Background Erosive hand osteoarthritis (OA) is characterized by a frequently aggressive inflammatory component that determine a significant aesthetic and functional impact on middle-aged women. Its pathogenesis is still unknown and in recent years is being investigated its relationship with inflammatory arthritis such as rheumatoid arthritis and psoriatic arthropathy. Some studies refer a slight elevation of CRP as an inflammatory marker although the series are small. Knowing the behavior of inflammatory markers, rheumatoid factor and citrullinated peptide can help us understand better the weight of the inflammatory component in this clinical entity and its pathogenesis.
Objectives To analyze the behavior of serum inflammatory markers, rheumatoid factor (RF) and citrullinated peptide (ACPA) in erosive hand osteoarthritis and to determine the possible relationship with articular inflammatory activity.
Methods Consecutive patients with erosive hand OA fulfilling theAmerican College of Rheumatology (ACR) criteria, with at least one erosion on hands radiography were included in our study. Clinical presentation form, number of tender and swollen joints, hypertension, diabetes and dyslipidemia were collected. Levels of CRP, ESR, RF, ACPA, total and HDL cholesterol level as well as triglycerides were registered.
Results A total of 75 patients were included. Attending to clinical presentation there was a 32.5% hands limited, 25.3% with hands and feet involvement and 42.2% polyarthrosis. We found elevated ESR in 8% of patients and PCR in 2.7% at a lower degree in all cases. Three patients presented positive rheumatoid factor (3.8%) all at low titles while 100% were ACPA negative. Number of swollen joints was 1,33+ 1.5 (0.6), and tender joint 3.36 + 3.39 (0 14). With regard to hypercholesterolemia we found 69.6% and hypertriglyceridemia in 24.1% of patients.
Conclusions In our series the percentage of patients with elevated inflammatory markers was small,as described in previous articles with low values and unrelated with articular inflammatory activity. FR found positive in three patients at low titers and all ACPA negative. This supports the high specificity of ACPA and its usefulness to differentiate early erosive osteoarthritis with proximal predominance of early RA. The high proportion of hypercholesterolemia goes for the described relationship between the metabolic pathway of lipids and osteoarthritis and metabolic syndrome more frequently described in this pathology.
Disclosure of Interest None declared