Progression of hand osteoarthritis over 2 years: a clinical and radiological follow-up study
Progression of hand osteoarthritis over 2 years: a clinical and radiological follow-up study
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DOI：
10.1136/ard.2008.087981
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发表时间：
2009-08-01
影响因子：
27.4
通讯作者：
Kloppenburg, M.
中科院分区：
文献类型：
--
作者：
Botha-Scheepers, S.;Riyazi, N.;Kloppenburg, M.
目的：用现有的预后指标调查手部骨关节炎2年以上的病程。方法：对189名手部骨关节炎的GARP研究参与者进行为期2年的随访。采用澳大利亚/加拿大骨关节炎手指数(AUSCAN LK 3.0)评估患者自我报告的手部疼痛和功能受限。指间关节和拇指根部关节侧向受压的疼痛强度按四分制进行分级。分别于基线和2年后对指间关节和拇指基关节进行骨赘评分(0~3分)和关节间隙狭窄评分(0~3分)。结果：172例(91%)患者完成2年随访(平均年龄60.5岁，78.5%为女性)。自报疼痛和功能评分、疼痛强度评分以及骨赘和JSN总分在两年内显著增加。自述疼痛和功能评分、疼痛强度评分、骨赘和JSN总分的SRM分别为0.25、0.23、0.67、0.34和0.35。放射学进展与自我报告的疼痛和功能的变化无关。处于绝经后早期的女性尤其有放射进展的风险。结论：目前可用的结果测量方法能够评估相对较短的两年时间内的进展。放射学结果比自我报告的结果更敏感。侧向压力引起的疼痛强度似乎是一种有效的测量方法，但需要验证。
Objectives: To investigate the course of hand osteoarthritis over 2 years by currently available outcome measures.Methods: 189 participants of the Genetics, Arthrosis and Progression (GARP) study with hand osteoarthritis were followed for 2 years. Self-reported hand pain and functional limitations were assessed with the Australian/Canadian osteoarthritis hand index (AUSCAN LK 3.0). Pain intensity upon lateral pressure in the interphalangeal and thumb base joints was graded on a four-point scale. Osteophytes (0-3) and joint space narrowing (JSN) (0-3) was scored at baseline and after 2 years in interphalangeal and thumb base joints. Standardised response means (SRM) were calculated.Results: 172 (91%) patients completed the 2-year follow-up (mean age 60.5 years, 78.5% women). Statistically significant increases in self-reported pain and function scores, in pain intensity scores as well as in osteophyte and JSN total scores were seen over 2 years. SRM were 0.25, 0.23, 0.67, 0.34 and 0.35, respectively, for self-reported pain and function scores, pain intensity scores, osteophyte and JSN total scores. Radiological progression was not associated with changes in self-reported pain and function. Women in an early postmenopausal stage were especially at risk of progressing radiologically.Conclusions: Currently available outcome measures were able to assess progression over the relatively short time period of 2 years. Radiographic outcomes were more responsive than self-reported outcomes. Pain intensity upon lateral pressure seems to be a responsive measure but needs validation.