Prevalence, incidence and progression of hand osteoarthritis in the general population: the Framingham Osteoarthritis Study
- Ida K Haugen1,
- Martin Englund2,3,
- Piran Aliabadi4,
- Jingbo Niu3,
- Margaret Clancy3,
- Tore K Kvien1,
- David T Felson3
- 1Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
- 2Department of Orthopedics, Lund University, Lund, Sweden
- 3Clinical Epidemiology Research and Training Unit, Boston University School of Medicine, Boston, Massachusetts, USA
- 4Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Correspondence to Ida K Haugen, Department of Rheumatology, Diakonhjemmet Hospital, PO Box 23, Vinderen, 0319 Oslo, Norway;
- Accepted 17 April 2011
- Published Online First 27 May 2011
Objectives To describe the prevalence and longitudinal course of radiographic, erosive and symptomatic hand osteoarthritis (HOA) in the general population.
Methods Framingham osteoarthritis (OA) study participants obtained bilateral hand radiographs at baseline and 9-year follow-up. The authors defined radiographic HOA at joint level as Kellgren–Lawrence grade (KLG)≥2, erosive HOA as KLG≥2 plus erosion and symptomatic HOA as KLG≥2 plus pain/aching/stiffness. Presence of HOA at individual level was defined as ≥1 affected joint. The prevalence was age-standardised (US 2000 Population 40–84 years).
Results Mean (SD) baseline age was 58.9 (9.9) years (56.5% women). The age-standardised prevalence of HOA was only modestly higher in women (44.2%) than men (37.7%), whereas the age-standardised prevalence of erosive and symptomatic OA was much higher in women (9.9% vs 3.3%, and 15.9% vs 8.2%). The crude incidence of HOA over 9-year follow-up was similar in women (34.6%) and men (33.7%), whereas the majority of those women (96.4%) and men (91.4%) with HOA at baseline showed progression during follow-up. Incident metacarpophalangeal and wrist OA were rare, but occurred more frequently and from an earlier age in men than women. Development of erosive disease occurred mainly in those with non-erosive HOA at baseline (as opposed to those without HOA), and was more frequent in women (17.3%) than men (9.6%).
Conclusions The usual female predominance of prevalent and incident HOA was less clear for radiographic HOA than for symptomatic and erosive HOA. With an ageing population, the impact of HOA will further increase.
Funding The Framingham Osteoarthritis Study is supported by the National Institutes of Health (NIH) AR47785. IKH is funded by grants from the South-Eastern Norway Regional Health Authority and a scholarship from OARSI. ME is funded by the Swedish Research Council and the Faculty of Medicine, Lund University, Sweden.
Competing interests None.
Patient consent Obtained.
Ethics approval This study was conducted with the approval of the Boston University Medical Center Institutional Review Board.
Provenance and peer review Not commissioned; externally peer reviewed.