A LONGITUDINAL-STUDY OF OSTEOARTHRITIS OF THE HAND - THE EFFECT OF AGE
A LONGITUDINAL-STUDY OF OSTEOARTHRITIS OF THE HAND - THE EFFECT OF AGE
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DOI：
10.1080/03014469100001712
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发表时间：
1991-09-01
影响因子：
1.7
通讯作者：
PLATO, CC
中科院分区：
文献类型：
--
作者：
BUSBY, J;TOBIN, J;PLATO, CC
骨关节炎是世界范围内最常见的风湿性疾病。虽然它在不同人群中的患病率已被充分记录，但很少有研究评估该疾病的纵向放射学进展，特别是当它在手部指间关节中表达时。在这项纵向研究中，巴尔的摩老龄化纵向研究的386名白色男性参与者的左手腕X线片至少随访5年，进行了两次或多次随访，检查了手部远端和近端指间关节骨关节炎的患病率和进展情况。正如其他研究所示，我们发现，随着受试者年龄的增加，远侧和近侧指间关节骨关节炎的患病率逐渐升高。使用生命表分析方法，我们研究了骨关节炎的进展，定义如下：（1）既往受累关节的放射学变化严重程度增加和（2）新受累关节数量增加。结果表明，老年人群中远侧和近侧指间关节的骨关节炎进展速度快于60岁以下人群。此外，无论起始点是Kellgren等级0（无疾病）还是1（可疑），指间关节骨关节炎的进展速度相同。因此，我们得出结论，1级是指间关节骨关节炎不可阻挡的进展的中间步骤，而不是0级的同义词，因为它已经习惯性地解释。
Osteoarthritis is the most ubiquitous rheumatic disease worldwide. Although its prevalence in various populations has been well documented, few studies have evaluated the longitudinal radiographic progression of the disease, especially as it is expressed in the interphalangeal joints of the hand. In this longitudinal study, left hand-wrist X-rays of 386 white male participants of the Baltimore Longitudinal Study of Aging followed for at least 5 years with two or more visits were examined for prevalence and progression of osteoarthritis of the distal and proximal interphalangeal joints of the hand. As other studies have shown, we found that the prevalence of osteoarthritis in both distal and proximal interphalangeal joints becomes progressively higher as the age of the subjects increases. Using the life table method of analysis we studied the progression of osteoarthritis as defined by the following criteria: (1) an increase in the severity of radiographic changes of the joints previously affected and (2) an increase in the number of new joints affected. The results indicated that osteoarthritis in both the distal and proximal interphalangeal joints progresses at a faster rate in the older population than in individuals < 60 years of age. Furthermore, osteoarthritis in the interphalangeal joints progresses at the same rate whether the starting point was a Kellgren grade of 0 (no disease) or 1 (doubtful). We therefore conclude that grade 1 is an intermediate step in the inexorable progression of osteoarthritis of the interphalangeal joints and not synonymous with grade 0, as it has been customarily interpreted.