Background Hand osteoarthritis (HOA) is a common and frequent cause of pain. HOA is a heterogeneous group of disorders with two main subsets including non-erosive disease and erosive, sometimes referred to as inflammatory, HOA. Few studies demonstrated inflammatory ultrasound changes and more severe clinical symptoms in patients with erosive compared with non-erosive disease, however the results are inconclusive.
Objectives The aim of the study was to compare pain, stiffness, physical impairment and ultrasound features between patients with erosive and non-erosive HOA in a cross-sectional study.
Methods Consecutive patients with symptomatic HOA fulfilling the American College of Rheumatology (ACR) criteria were included in this study. Joint pain and swelling were assessed. Pain, joint stiffness and disability were assessed by the Australian/Canadian OA hand index (AUSCAN). Radiographs of both hands were examined and erosive disease was defined by at least one erosive interphalangeal joint. Synovial hypertrophy and power Doppler signal (PDS) were scored with ultrasound. Synovitis was graded on a scale of 0–3 and osteophytes were defined as cortical protrusions seen in two planes.
Results Altogether, 134 patients (13 male) with symptomatic nodal HOA were included in this study between April 2012 and January 2015. Out of these patients, 72 had erosive disease.Patient's characteristics are given in table. The disease duration (p<0.01), duration of morning stiffness (p<0.01) and number of clinically swollen joints (p<0.05) were significantly higher in patients with erosive compared with non-erosive disease. According to the AUSCAN, patients with erosive compared with non-erosive disease had more pain (p<0.05) and stiffness (p<0.01). US-detected pathologies such as gray-scale synovitis total score (p<0.001), intensity of PDS (p<0.01) and number of osteophytes (p<0.01) were significantly higher in patients with erosive compared with non-erosive disease (table).
Conclusions In general, this study shows that patients with erosive HOA have more severe pain and stiffness associated with US-detected synovial hypertrophy, inflammatory signs and osteophyte formation than patients with non-erosive disease.
Acknowledgements This work was supported by the project (Ministry of Health, Czech Republic) for consensual development of research organization 023728.
Disclosure of Interest None declared