I K Haugen1, A Mathiessen2, B Slatkowsky-Christensen3, K Magnusson4, P Bøyesen5, S Sesseng6, D van der Heijde7, T K Kvien8, H B Hammer9. 1. Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway. Electronic address: ida.k.haugen@gmail.com. 2. Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway. Electronic address: alexander_mathiessen@hotmail.com. 3. Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway. Electronic address: barbaraschrist@hotmail.com. 4. National Advisory Unit on Rehabilitation in Rheumatology, Diakonhjemmet Hospital, Oslo, Norway. Electronic address: magnusson_karin@outlook.com. 5. Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway. Electronic address: pernilleboyesen@gmail.com. 6. Department of Radiology, Diakonhjemmet Hospital, Oslo, Norway; Department of Radiology, Kongsvinger Hospital, Oslo, Norway. 7. Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands. Electronic address: mail@dvanderheijde.nl. 8. Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway. Electronic address: t.k.kvien@medisin.uio.no. 9. Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway. Electronic address: hbham@online.no.
Abstract
OBJECTIVE: To compare the prevalence of synovitis, pain and radiographic progression in non-erosive and erosive hand osteoarthritis (HOA), and to explore whether the different rate of disease progression is explained by different levels of synovitis and structural damage. DESIGN: We included 31 and 34 participants with non-erosive and erosive HOA at baseline, respectively. Using Generalized Estimating Equations, we explored whether participants with erosive HOA had more synovitis (by MRI, ultrasound and clinical examination) independent of the degree of structural damage. Similarly, we explored whether pain at baseline and radiographic progression after 5 years were higher in erosive HOA, independent of the levels of synovitis and structural damage. All analyses were adjusted for age and sex. RESULTS: Power Doppler activity was found mainly in erosive HOA. Participants with erosive HOA demonstrated more moderate-to-severe synovitis, assessed by MRI (OR = 1.73, 95% CI 1.11-2.70), grey-scale ultrasound (OR = 2.02, 95% CI 1.25-3.26) and clinical examination (OR = 1.80, 95% CI 1.44-2.25). The associations became non-significant when adjusting for more structural damage. The higher frequency of joint tenderness in erosive HOA was at least partly explained more structural damage and inflammation. Radiographic progression (OR = 2.53, 95% CI 1.73-3.69) was more common in erosive HOA independent of radiographic HOA severity and synovitis (here: adjusted for grey-scale synovitis by ultrasound). CONCLUSION: Erosive HOA is characterized by higher frequency and more severe synovitis, pain and radiographic progression compared to non-erosive HOA. The higher rate of disease progression was independent of baseline synovitis and structural damage.
OBJECTIVE: To compare the prevalence of synovitis, pain and radiographic progression in non-erosive and erosive hand osteoarthritis (HOA), and to explore whether the different rate of disease progression is explained by different levels of synovitis and structural damage. DESIGN: We included 31 and 34 participants with non-erosive and erosive HOA at baseline, respectively. Using Generalized Estimating Equations, we explored whether participants with erosive HOA had more synovitis (by MRI, ultrasound and clinical examination) independent of the degree of structural damage. Similarly, we explored whether pain at baseline and radiographic progression after 5 years were higher in erosive HOA, independent of the levels of synovitis and structural damage. All analyses were adjusted for age and sex. RESULTS: Power Doppler activity was found mainly in erosive HOA. Participants with erosive HOA demonstrated more moderate-to-severe synovitis, assessed by MRI (OR = 1.73, 95% CI 1.11-2.70), grey-scale ultrasound (OR = 2.02, 95% CI 1.25-3.26) and clinical examination (OR = 1.80, 95% CI 1.44-2.25). The associations became non-significant when adjusting for more structural damage. The higher frequency of joint tenderness in erosive HOA was at least partly explained more structural damage and inflammation. Radiographic progression (OR = 2.53, 95% CI 1.73-3.69) was more common in erosive HOA independent of radiographic HOA severity and synovitis (here: adjusted for grey-scale synovitis by ultrasound). CONCLUSION: Erosive HOA is characterized by higher frequency and more severe synovitis, pain and radiographic progression compared to non-erosive HOA. The higher rate of disease progression was independent of baseline synovitis and structural damage.
Authors: Jean-Yves L Reginster; Nigel K Arden; Ida K Haugen; Francois Rannou; Etienne Cavalier; Olivier Bruyère; Jaime Branco; Roland Chapurlat; Sabine Collaud Basset; Nasser M Al-Daghri; Elaine M Dennison; Gabriel Herrero-Beaumont; Andrea Laslop; Burkhard F Leeb; Stefania Maggi; Ouafa Mkinsi; Anton S Povzun; Daniel Prieto-Alhambra; Thierry Thomas; Daniel Uebelhart; Nicola Veronese; Cyrus Cooper Journal: Semin Arthritis Rheum Date: 2017-12-07 Impact factor: 5.532
Authors: Marthe Gløersen; Elisabeth Mulrooney; Alexander Mathiessen; Hilde Berner Hammer; Barbara Slatkowsky-Christensen; Karwan Faraj; Thore Isaksen; Tuhina Neogi; Tore K Kvien; Karin Magnusson; Ida Kristin Haugen Journal: BMJ Open Date: 2017-09-24 Impact factor: 2.692