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Erosive hand osteoarthritis and sarcopenia: data from Osteoarthritis Initiative cohort
  1. Kamyar Moradi1,
  2. Robert M Kwee1,2,
  3. Bahram Mohajer1,
  4. Ali Guermazi3,
  5. Frank W Roemer3,4,
  6. Hamza Ahmed Ibad1,
  7. Ida K Haugen5,
  8. Francis Berenbaum6,
  9. Shadpour Demehri1
  1. 1 Russell H. Morgan Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
  2. 2 Department of Radiology, Zuyderland Medical Center, Heerlen/Sittard/Geleen, The Netherlands
  3. 3 Department of Radiology, Chobanian & Avedisian Boston University School of Medicine, Boston, Massachusetts, USA
  4. 4 Department of Radiology, Universitätsklinikum Erlangen & Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
  5. 5 Center for Treatment of Rheumatic and Musculoskeletal Diseases, Diakonhjemmet Hospital, Oslo, Norway
  6. 6 Department of Rheumatology, Sorbonne University, INSERM CRSA, Saint-Antoine Hospital APHP, Paris, France
  1. Correspondence to Dr Shadpour Demehri, Radiology, Johns Hopkins University, Baltimore, MD 21287, USA; demehri2001{at}


Objectives There is no evidence linking specific osteoarthritis (OA) types, such as erosive hand OA (EHOA), with distant generalised changes in muscle composition (sarcopenia), which can potentially be modified. This study pioneers the exploration of the association between EHOA and sarcopenia, both of which are predominantly observed in the older adults.

Methods Using the Osteoarthritis Initiative cohort, we selected hand OA (modified Kellgren and Lawrence (grade ≥2 in ≥1 hand joint) participants with radiographic central erosions in ≥1 joints (EHOA group) and propensity score-matched hand OA participants with no erosion (non-EHOA group). MRI biomarkers of thigh muscles were measured at baseline, year 2 and year 4 using a validated deep-learning algorithm. To adjust for ‘local’ effects of coexisting knee OA (KOA), participants were further stratified according to presence of radiographic KOA. The outcomes were the differences between EHOA and non-EHOA groups in the 4-year rate of change for both intramuscular adipose tissue (intra-MAT) deposition and contractile (non-fat) area of thigh muscles.

Results After adjusting for potential confounders, 844 thighs were included (211 EHOA:633 non-EHOA; 67.1±7.5 years, female/male:2.9). Multilevel mixed-effect regression models showed that EHOA is associated a different 4-year rate of change in intra-MAT deposition (estimate, 95% CI: 71.5 mm2/4 years, 27.9 to 115.1) and contractile area (estimate, 95% CI: −1.8%/4 years, −2.6 to −1.0) of the Quadriceps. Stratified analyses showed that EHOA presence is associated with adverse changes in thigh muscle quality only in participants without KOA.

Conclusions EHOA is associated with longitudinal worsening of thigh muscle composition only in participants without concomitant KOA. Further research is needed to understand the systemic factors linking EHOA and sarcopenia, which unlike EHOA is modifiable through specific interventions.

  • Inflammation
  • Machine Learning
  • Osteoarthritis
  • Magnetic Resonance Imaging

Data availability statement

Data are available on reasonable request. The deidentified clinical and demographic information of subjects is publicly available at the osteoarthritis initiative project data repository at The R codes used in this work are available from the corresponding author on reasonable requests.

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Data availability statement

Data are available on reasonable request. The deidentified clinical and demographic information of subjects is publicly available at the osteoarthritis initiative project data repository at The R codes used in this work are available from the corresponding author on reasonable requests.

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  • Handling editor Josef S Smolen

  • X @larhumato

  • Contributors All authors participated in the study design, interpretation of results and drafting the manuscript or critically revising it for relevant intellectual content. As the corresponding author of the manuscript, SD confirms to have full access to the data and take full responsibility for the integrity of this work, including the data and their analysis, as well as the decision to publish this manuscript.

  • Funding This research was supported by the NIH National Institute of Aging (NIA) under Award Number P01AG066603 and NIH National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) under Award Number R01AR079620-01.

  • Disclaimer The results of this work do not necessarily reflect the opinions of the osteoarthritis initiative project investigators, the NIH or the private funding partners. The views expressed are those of the authors and not necessarily those of the National Health Service, the NIHR, or the Department of Health.

  • Competing interests AG is a shareholder of BICL and consultant to Pfizer, TissueGene, Pfizer, Novartis, Coval, ICM, TrialSpark and Medipost. FWR is shareholder of BICL, LLC and consultant to and Grünenthal. IKH has research grant from Pfizer/Lily, consultancies from Novartis, GSK and Grünenthal, and speaker honorarium from Abbvie. SD reported that he received funding from Toshiba Medical Systems (for consultation) and grants from GERRAF and Carestream Health (for a clinical trial study). None of the authors has any conflicting personal or financial relationships that could have influenced the results of this study. Other authors declare that they did not have any competing interests.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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