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Abstract
Objectives: To investigate the clinical associations of hand osteoarthritis (HOA) and their relationships with radiographic features.
Methods: A total of 446 patients with hand osteoarthritis (HOA; 233 with erosive HOA (EHOA) and 213 with non-EHOA) and 307 controls were evaluated. Demographic and clinical data from patients and controls were recorded based on medical records/clinical reports and an anamnesis of drug consumption. Posteroanterior radiographs of both hands were obtained from all HOA patients and were assessed using the Kellgren and Lawrence (K&L) and Kallman scoring systems.
Results: After adjustment for age, gender, and body mass index (BMI), HOA patients showed a significantly increased odds ratio (OR) for hypercholesterolaemia [OR 2.10, 95% confidence interval (CI) 1.39–3.16, p < 0.0005] and autoimmune thyroiditis (OR 4.85, 95% CI 1.77–13.29, p = 0.002), as well as for knee (OR 1.63, 95% CI 1.09–2.44, p = 0.018) and hip OA (OR 1.87, 95% CI 1.07–3.27, p = 0.029). No significant increase for systemic hypertension, ischaemic heart disease, and diabetes mellitus was found. Patients with EHOA and non-EHOA showed similar risks for the above-mentioned co-morbidities. A similar occurrence of clinical associations was also observed in patients with HOA alone and in those with generalized OA. No association between radiographic scores and clinical associations was observed.
Conclusions: Patients with HOA present a direct association with hypercholesterolaemia (and autoimmune thyroiditis) but do not show increased ischaemic cardiovascular manifestations compared to controls. No significant association between radiographic scores and co-morbidities was found.
Acknowledgements
We thank A Teff for her linguistic advice, and also Drs S Gnudi and E Sitta for their collaboration. This work was supported by grants from the University of Bologna, The Rizzoli Orthopaedic Institute, Bologna, and The Foundation of Monte di Bologna and Ravenna, Bologna.