pp. 1835-1837 ◽  
Author(s):  
Marion C Kortekaas ◽  
Wing-Yee Kwok ◽  
Monique Reijnierse ◽  
Tom W J Huizinga ◽  
Margreet Kloppenburg
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Joint Space Narrowing ◽  
Joint Space ◽  
Hand Osteoarthritis ◽  
X Rays ◽  
Finger Joints ◽  
Hand Joints ◽  
American College Of Rheumatology ◽  
Structural Abnormalities

ObjectiveTo study the associations between structural abnormalities on ultrasound (US) or conventional x-rays (CR) and pain in hand osteoarthritis (HOA).MethodsIn 55 consecutive patients with HOA (mean age 61 years, 86% women) fulfilling the American College of Rheumatology criteria, pain in 30 separate hand joints was assessed upon palpation; osteophytes were assessed by US and CR and joint space narrowing (JSN) by CR. Associations between structural abnormalities and pain per joint were analysed using generalised estimated equations to account for patient effects and adjusted for age, sex, body mass index, US inflammatory features and other remaining structural abnormalities.ResultsIn 1649 joints, 69% and 46% had osteophytes on US and CR, respectively and 47% had JSN. Osteophytes and JSN showed independent associations with pain per joint adjusted: OR for osteophytes: 4.8 (95% CI 3.1 to 7.5) for US and 4.1 (95% CI 2.4 to 7.1) for CR; for JSN: 4.2 (95% CI 2.0 to 9.0).ConclusionsOsteophytes and JSN are independently associated with pain in individual HOA joints, taking into account patient effects.

scholarly journals Increased radiographic progression of distal hand osteoarthritis occurring during biologic DMARD monotherapy for concomitant rheumatoid arthritis

2021 ◽  
Vol 23 (1) ◽  
Author(s):  
C. A. Lechtenboehmer ◽  
T. Burkard ◽  
S. Reichenbach ◽  
U. A. Walker ◽  
A. M. Burden ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Joint Space Narrowing ◽  
Radiographic Progression ◽  
Cox Regression ◽  
Joint Space ◽  
Estimating Equation ◽  
Considerable Proportion ◽  
Hand Osteoarthritis ◽  
Increased Risk ◽  
Subchondral Sclerosis

Abstract Objectives A considerable proportion of patients with rheumatoid arthritis (RA) also suffer from hand osteoarthritis (OA). We here assess the association between conventional synthetic (cs) and biological (b) disease-modifying antirheumatic drugs (DMARDs) and radiographic distal interphalangeal-(DIP) OA in patients with RA. Methods Adult RA patients from a longitudinal Swiss registry of rheumatic diseases who had ≥ 2 hand radiographs were included at the first radiograph and followed until the outcome or the last radiograph. Patients were grouped into two cohorts based on whether DIP OA was present or absent at cohort entry (cohorts 1 and 2, respectively). Modified Kellgren-Lawrence scores (KLS) were obtained by evaluating DIP joints for the severity of osteophytes, joint space narrowing, subchondral sclerosis, and erosions. KLS ≥ 2 in ≥ 1 DIP joint indicated incident or existing OA, and increase of ≥ 1 in KLS in ≥ 1 DIP joint indicated progression in existing DIP OA. Time-varying Cox regression and generalized estimating equation (GEE) analyses were performed. We estimated hazard ratios (HRs) and odds ratios (ORs) with 95% confidence intervals (CI) of DIP OA incidence (cohort 2), or progression (cohort 1), in bDMARD monotherapy, bDMARD/csDMARD combination therapy, and past or never DMARD use, when compared to csDMARD use. In post hoc analyses, we descriptively and analytically assessed the individual KLS features in cohort 1. Results Among 2234 RA patients with 5928 radiographs, 1340 patients had DIP OA at baseline (cohort 1). Radiographic progression of DIP OA was characterized by new or progressive osteophyte formation (666, 52.4%), joint space narrowing (379, 27.5%), subchondral sclerosis (238, 17.8%), or erosions (62, 4.3%). bDMARD monotherapy had an increased risk of radiographic DIP OA progression compared to csDMARD monotherapy (adjusted HR 1.34 [95% CI 1.07–1.69]). The risk was not significant in csDMARD/bDMARD combination users (HR 1.12 [95% CI 0.96–1.31]), absent in past DMARD users (HR 0.96 [95% CI 0.66–1.41]), and significantly lower among never DMARD users (HR 0.54 [95% CI 0.33–0.90]). Osteophyte progression (HR 1.74 [95% CI 1.11–2.74]) was the most significantly increased OA feature with bDMARD use compared to csDMARD use. In 894 patients without initial DIP OA (cohort 2), the risk of incident OA did not differ between the treatment groups. The results from GEE analyses corroborated all findings. Conclusions These real-world RA cohort data indicate that monotherapy with bDMARDs is associated with increased radiographic progression of existing DIP OA, but not with incident DIP OA.

scholarly journals POS0126 EARLY STAGE HAND OSTEOARTHRITIS IN PATIENTS WITH THE EHLERS-DANLOS SYNDROME: AN EXPLORATIVE STUDY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 275.1-275
Author(s):  
L. Rombaut ◽  
K. De Baere ◽  
E. Debacker ◽  
L. Decavele ◽  
F. Malfait ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Clinical Features ◽  
Joint Space Narrowing ◽  
Early Stage ◽  
Hand Function ◽  
Joint Space ◽  
Joint Hypermobility ◽  
Finger Joints ◽  
Explorative Study ◽  
Soft Tissue Swelling

Background:The Ehlers-Danlos Syndromes (EDS) are a group of rare heritable connective tissue disorders caused by various defects in the biosynthesis or secretion of fibrillar collagens. The three main clinical features of EDS are joint hypermobility, skin fragility and general soft tissue fragility. 13 clinical subtypes of EDS are recognized, of which the hypermobile type (hEDS) and classical type (cEDS) are the most prevalent. It has been hypothesized that the (micro-)trauma in the joint due to typical subluxations and dislocations, make EDS patients prone to developing osteoarthritis (OA) in early stage. Conversely, it has been mentioned that joint hypermobility provides a larger joint surface area and prevents OA. Abnormal biomechanical loading has been identified as a risk factor for the development of OA in the wrist and hand. However, no studies have yet been performed in EDS patients.Objectives:The primary aim was to investigate the presence of any degenerative features for hand OA, and if this differs between cEDS and hEDS patients. The second aim was to evaluate hand function and pain related to OA signs in EDS patients.Methods:cEDS and hEDS patients between 35 and 50 years old were invited to participate. cEDS diagnosis was genetically confirmed and hEDS diagnosis was performed according the clinical 2017 hEDS criteria. Exclusion criteria were a body mass index ≥35, not being able to stand straight up for five minutes, suffering from an auto-immune disease or rheumatological condition, or pregnancy. Conventional X-rays of both hands were performed and scored independently by three assessors according to Kallman1. Presence of osteophytes (0-3), joint space narrowing (0-3), malalignment (>15°)(0/1), erosions (0/1), subchondral sclerosis (0/1), and subchondral cysts (0/1) were scored in all interphalangeal (distal and proximal), metacarpophalangeal and thumb base joints of both hands1. We defined early hand OA as minimally three features (≥1) were present. Several clinical assessments were made, e.g. tenderness, bony swelling and soft tissue swelling. The Michigan Hand Outcomes Questionnaire (MHOQ) and Australian/Canadian Osteoarthritis Hand Index (AUSCAN) questionnaires were completed.Results:In total, 31 patients (mean age 41 ± 5.6 years, 13 men and 18 women) diagnosed with EDS participated, of whom 19 with cEDS and with 12 hEDS. In total, 927 joints were assessed. Level of agreement of radiographic assessments was very high (>98%). Early hand OA was found in more than 40% of the EDS patients, with a significant higher frequency in cEDS patients compared to hEDS patients (58% vs. 17%) (p=0.032). Joint space narrowing was most frequently present and significantly more in the cEDS patients compared to hEDS patients (79% vs. 21%) (p=0.003). However, radiographic changes were found in only 10% of all finger joints. Of all fingers, thumb joints were most affected. Regarding the clinical features of hand OA, all patients showed deformity in one or more finger joints, most frequently at the thumb, especially the IP joint (both hyperflexion and hyperextension). Tenderness and bony swelling was present in 36% and 45% of all patients, respectively, whereas soft tissue swelling was less frequently observed (10% of all patients). Here, no significant differences were found between cEDS and hEDS patients. Moderate disability was present (mean (SD) AUSCAN= 45.47 (27.10) and MHQ = 65.97 (14.21). cEDS showed significant less hand pain (p=0.03), a better hand function (p=0.03) and less disability (p=0.026) than hEDS.Conclusion:This explorative study demonstrates that a high number of EDS patients present with minimal degenerative features of hand OA, but in a minority of joints. Patients with cEDS were significantly more affected, but showed a better function compared to hEDS. Possibly, cEDS patients are more susceptible to develop hand OA.References:[1]Altman R, Gold G. Atlas of individual radiographic features in osteoarthritis, revised. OARSI. 2007;15:A1-A56.Disclosure of Interests:None declared

scholarly journals POS0122 THE ASSOCIATIONS BETWEEN DISEASE MODIFYING ANTI-RHEUMATIC DRUGS AND INCIDENT, AND PROGRESSION OF, RADIOGRAPHIC HAND OSTEOARTHRITIS IN RHEUMATOID ARTHRITIS PATIENTS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 272.2-273
Author(s):  
T. Burkard ◽  
C. Lechtenboehmer ◽  
S. Reichenbach ◽  
M. Hebeisen ◽  
U. Walker ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Combination Therapy ◽  
Joint Space Narrowing ◽  
Radiographic Progression ◽  
Joint Space ◽  
Hand Osteoarthritis ◽  
Cohort Entry ◽  
Covariate Information ◽  
Disease Modifying ◽  
Subchondral Sclerosis

Background:Hand osteoarthritis (OA) is characterized by bone erosions, joint space remodeling, and new bone formation mainly in distal interphalangeal (DIP) joints and thereby differs from hand manifestations in rheumatoid arthritis (RA). There are conflicting data about the benefit of treatment with conventional synthetic (cs) and biologic (b) disease modifying anti-rheumatic treatment (DMARD) on DIP OA.Objectives:To assess the associations between DMARDs and incident, and progression of, radiographic DIP OA in RA patients.Methods:We performed two observational cohort studies in the longitudinal Swiss Clinical Quality Management in Rheumatic Diseases registry (SCQM) between 1997 and 2014. RA patients who had ≥2 eligible hand radiographs were included at their first eligible radiograph (baseline) and were followed until the outcome or their last eligible radiograph. Radiographs were eligible if all 8 DIP joints could be scored. Modified Kellgren-Lawrence scores (KLS) were obtained by evaluating DIP joints for severity of osteophytes, joint space narrowing, subchondral sclerosis, and erosions. Incident/existing DIP OA was defined as KLS ≥2 in ≥1 DIP joint. Progression of existing DIP OA was defined as an increase of ≥1 in KLS in ≥1 DIP joint. We divided the study population into two cohorts based on whether DIP OA was present or absent at cohort entry (cohorts 1 and 2, respectively). Exposure status was defined time-dependently into mutually exclusive exposure groups: csDMARD monotherapy, bDMARD monotherapy, bDMARD/csDMARD combination therapy, past bDMARD/csDMARD therapy, or never DMARD use. Cox time-varying proportional hazard regression analyses were used to estimate hazard ratios (HRs) with 95% confidence intervals (CI) of DIP OA progression (cohort 1) or DIP OA incidence (cohort 2) associated with DMARD exposure categories (csDMARD monotherapy was the reference group because it was the largest group). Exposure and covariate information were extracted at every radiograph and other visit date. Missing covariate information was imputed using multiple imputation by chained equations. In sensitivity analyses, we repeated all analyses using generalised estimation equations (GEE).Results:Among 2234 RA patients with 5928 eligible radiographs, 1340 patients had radiographic DIP OA at cohort entry (cohort 1) and 894 were DIP OA naïve (cohort 2). In cohort 1, radiographic progression of existing DIP OA was characterized by new osteophyte formation (666, 52.4%), followed by joint space narrowing (379, 27.5%), subchondral sclerosis (238, 17.8%), and erosion (62, 4.3%). bDMARD monotherapy was associated with an increased risk of radiographic DIP OA progression compared to csDMARD monotherapy (adjusted HR 1.34, 95% CI 1.07–1.69). The risk of DIP OA progression was not significant in csDMARD/bDMARD combination therapy users (adjusted HR 1.12, 95% CI 0.96–1.31), absent in past DMARD users (adjusted HR 0.96, 95% CI 0.66–1.41), and significantly lower among never DMARD users (adjusted HR 0.54, 95% CI 0.33–0.90), compared to csDMARD monotherapy users. In cohort 2, the risk of incident OA did not differ materially between treatment groups. Results from GEE analyses corroborated all findings.Conclusion:Our results from this real-world RA cohort suggest that monotherapy with bDMARDs is not associated with incident DIP OA but may increase the risk of radiographic progression of existing DIP OA when compared to csDMARDs.Acknowledgements:We thank all patients and rheumatologists involved for their contribution to the SCQM RA cohort. A list of rheumatology offices and hospitals that contribute to the SCQM registry can be found at http://www.scqm.ch/institutions. The SCQM is financially supported by pharmaceutical industries and donors. A list of financial supporters can be found at http://www.scqm.ch/sponsors.Disclosure of Interests:Theresa Burkard: None declared, Christian Lechtenboehmer: None declared, Stephan Reichenbach: None declared, Monika Hebeisen: None declared, Ulrich Walker: None declared, Andrea Michelle Burden: None declared, Thomas Hügle Consultant of: Pfizer, Abbvie, Novartis, Grant/research support from: GSK, Jansen, Pfizer, Abbvie, Novartis, Roche, MSD, Sanofi, BMS, Eli Lilly, UCB

scholarly journals Radiographic temporal subtraction analysis can detect finger joint space narrowing progression in rheumatoid arthritis with clinical low disease activity

2017 ◽  
Vol 59 (4) ◽  
pp. 460-467 ◽  
Author(s):  
Taichi Okino ◽  
Tamotsu Kamishima ◽  
Kenneth Lee Sutherland ◽  
Jun Fukae ◽  
Akihiro Narita ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Joint Space Narrowing ◽  
Joint Space ◽  
Scoring Method ◽  
Radiographic Images ◽  
Low Disease Activity ◽  
Finger Joints ◽  
Computer Based

Background Recent papers suggest that finger joints with positive synovial vascularity (SV) assessed by ultrasonography under clinical low disease activity (CLDA) in rheumatoid arthritis (RA) patients may cause joint space narrowing (JSN) progression. Purpose To investigate the performance of a computer-based method by directly comparing with the conventional scoring method in terms of the detectability of JSN progression in hand radiography of RA patients with CLDA. Material and Methods Fifteen RA patients (13 women, 2 men) with long-term sustained CLDA of >2 years were included. Radiological progression of finger joints was measured or scored using the computer-based method which can detect JSN progression between two radiographic images as the joint space difference index (JSDI), as well as the Genant-modified Sharp score (GSS). We also quantitatively assessed SV of these joints using ultrasonography. Results Out of 270 joints, we targeted 259 finger joints after excluding nine damaged joints (four ankylosis, three complete luxation, and two subluxation) and two improved joints according to the GSS results. The JSDI of finger joints with JSN progression was significantly higher than those without JSN progression ( P = 0.018). The JSDI of finger joints with ultrasonographic SV was significantly higher than those without ultrasonographic SV ( P = 0.004). Progression in JSDI showed stronger associations with ultrasonographic SV than progression in GSS (odds ratio [95% confidence interval]: 7.19 [3.37–15.36] versus 5.84 [2.76–12.33]). Conclusion The computer-based method was comparable to the conventional scoring method regarding the detectability of JSN progression in RA patients with CLDA.

scholarly journals POS0967 DESCRIPTION OF SACROILIAC CT FINDINGS IN PATIENTS WITH ANKYLOSING SPONDYLITIS AGED OVER 50 YEARS: PRELIMINARY RESULTS OF THE CASIAGE STUDY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 748.2-749
Author(s):  
O. Fakih ◽  
M. Chouk ◽  
C. Prati ◽  
D. Wendling ◽  
F. Verhoeven
Keyword(s):  
Ankylosing Spondylitis ◽  
Joint Space Narrowing ◽  
Joint Space ◽  
Pelvic Bone ◽  
Factors Associated ◽  
Ct Findings ◽  
Total Score Range ◽  
Computed Tomography Scanning ◽  
Duration Of Disease ◽  
Si Joint

Background:Diagnosis of axial spondyloarthritis (SpA) is nowadays commonly made with the help of pelvic radiography or MRI. However, there is an important inter-observer variability for radiographs, and MRI is subject to possible false positives, and is not the best modality for studying structural lesions. Conversely, pelvic CT has an excellent specificity and appears to be more effective than radiography for the diagnosis of SpA [1]. However, CT findings in patients over 50 years of age have not been studied.Objectives:To describe sacroiliac (SI) joint CT characteristics in patients with ankylosing spondylitis (AS), aged 50 years or older.Methods:An observational, cross sectional study was performed using medical records from Besançon University Hospital’s rheumatology department, which were screened to identify patients with AS. A search was then carried out for patients over 50 years old in the hospital’s imaging archiving system to identify those who had benefited from a CT which included the SI joints in their entirety. Non-inclusion criteria were the existence of pelvic bone lesions and a history of pelvic radiotherapy. For each patient, CT was interpreted using a score previously used by Diekhoff et al. [2], dividing each SI joint into 12 regions, for each of which joint space narrowing (JSN), erosions, and sclerosis are assessed. For this study, we also observed the existence of intra-articular gas and diffuse idiopathic skeletal hyperostosis (DISH) lesions for each region. Quantitative variables are expressed as mean ± standard deviation, qualitative variables as numbers and percentages. Wilcoxon rank-sum test was used to determine factors associated with a higher CT score.Results:A total of 66 patients were included. Mean (SD) age was 65.10 ± 10.59 with a mean (SD) duration of disease of 22.87 ± 14.95 years. 60.29% were male, and 87.04 % were HLA-B27 positive. 40.30% had a bamboo spine. CT findings are described in Table 1. The vast majority of patients have a positive JSN score but significant erosions are found in only a minority of cases. This is partly explained by the fact that 55.9% of the patients had at least one complete bilateral ankylosis (and therefore no erosions) on one of the three slices studied. Bilateral anklylosis was associated with a longer duration of disease (p<0.001) and presence of bamboo spine (p<0.001). Also noteworthy is the low proportion of DISH compared to the general population in this age group, which is 15-25%.Factors associated with a higher total CT score were male sex (p=0.017), longer duration of disease (p<0.001), tobacco use (p=0.033), presence of bamboo spine (p=0.004), absence of DISH (p=0.045) and absence of intra-articular gas (p<0.001). The distribution of lesions appeared to be homogenous over all 24 regions studied (Figure 1).Conclusion:CT findings in AS patients over 50 years of age are mostly represented by changes in joint space, with bilateral ankylosis present in half of the patients. AS appears to be a protective factor for DISH.References:[1]Devauchelle-Pensec V, D’Agostino MA, Marion J, et al. Computed tomography scanning facilitates the diagnosis of sacroiliitis in patients with suspected spondylarthritis: Results of a prospective multicenter French cohort study. Arthritis Rheum 2012;64:1412–9. doi:10.1002/art.33466[2]Diekhoff T, Hermann K-GA, Greese J, et al. Comparison of MRI with radiography for detecting structural lesions of the sacroiliac joint using CT as standard of reference: results from the SIMACT study. Ann Rheum Dis 2017;76:1502–8. doi:10.1136/annrheumdis-2016-210640Table 1.Sacro-iliac CT findings using a score modified from Diekhoff et al.Mean total score (range 0-108)70.36±38.90Presence of joint space narrowing58 (85.29 %)Presence of erosion20 (29.41 %)Presence of sclerosis15 (22.06 %)Presence of Intra-articular gas22 (32.35 %)Presence of DISH3 (4.41 %)Figure 1.Mean scores per region in the anterior, central and posterior SI slices (JSN: joint space narrowing (0-4), Ero: erosions (0-3), Scl: sclerosis (0-2)).Disclosure of Interests:None declared.

scholarly journals AB0867 INCREASED ADIPONECTIN LEVELS ARE ASSOCIATED WITH HIGHER RADIOGRAPHIC SCORES IN THE KNEE JOINT, BUT NOT IN THE HAND JOINT: THE DONG-GU STUDY

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1740.1-1740
Author(s):  
J. H. Kang ◽  
S. E. Choi ◽  
H. Xu ◽  
D. J. Park ◽  
S. S. Lee
Keyword(s):  
Body Mass Index ◽  
Knee Joint ◽  
Body Mass ◽  
Linear Regression Analysis ◽  
Joint Space ◽  
Serum Adiponectin ◽  
Hand Osteoarthritis ◽  
X Rays ◽  
Subchondral Cyst ◽  
The Relationship

Background:Several studies have evaluated the association between serum adiponectin levels and knee and hand osteoarthritis (OA), with mixed results.Objectives:The aim of this study was to investigate the relationship between OA and serum adiponectin levels according to the radiographic features of knee and hand OA.Methods:A total of 2,402 subjects were recruited from the Dong-gu Study. Baseline characteristics were collected via a questionnaire, and X-rays of knee and hand joints were scored by a semi-quantitative grading system. The relationship between serum adiponectin levels and radiographic severity was evaluated by linear regression analysis.Results:Subjects with higher tertiles of serum adiponectin were older and had a lower body mass index than those with lower tertiles. In the knee joint scores, serum adiponectin levels were positively associated with the total score (P<0.001), osteophyte score (P=0.003), and joint space narrowing (JSN) score (P<0.001) among the three tertiles after adjustment for age, sex, body mass index, smoking, alcohol consumption, education, and physical activity. In the hand joint scores, no association was found between serum adiponectin levels and the total score, osteophyte score, JSN score, subchondral cyst score, sclerosis score, erosion score, and malalignment score among the three tertiles after adjustment.Conclusion:In this study, we found that increased adiponectin levels were associated with higher radiographic scores in the knee joint, but not in the hand joint, suggesting different pathophysiologic mechanisms in the development of OA.Disclosure of Interests:None declared

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