Comparison of clinical burden between patients with erosive hand osteoarthritis and inflammatory arthritis in symptomatic community-dwelling adults: the Keele clinical assessment studies
Comparison of clinical burden between patients with erosive hand osteoarthritis and inflammatory arthritis in symptomatic community-dwelling adults: the Keele clinical assessment studies
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DOI：
10.1093/rheumatology/ket267
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发表时间：
2013-12-01
期刊：
影响因子：
5.5
通讯作者：
Peat, George
中科院分区：
文献类型：
--
作者：
Kwok, Wing-Yee;Kloppenburg, Margreet;Peat, George
目标。目的：探讨普通人群指间关节（IPJs）糜烂性骨性关节炎的临床影响，并与有症状的影像学手骨性关节炎和炎性关节炎进行比较。在北斯塔福德郡的两个以人群为基础的队列中，在过去一个月内手部症状持续1天的参与者进行了手部x线片的标准化评估。使用Verbruggen-Veys方法将侵蚀性OA定义为epsilon 1 IPJ中存在侵蚀或重塑相。x线摄影手部OA定义为存在epsilon 1 IPJ/第一腕掌关节，kelgren - lawrence评分为epsilon 2。炎性关节炎的诊断基于医疗记录。用澳大利亚/加拿大手骨关节炎指数（AUSCAN）评估了手疼痛和残疾。采用线性回归分析比较各组之间的临床决定因素，并计算95% ci的平均差异，调整年龄和性别。1076名有手部症状的参与者[60%为女性，平均年龄64.8岁（sd 8.3岁）]；侵蚀性OA 80例（7.4%）。epsilon 1 IPJ人群中糜烂性OA患病率为2.4% （95% CI 1.8, 3.0）。侵蚀性骨关节炎患者报告的疼痛和残疾比有症状的放射学手部骨关节炎患者更多[调整后平均差分别为1.3 （95% CI 0.3, 2.3）和2.3 (95% CI 0.4, 4.2)]。炎性关节炎患者（n = 44）比侵蚀性OA患者报告更多的疼痛和残疾[调整后平均差异分别为1.7 （95% CI 0.05, 3.4）和6.3 (95% CI 2.8, 9.9)]。虽然在一般人群中，糜烂性关节炎比有症状的放射学手部关节炎影响更大，但在手部疼痛和残疾方面，它不如炎症性RA严重。
Objective. To investigate in the general population the clinical impact of erosive OA in interphalangeal joints (IPJs) compared with symptomatic radiographic hand OA and inflammatory arthritis.Methods. Standardized assessments with hand radiographs were performed in participants of two population-based cohorts in North Staffordshire with hand symptoms lasting epsilon 1 day in the past month. Erosive OA was defined as the presence of an eroded or remodelled phase in epsilon 1 IPJ using the Verbruggen-Veys method. Radiographic hand OA was defined as the presence of epsilon 1 IPJ/first carpometacarpal joint with a Kellgren-Lawrence score of epsilon 2. Diagnoses of inflammatory arthritis were based on medical records. Hand pain and disability were assessed with the Australian/Canadian Hand Osteoarthritis Index (AUSCAN). Linear regression analyses were used to compare clinical determinants between groups and calculate mean differences with 95% CIs, adjusted for age and sex.Results. Of 1076 participants with hand symptoms [60% women, mean age 64.8 years (s.d. 8.3 years)]; 80 persons (7.4%) had erosive OA. The population prevalence of erosive OA in epsilon 1 IPJ was 2.4% (95% CI 1.8, 3.0). Persons with erosive OA reported more pain and disability than persons with symptomatic radiographic hand OA [adjusted mean difference 1.3 (95% CI 0.3, 2.3) and 2.3 (95% CI 0.4, 4.2), respectively]. Individuals with inflammatory arthritis (n = 44) reported more pain and disability than those with erosive OA [adjusted mean difference 1.7 (95% CI 0.05, 3.4) and 6.3 (95% CI 2.8, 9.9), respectively].Conclusion. While erosive OA has a greater impact than symptomatic radiographic hand OA in the general population, it is not as severe in terms of hand pain and disability as inflammatory RA.