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Wu R, Peng Q, Wang W, Zheng J, Zhou Y, Yang Q, Zhang X, Li H, Meng L. Systematic review and network meta-analysis on the efficacy and safety of parmacotherapy for hand osteoarthritis. PLoS One 2024; 19:e0298774. [PMID: 38722915 PMCID: PMC11081354 DOI: 10.1371/journal.pone.0298774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 01/31/2024] [Indexed: 05/13/2024] Open
Abstract
OBJECTIVE Hand osteoarthritis poses a significant health challenge globally due to its increasing prevalence and the substantial burden on individuals and the society. In current clinical practice, treatment options for hand osteoarthritis encompass a range of approaches, including biological agents, antimetabolic drugs, neuromuscular blockers, anti-inflammatory drugs, hormone medications, pain relievers, new synergistic drugs, and other medications. Despite the diverse array of treatments, determining the optimal regimen remains elusive. This study seeks to conduct a network meta-analysis to assess the effectiveness and safety of various drug intervention measures in the treatment of hand osteoarthritis. The findings aim to provide evidence-based support for the clinical management of hand osteoarthritis. METHODS We performed a comprehensive search across PubMed, Embase, Web of Science, and Cochrane Central Register of Controlled Trials was conducted until September 15th, 2022, to identify relevant randomized controlled trials. After meticulous screening and data extraction, the Cochrane Handbook's risk of bias assessment tool was applied to evaluate study quality. Data synthesis was carried out using Stata 15.1 software. RESULTS 21 studies with data for 3965 patients were meta-analyzed, involving 20 distinct Western medicine agents. GCSB-5, a specific herbal complex that mainly regulate pain in hand osteoarthritis, showed the greatest reduction in pain [WMD = -13.00, 95% CI (-26.69, 0.69)]. CRx-102, s specific medication characterized by its significant effect for relieving joint stiffness symptoms, remarkably mitigated stiffness [WMD = -7.50, 95% CI (-8.90, -6.10)]. Chondroitin sulfate displayed the highest incidence of adverse events [RR = 0.26, 95% CI (0.06, 1.22)]. No substantial variation in functional index for hand osteoarthritis score improvement was identified between distinct agents and placebo. CONCLUSIONS In summary, GCSB-5 and CRx-102 exhibit efficacy in alleviating pain and stiffness in HOA, respectively. However, cautious interpretation of the results is advised. Tailored treatment decisions based on individual contexts are imperative.
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Affiliation(s)
- Ruiqi Wu
- Guangxi University of Chinese Medicine, Nanning, 530000, Guangxi Zhuang Autonomous Region, China
| | - Qinglin Peng
- Guangxi University of Chinese Medicine, Nanning, 530000, Guangxi Zhuang Autonomous Region, China
| | - Weiwei Wang
- Guangxi University of Chinese Medicine, Nanning, 530000, Guangxi Zhuang Autonomous Region, China
| | - Jixian Zheng
- Hainan Medical University, Haikou, 570100, Hainan, China
| | - Yi Zhou
- Guangxi University of Chinese Medicine, Nanning, 530000, Guangxi Zhuang Autonomous Region, China
| | - Qipei Yang
- Guangxi University of Chinese Medicine, Nanning, 530000, Guangxi Zhuang Autonomous Region, China
| | - Xuan Zhang
- Guangxi University of Chinese Medicine, Nanning, 530000, Guangxi Zhuang Autonomous Region, China
| | - Hongyu Li
- Guangxi Orthopedic Hospital, Nanning, 530000, Guangxi Zhuang Autonomous Region, China
| | - Lin Meng
- Guangxi Orthopedic Hospital, Nanning, 530000, Guangxi Zhuang Autonomous Region, China
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Genaro LE, Marconato JV, Tagliaferro EPDS, Pinotti FE, Valsecki Júnior A, Adas Saliba T, Rosell FL. Home Care for the Elderly: An Integrated Approach to Perception, Quality of Life, and Cognition. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:539. [PMID: 38791748 PMCID: PMC11121688 DOI: 10.3390/ijerph21050539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 03/01/2024] [Accepted: 03/02/2024] [Indexed: 05/26/2024]
Abstract
This study investigated the impact of home care, health status, and cognition. A qualitative and quantitative approach was employed through a cross-sectional study with a sample of 60 elderly individuals in need of home care in the municipality of Itatiba, São Paulo, Brazil. The analysis utilized the Discourse of the Collective Subject (DCS), EQ-5D, EQ VAS, and Mini-Mental State Examination (MMSE). The sample consisted of 40.0% male and 60.0% female individuals. The majority (61.6%) received weekly visits, mainly from community health agents, who were responsible for the majority of the care (45%). Positive considerations were highlighted, with 36.6% emphasizing the contribution to treatment continuity. The EQ VAS assessment indicated a moderately good perception of health. The EQ-5D analysis revealed significant differences between genders in personal care (p = 0.04). There were significant differences between clinical characteristics and EQ-5D dimensions, such as neoplasia and reduced mobility (p = 0.04), and arthritis/osteoarthritis/rheumatism and a limitation in common activities (p = 0.01). The presence of anxiety/depression was significant in cases of neoplasia (p = 0.006), arthritis/osteoarthritis/rheumatism (p = 0.01), and stroke (p = 0.04). The logistic regression analysis showed associations between usual activities and arthritis, osteoarthritis, rheumatism (p = 0.034), pain/malaise and arthritis, osteoarthritis, rheumatism (p = 0.038), and anxiety/depression and stroke (p= 0.028). The average MMSE scores (17.52) suggested a mild cognitive impairment, with no statistical differences between genders. Based on these results, it can be concluded that home care can provide a comprehensive approach and continuous assistance, emphasizing the importance of personalized care based on perceived and clinical differences.
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Affiliation(s)
- Luis Eduardo Genaro
- Postgraduate Program in Collective Health in Dentistry, School of Dentistry, São Paulo State University, Araçatuba 16.015-050, SP, Brazil;
| | - José Victor Marconato
- School of Medicine, San Francisco University, Bragança Paulista 12.916-900, SP, Brazil;
| | - Elaine Pereira da Silva Tagliaferro
- Department of Community Dentistry, School of Dentistry, São Paulo State University, Araraquara 14.801-903, SP, Brazil; (E.P.d.S.T.); (A.V.J.); (F.L.R.)
| | - Felipe Eduardo Pinotti
- Postgraduate Program in Collective Health in Dentistry, School of Dentistry, São Paulo State University, Araçatuba 16.015-050, SP, Brazil;
| | - Aylton Valsecki Júnior
- Department of Community Dentistry, School of Dentistry, São Paulo State University, Araraquara 14.801-903, SP, Brazil; (E.P.d.S.T.); (A.V.J.); (F.L.R.)
| | - Tânia Adas Saliba
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University, Araçatuba 16.015-050, SP, Brazil;
| | - Fernanda Lopez Rosell
- Department of Community Dentistry, School of Dentistry, São Paulo State University, Araraquara 14.801-903, SP, Brazil; (E.P.d.S.T.); (A.V.J.); (F.L.R.)
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Dellestable A, Cheval D, Kerfant N, Stindel E, Le Nen D, Letissier H. Long-term outcomes of trapeziectomy with Gore-Tex® ligament reconstruction for trapezio-metacarpal osteoarthritis. Orthop Traumatol Surg Res 2024; 110:103366. [PMID: 35840046 DOI: 10.1016/j.otsr.2022.103366] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 01/05/2022] [Accepted: 01/25/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND Trapezio-metacarpal osteoarthritis is a common condition for which the reference standard treatment after failure of non-operative measures is trapeziectomy. Several techniques have been devised to avoid proximal migration of the first metacarpal bone (M1) with impingement on the scaphoid bone. We have developed a Gore-Tex® ligament reconstruction technique that avoids potential complications of tendon harvesting. The objective of this study was to assess the long-term outcomes of this technique. HYPOTHESIS Trapeziectomy with Gore-Tex® ligament reconstruction is a reliable option for providing lasting pain relief in patients with trapezio-metacarpal osteoarthritis. MATERIALS AND METHODS We conducted an observational, single-centre, single-surgeon, retrospective cohort study in consecutive patients managed by primary trapeziectomy. We excluded patients with revision trapeziectomy or less than 10 years' follow-up. The primary outcome was event-free survival, defined as absence of revision surgery and of a numerical rating scale score for pain above 3/10. The secondary criteria were clinical tolerance of the Gore-Tex® implant and radiological changes. The patients were assessed at last follow-up either in person or during a teleconsultation. RESULTS Of 78 included joints, 54 were assessed during patient visits and 24 by teleconsultation. At 10 years, the event-free survival rate was 91.3%, and 60.3% of patients were free of pain. Evidence of osteolysis was visible in 24% of patients. No patient experienced clinical intolerance of the Gore-Tex® implant. The mean Disabilities of Arm, Shoulder and Hand score was 25.5. Metacarpo-phalangeal hyperextension was significantly increased, to 30.6°, and the mean trapezial space ratio was significantly decreased, to 39.1% of the baseline value. CONCLUSION Long-term event-free survival was high. Functional outcomes and pain were similar to previous reports. Trapeziectomy with Gore-Tex® ligament reconstruction obviates the need for tendon harvesting. Osteolysis developed in some patients but did not correlate with clinical intolerance. Long-term clinical and radiological monitoring is in order after Gore-Tex® implantation. LEVEL OF EVIDENCE IV, Observational, single-centre, single-surgeon, retrospective cohort study.
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Affiliation(s)
- Arthur Dellestable
- Service de chirurgie orthopédique et traumatologique, hôpital de la Cavale Blanche, boulevard Tanguy-Prigent, 29200 Brest, France
| | - Damien Cheval
- Service de chirurgie orthopédique et traumatologique, centre hospitalier De Cornouaille, avenue Yves-Thépot, 29107 Quimper, France
| | - Nathalie Kerfant
- LaTIM, INSERM, UMR 1101, SFR IBSAM, avenue Foch, 29200 Brest, France; Université de Bretagne Occidentale, UBO, 29200 Brest, France; Service de chirurgie plastique et reconstructrice, hôpital de la Cavale Blanche, boulevard Tanguy-Prigent, 29200 Brest, France
| | - Eric Stindel
- Service de chirurgie orthopédique et traumatologique, hôpital de la Cavale Blanche, boulevard Tanguy-Prigent, 29200 Brest, France; LaTIM, INSERM, UMR 1101, SFR IBSAM, avenue Foch, 29200 Brest, France; Université de Bretagne Occidentale, UBO, 29200 Brest, France
| | - Dominique Le Nen
- Service de chirurgie orthopédique et traumatologique, hôpital de la Cavale Blanche, boulevard Tanguy-Prigent, 29200 Brest, France; Université de Bretagne Occidentale, UBO, 29200 Brest, France
| | - Hoël Letissier
- Service de chirurgie orthopédique et traumatologique, hôpital de la Cavale Blanche, boulevard Tanguy-Prigent, 29200 Brest, France; LaTIM, INSERM, UMR 1101, SFR IBSAM, avenue Foch, 29200 Brest, France; Université de Bretagne Occidentale, UBO, 29200 Brest, France.
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Bean MB, Favero M, Ramonda R, Scanzello CR. Erosive Hand Osteoarthritis: Recent Advances and Future Treatments. Curr Rheumatol Rep 2024; 26:103-111. [PMID: 38214806 DOI: 10.1007/s11926-023-01130-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/28/2023] [Indexed: 01/13/2024]
Abstract
PURPOSE OF THE REVIEW Erosive hand osteoarthritis (EHOA) is an aggressive form of hand osteoarthritis that leads to significant disability, and recent data suggests that it is increasing in prevalence. This review provides an update of our current understanding of epidemiology, genetic associations, biomarkers, pathogenesis, and treatment of EHOA, with particular focus on studies published within the last 5 years. RECENT FINDINGS New studies of EHOA have identified new genetic loci associated with disease, including variants in genes involved in inflammation and bone remodeling. Preclinical studies implicate pathways of innate immunity, including some that may be causal in the condition. Recent novel studies showed that inflammatory features identified by ultrasound and MRI are associated with development of erosive lesions over time on conventional radiography. In the future, these imaging modalities may be useful in identifying patients at risk of adverse outcomes. Promising new findings in genetics, biomarkers, and treatment targets will hopefully allow for future therapeutic options for this debilitating condition.
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Affiliation(s)
- Marta B Bean
- Division of Rheumatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, 19104, USA.
| | - Marta Favero
- Rheumatology Unit, Department of Medicine-DIMED, Padova University Hospital, Padova, Italy
- Medicine Unit 1, Ca' Foncello Hospital, Treviso, Italy
| | - Roberta Ramonda
- Rheumatology Unit, Department of Medicine-DIMED, Padova University Hospital, Padova, Italy
| | - Carla R Scanzello
- Division of Rheumatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, 19104, USA
- Department of Medicine & Translational Musculoskeletal Research Center, Corp. Crescenz VA Medical Center, Philadelphia, PA, 19104, USA
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Silva-Díaz M, Pértega-Díaz S, Balboa-Barreiro V, Tilve-Álvarez CM, Raga-Sivira A, Rego-Pérez I, Blanco FJ, Oreiro N. Metabolic syndrome is not associated with erosive hand osteoarthritis: a cross-sectional study using data from the PROCOAC cohort. Sci Rep 2024; 14:5968. [PMID: 38472231 DOI: 10.1038/s41598-024-55374-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 02/22/2024] [Indexed: 03/14/2024] Open
Abstract
To delineate the phenotype of erosive hand osteoarthritis (EHOA) in a Spanish population and assess its correlation with metabolic syndrome. We conducted a cross-sectional study using baseline data from the Prospective Cohort of Osteoarthritis from A Coruña (PROCOAC). Demographic and clinical variables, obtained through questionnaires, clinical examinations, and patient analytics, were compared among individuals with hand OA, with and without EHOA. We performed appropriate univariate and multivariate stepwise regression analyses using SPSS v28. Among 1039 subjects diagnosed with hand OA, 303 exhibited EHOA. Multivariate logistic regression analysis revealed associations with inflamed joints, nodular hand OA, and total AUSCAN. Furthermore, the association with a lower prevalence of knee OA remained significant. The influence of metabolic syndrome (MetS) on EHOA patients was analyzed by including MetS as a covariate in the model. It was observed that MetS does not significantly impact the presence of EHOA, maintaining the effect size of other factors. In conclusion, in the PROCOAC cohort, EHOA is associated with nodular hand OA, inflammatory hand OA, and a higher total AUSCAN. However, EHOA is linked to a lower prevalence of knee OA. Importantly, in our cohort, no relationship was found between EHOA and MetS.
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Affiliation(s)
- Maite Silva-Díaz
- Grupo de Investigación Clinica en Reumatología (GIR), INIBIC-Complejo Hospitalario Universitario A Coruña (CHUAC), SERGAS, As Xubias, 15006, A Coruña, Spain
| | - Sonia Pértega-Díaz
- Grupo de Investigación en Reumatología y Salud (GIR-S), Centro de Investigaciones Científicas Avanzadas (CICA), Universidade da Coruña, A Coruña, Spain
| | - Vanesa Balboa-Barreiro
- Unidad de Epidemiología Clínica y Bioestadística, INIBIC-Complejo Hospitalario Universitario A Coruña (CHUAC), SERGAS, A Coruña, Spain
| | - Carlos M Tilve-Álvarez
- Avances en Telemedicina e Informática Sanitaria (ATIS), INIBIC-Complejo Hospitalario Universitario A Coruña (CHUAC), SERGAS, A Coruña, Spain
| | - Ana Raga-Sivira
- Grupo de Investigación Clinica en Reumatología (GIR), INIBIC-Complejo Hospitalario Universitario A Coruña (CHUAC), SERGAS, As Xubias, 15006, A Coruña, Spain
| | - Ignacio Rego-Pérez
- Grupo de Investigación Clinica en Reumatología (GIR), INIBIC-Complejo Hospitalario Universitario A Coruña (CHUAC), SERGAS, As Xubias, 15006, A Coruña, Spain.
| | - Francisco J Blanco
- Grupo de Investigación Clinica en Reumatología (GIR), INIBIC-Complejo Hospitalario Universitario A Coruña (CHUAC), SERGAS, As Xubias, 15006, A Coruña, Spain.
- Grupo de Investigación en Reumatología (GIR), INIBIC-Complejo Hospitalario Universitario A Coruña (CHUAC), SERGAS, A Coruña, Spain.
| | - Natividad Oreiro
- Grupo de Investigación Clinica en Reumatología (GIR), INIBIC-Complejo Hospitalario Universitario A Coruña (CHUAC), SERGAS, As Xubias, 15006, A Coruña, Spain
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Moen HV, Hänel M, Therkildsen J, Klose-Jensen R, Keller KK, Hauge EM. Bony proliferations in rheumatoid arthritis, psoriatic arthritis and osteoarthritis using high-resolution peripheral quantitative computed tomography-A systematic literature review. Int J Rheum Dis 2024; 27:e15068. [PMID: 38334245 DOI: 10.1111/1756-185x.15068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 01/09/2024] [Accepted: 01/22/2024] [Indexed: 02/10/2024]
Abstract
PURPOSE Osteoarthritis (OA), rheumatoid arthritis (RA), and psoriatic arthritis (PsA) can all lead to the formation of bony proliferations (BP). This systematic review aimed to examine the characteristics of BPs in patients with RA, PsA, OA, and healthy controls (HC) using high-resolution peripheral quantitative computed tomography (HR-pQCT). Secondarily, we examined any treatment-related effect on BP number and size. METHODS A systematic literature search was conducted in PubMed and Embase, and a total of 15 studies were included. RESULTS Seven studies demonstrated a disease-specific variation in BP location. One study showed no difference in the number of BPs between patients with PsA and OA. The number of BPs was greater in patients with PsA compared to RA in one study, and to HC in another study, while one study documented no difference in the number of BPs between patients with RA and HC. Five studies showed larger BPs in patients with PsA compared to HC, and one study larger BPs in patients with PsA compared to RA. One study showed no difference in BP size between patients with PsA and OA. Secukinumab may have a potential effect on arresting BP progression. Otherwise, no other treatment was reported to influence BP size and progression. No standard definitions or measurement techniques for BPs using HR-pQCT have been identified. CONCLUSION BPs showed disease-specific variations in location, size, and number. Results regarding treatment-related effects are sparse. An agreement on the definition and measurement technique for BPs using HR-pQCT is warranted for diagnostic accuracy, disease comparability, and monitoring potential.
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Affiliation(s)
- Haakon Vilstrup Moen
- Department of Internal Medicine, Gødstrup Regional Hospital, Gødstrup, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Mathias Hänel
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark
| | - Josephine Therkildsen
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark
| | - Rasmus Klose-Jensen
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark
| | - Kresten Krarup Keller
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark
| | - Ellen Margrethe Hauge
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark
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Moradi K, Kwee RM, Mohajer B, Guermazi A, Roemer FW, Ibad HA, Haugen IK, Berenbaum F, Demehri S. Erosive hand osteoarthritis and sarcopenia: data from Osteoarthritis Initiative cohort. Ann Rheum Dis 2024:ard-2023-224997. [PMID: 38242637 DOI: 10.1136/ard-2023-224997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 01/04/2024] [Indexed: 01/21/2024]
Abstract
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.
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Affiliation(s)
- Kamyar Moradi
- Russell H. Morgan Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Robert M Kwee
- Russell H. Morgan Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Department of Radiology, Zuyderland Medical Center, Heerlen/Sittard/Geleen, The Netherlands
| | - Bahram Mohajer
- Russell H. Morgan Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Ali Guermazi
- Department of Radiology, Chobanian & Avedisian Boston University School of Medicine, Boston, Massachusetts, USA
| | - Frank W Roemer
- Department of Radiology, Chobanian & Avedisian Boston University School of Medicine, Boston, Massachusetts, USA
- Department of Radiology, Universitätsklinikum Erlangen & Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Hamza Ahmed Ibad
- Russell H. Morgan Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Ida K Haugen
- Center for Treatment of Rheumatic and Musculoskeletal Diseases, Diakonhjemmet Hospital, Oslo, Norway
| | - Francis Berenbaum
- Department of Rheumatology, Sorbonne University, INSERM CRSA, Saint-Antoine Hospital APHP, Paris, France
| | - Shadpour Demehri
- Russell H. Morgan Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Perruccio AV, Badley EM, Antflek D, Power JD, Baltzer H. Frequency of multisite non-hand joint involvement in patients with thumb-base osteoarthritis, and associations with functional and patient-reported outcomes. OSTEOARTHRITIS AND CARTILAGE OPEN 2023; 5:100397. [PMID: 37609061 PMCID: PMC10440563 DOI: 10.1016/j.ocarto.2023.100397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 08/02/2023] [Accepted: 08/07/2023] [Indexed: 08/24/2023] Open
Abstract
Purpose In OA studies, the focus often is on an index-joint; other affected joint sites are often overlooked. In this thumb-base OA study, we documented the frequency of symptomatic non-hand joint sites and investigated whether their count was associated with thumb-specific functional and patient-reported outcome measures. Design Patients seeking care for thumb-base OA (conservative or surgical) were included. A patient-completed questionnaire captured sociodemographic and health characteristics, symptomatic hand and non-hand joint sites, and outcome measures (thumb-base pain intensity, symptoms and disability (TASD) and upper-extremity disability/symptoms (quickDASH)). Grip and pinch strength were measured. Linear regressions examined the association between each outcome and symptomatic joint site count, adjusted for several covariates. Results The mean age of the 145 patients was 62 years, 72% were female. Mean symptomatic non-hand joint site count was 3.6. Ten percent reported only their hands as symptomatic; 30% reported 2-3 other symptomatic sites, and 49% reported 4+. From cross-sectional multivariable analyses, a higher symptomatic non-hand joint site count was associated with worse scores for all patient-reported outcomes and grip strength. Every unit increase in joint site count (49% had a 4+ count) was associated with a 2.1-3.3 unit increase (worse) in patient-reported outcome scores (all p < 0.02). Conclusions In this sample, nearly 80% of patients had 2+ symptomatic non-hand joint sites. These symptoms were associated with worse thumb- and hand-specific outcomes, suggesting a need for awareness of whole body OA burden, with implications for outcome score interpretations, study designs, and provision of care in thumb-base OA.
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Affiliation(s)
- Anthony V. Perruccio
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Canada
- Arthritis Community Research and Epidemiology Unit (ACREU), Canada
- Institute of Health Policy, Management & Evaluation, Dalla Lana School of Public Health, University of Toronto, Canada
- Department of Surgery, Faculty of Medicine, University of Toronto, Canada
| | - Elizabeth M. Badley
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Canada
- Arthritis Community Research and Epidemiology Unit (ACREU), Canada
- Dalla Lana School of Public Health, University of Toronto, Canada
| | - Daniel Antflek
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Canada
| | - J Denise Power
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Canada
| | - Heather Baltzer
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Canada
- Department of Surgery, Faculty of Medicine, University of Toronto, Canada
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Srikesavan C, Dean B, Toye F, Bolt A, Thurley N. Experiences of people with hand osteoarthritis and perceptions of clinicians and carers on quality of life and treatment services: A qualitative synthesis. HAND THERAPY 2023; 28:121-132. [PMID: 38033524 PMCID: PMC10683712 DOI: 10.1177/17589983231210762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 10/11/2023] [Indexed: 12/02/2023]
Abstract
Introduction We aimed to synthesise the experiences of people living with hand osteoarthritis (HOA) and the perceptions of clinicians and carers relating to the quality of life and treatment services. Methods We undertook a systematic search on MEDLINE, Embase, and CINAHL electronic databases for qualitative studies in HOA. We used the Critical Appraisal Skills Programme (CASP) checklist to assess methodological quality and thematically-synthesise the findings. We used GRADE-CERQual (Grading of Recommendations Assessment, Development, and Evaluation- Confidence in the Evidence from Reviews of Qualitative Research) to assess the quality of the evidence. Results We identified 13 studies involving people with HOA (288 women and 39 men, average age 61.4 years) and clinicians. Five themes were identified from studies involving people with HOA: i) My hands are painful whenever I use them; ii) It stops me doing everyday activities; iii) It stops me doing things I value; iv) It's psychologically challenging and v) I find ways of doing things. The quality of evidence was moderate except for pain with low quality of evidence. Most studies were conducted in Europe and the United Kingdom with participants recruited predominantly from hospital settings. We were not able to synthesise the three studies that involved clinicians as each explored different topics of HOA. There were no studies that involved carers. Conclusions Our findings highlighted the impact of HOA in various areas of life and the need for personalised psychological support in practice.
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Affiliation(s)
- Cynthia Srikesavan
- Nuffield Department of Orthopaedics and Musculoskeletal Sciences, University of Oxford, Oxford, UK
- Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - Benjamin Dean
- Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | - Francine Toye
- Physiotherapy Research Unit, Oxford University Hospitals NHS Trust, Nuffield Orthopaedic Centre, Oxford, UK
| | - Alex Bolt
- University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK
| | - Neal Thurley
- Bodleian Health Care Libraries, University of Oxford, Oxford, UK
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10
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Chen L, Zhao L, Cheng K, Lin L, Wu F, Shen X. Effect of 10.6-μm CO 2 laser moxibustion on the fastest 15-m walking time in patients with knee osteoarthritis: a double-blind, sham-controlled, multi-site randomized trial. J Orthop Surg Res 2023; 18:891. [PMID: 37993959 PMCID: PMC10666435 DOI: 10.1186/s13018-023-04380-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 11/16/2023] [Indexed: 11/24/2023] Open
Abstract
BACKGROUND In this study, we investigated the impact of 10.6-μm CO2 laser moxibustion (LM) on the fastest 15-m walking time in individuals suffering from knee osteoarthritis (KOA). METHODS A total of 392 individuals diagnosed with KOA and meeting the specified eligibility criteria were assigned randomly into two groups: the LM treatment group and the sham LM control group (ratio 1:1). Both groups received either LM therapy or simulated LM therapy to address the affected area of the knee joint. This treatment was administered three times a week for a duration of 4 weeks. RESULTS In the LM group, the fastest 15-m walking times at both Week 4 and Week 12 were significantly reduced compared to the times before treatment (all P < 0.05). However, in the sham LM group, there were no notable differences in the fastest 15-m walking times after treatment (all P > 0.05). Moreover, the LM group exhibited shorter 15-m walking times than the sham LM group at both Week 4 and Week 12 (all P < 0.05). CONCLUSION The use of CO2 LM can lead to a substantial enhancement in the fastest 15-m walking time of individuals suffering from KOA, and its therapeutic impact can last for a minimum of 8 weeks post-treatment. The fastest 15-m walking time serves as an indicator of alterations in the walking capacity of patients with KOA.
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Affiliation(s)
- Lusheng Chen
- Shanghai Key Laboratory of Acupuncture Mechanism and Acupoint Function, Fudan University, Shanghai, 201433, China
| | - Ling Zhao
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, No. 1200 of Cailun Road, Pudong New District, Shanghai, 201203, China
| | - Ke Cheng
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, No. 1200 of Cailun Road, Pudong New District, Shanghai, 201203, China
- Shanghai Research Center of Acupuncture and Meridian, 421 Niudun Road, Shanghai, 201203, China
| | - Lin Lin
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, No. 1200 of Cailun Road, Pudong New District, Shanghai, 201203, China
| | - Fan Wu
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, No. 1200 of Cailun Road, Pudong New District, Shanghai, 201203, China
| | - Xueyong Shen
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, No. 1200 of Cailun Road, Pudong New District, Shanghai, 201203, China.
- Shanghai Research Center of Acupuncture and Meridian, 421 Niudun Road, Shanghai, 201203, China.
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11
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Magnussen HJ, Kjeken I, Pinxsterhuis I, Sjøvold TA, Feiring M. Negotiating Professional Tasks in a Hospital: A Qualitative Study of Rheumatologists and Occupational Therapists in the Management of Hand Osteoarthritis. J Multidiscip Healthc 2023; 16:3057-3074. [PMID: 37873535 PMCID: PMC10590564 DOI: 10.2147/jmdh.s425640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 10/05/2023] [Indexed: 10/25/2023] Open
Abstract
Purpose Societal change and rise in demand for healthcare call for new health professional practices and task redistribution. Through negotiated order theory, this study explores how hospital rheumatologists (RT) and occupational therapists (OT) negotiate professional tasks in the clinical management of hand osteoarthritis. Methodology Fourteen qualitative interviews and 16 observations in clinical consultations were conducted in two hospitals specialized in rheumatology in Norway. Participants included eight OTs, six RTs, and patients in consultations. Data were analyzed using reflexive thematic analysis. Results Three themes were developed from codes: hierarchical ordering of hospital work impacts interprofessional negotiations; diagnostic organization of tasks preserves RT authority; and evidence-based recommendations in rheumatology enhance OT responsibilities. Overall, RTs and OTs enact tasks in succession where higher-ranking RTs establish a diagnosis and decide the subsequent in-hospital trajectory entrenched in a medical knowledge system. When medicine does not hold evidence-based treatment alternatives for patients, OTs respond by providing therapeutic interventions that are legitimized through international recommendations in rheumatology when they equip patients with tools to cope with chronic illness. Conclusion Negotiations over tasks do not take place from equal power positions when status and knowledge hierarchies frame professional practices. The enactment of tasks is concurrently highly influenced by the arena of the workplace, where the two professional groups both cross boundaries and work together in concert despite professional differences in order to meet patient interests and provide relevant healthcare.
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Affiliation(s)
- Hege Johanne Magnussen
- Department of Rehabilitation Science and Health Technology, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
- Norwegian National Advisory Unit on Rehabilitation in Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
| | - Ingvild Kjeken
- Department of Rehabilitation Science and Health Technology, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
- Norwegian National Advisory Unit on Rehabilitation in Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
- REMEDY - Center for Treatment of Rheumatic and Musculoskeletal Diseases, Diakonhjemmet Hospital, Oslo, Norway
| | - Irma Pinxsterhuis
- Department of Rehabilitation Science and Health Technology, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | | | - Marte Feiring
- Department of Rehabilitation Science and Health Technology, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
- Norwegian National Advisory Unit on Rehabilitation in Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
- REMEDY - Center for Treatment of Rheumatic and Musculoskeletal Diseases, Diakonhjemmet Hospital, Oslo, Norway
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12
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Wu J, Li Y, Zhang X, Liu J, Qian Z, Ren P, Xu R, Ren L, Ren L. Assessment of blood flow around the knee joint in patients with knee osteoarthritis by color Doppler ultrasound. Eur J Radiol 2023; 166:111005. [PMID: 37499479 DOI: 10.1016/j.ejrad.2023.111005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 06/19/2023] [Accepted: 07/20/2023] [Indexed: 07/29/2023]
Abstract
OBJECTIVE To explore a method for early diagnosis of knee osteoarthritis (OA) by comparing vascular morphology and hemodynamic parameters between healthy controls and patients, and explore the effects of age on the blood flow of healthy subjects. MATERIAL AND METHODS 80 healthy subjects and 106 patients with knee OA were recruited. Color Doppler ultrasound was used to measure the vascular morphology and hemodynamic parameters of 11 blood vessels around the knee joint. A general linear model was used to analyze the difference of blood flow parameters between healthy controls and patients, and to explore the effects of sex and age on the blood flow of healthy subjects. RESULTS Age has no significant effect on the vessel diameter of healthy subjects, and it only affect the blood flow velocity (P < 0.05) and blood flow volume (P <0.0083) of a few blood vessels. There was no significant difference in vascular morphological parameter between healthy controls, patients with mild OA and moderate/severe OA, but there was significant difference in vascular hemodynamic parameters (P < 0.0167). Specifically, in the early stage of knee OA, hemodynamic parameters of main arteries in patients did not change significantly, but those of branch vessels changed significantly (P < 0.0167). With the development of knee OA, the difference of hemodynamic parameters of branch vessels in patients increased gradually. CONCLUSION Hemodynamic parameters of branch vessels around the knee joint have changed significantly in the early stage of knee OA, which can be treated as an important index to screening the early patients.
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Affiliation(s)
- Jianan Wu
- Key Laboratory of Bionic Engineering, Ministry of Education, Jilin University, Changchun, 130025 PR China
| | - Ying Li
- Editorial Department of Journal of Bionic Engineering, Jilin University, Changchun 130022, PR China
| | - Xiao Zhang
- School of Medical Informatics and Engineering, Xuzhou Medical University 221004, PR China
| | - Jing Liu
- Key Laboratory of Bionic Engineering, Ministry of Education, Jilin University, Changchun, 130025 PR China.
| | - Zhihui Qian
- Key Laboratory of Bionic Engineering, Ministry of Education, Jilin University, Changchun, 130025 PR China
| | - Peng Ren
- School of Medical Informatics and Engineering, Xuzhou Medical University 221004, PR China
| | - Ruixia Xu
- Key Laboratory of Bionic Engineering, Ministry of Education, Jilin University, Changchun, 130025 PR China
| | - Lei Ren
- Key Laboratory of Bionic Engineering, Ministry of Education, Jilin University, Changchun, 130025 PR China.
| | - Luquan Ren
- Key Laboratory of Bionic Engineering, Ministry of Education, Jilin University, Changchun, 130025 PR China
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13
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Giulini M, Brinks R, Vordenbäumen S, Acar H, Richter JG, Baraliakos X, Ostendorf B, Schneider M, Sander O, Sewerin P. High Frequency of Osteophytes Detected by High-Resolution Ultrasound at the Finger Joints of Asymptomatic Factory Workers. J Pers Med 2023; 13:1343. [PMID: 37763111 PMCID: PMC10532985 DOI: 10.3390/jpm13091343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 08/28/2023] [Accepted: 08/30/2023] [Indexed: 09/29/2023] Open
Abstract
Hand Osteoarthritis (HOA) is a frequently occurring musculoskeletal disease that impacts health. Diagnostic criteria often incorporate osteophytes documented through imaging procedures. Radiographic imaging is considered the gold standard; however, more sensitive and safer methods like ultrasound imaging are becoming increasingly important. We conducted a population-based cross-sectional study to examine the prevalence, grade, and pattern of osteophytes using high-resolution ultrasound investigation. Factory workers were recruited on-site for the study. Each participant had 26 finger joints examined using ultrasonography to grade the occurrence of osteophytes on a semi-quantitative scale ranging from 0-3, where higher scores indicate larger osteophytes. A total of 427 participants (mean age 53.5 years, range 20-79 years) were included, resulting in 11,000 joints scored. At least one osteophyte was found in 4546 out of 11,000 (41.3%) joints or in 426 out of 427 (99.8%) participants, but only 5.0% (553) of the joints showed grade 2 or 3 osteophytes. The total osteophyte sum score increased by 0.18 per year as age increased (p < 0.001). The distal interphalangeal joints were the most commonly affected, with 61%, followed by the proximal interphalangeal joints with 48%, carpometacarpal joint 1 with 39%, and metacarpophalangeal joints with 16%. There was no observed impact of gender or workload. In conclusion, ultrasound imaging proves to be a practical screening tool for osteophytes and HOA. Grade 1 osteophytes are often detected in the working population through ultrasound assessments and their incidence increases with age. The occurrence of grade 2 or 3 osteophytes is less frequent and indicates the clinical presence of HOA. Subsequent evaluations are imperative to ascertain the predictive significance of early osteophytes.
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Affiliation(s)
- Mario Giulini
- Department and Hiller-Research-Unit for Rheumatology, Medical Faculty, Heinrich-Heine-University Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany
| | - Ralph Brinks
- Department and Hiller-Research-Unit for Rheumatology, Medical Faculty, Heinrich-Heine-University Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany
| | - Stefan Vordenbäumen
- Department and Hiller-Research-Unit for Rheumatology, Medical Faculty, Heinrich-Heine-University Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany
| | - Hasan Acar
- Department and Hiller-Research-Unit for Rheumatology, Medical Faculty, Heinrich-Heine-University Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany
| | - Jutta G. Richter
- Department and Hiller-Research-Unit for Rheumatology, Medical Faculty, Heinrich-Heine-University Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany
| | - Xenofon Baraliakos
- Rheumazentrum Ruhrgebiet, Ruhr University Bochum, Claudiusstrasse 45, 44649 Herne, Germany
| | - Benedikt Ostendorf
- Department and Hiller-Research-Unit for Rheumatology, Medical Faculty, Heinrich-Heine-University Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany
| | - Matthias Schneider
- Department and Hiller-Research-Unit for Rheumatology, Medical Faculty, Heinrich-Heine-University Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany
| | - Oliver Sander
- Department and Hiller-Research-Unit for Rheumatology, Medical Faculty, Heinrich-Heine-University Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany
| | - Philipp Sewerin
- Department and Hiller-Research-Unit for Rheumatology, Medical Faculty, Heinrich-Heine-University Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany
- Rheumazentrum Ruhrgebiet, Ruhr University Bochum, Claudiusstrasse 45, 44649 Herne, Germany
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Automatic measuring of finger joint space width on hand radiograph using deep learning and conventional computer vision methods. Biomed Signal Process Control 2023; 84. [DOI: 10.1016/j.bspc.2023.104713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2023]
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15
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Windt JWVD, Akkerman W, Hofstra M, Meussen P. Reduced pain and improved daily activities for individuals with hand osteoarthritis using a silicone wrist hand orthosis. J Hand Ther 2023; 36:669-677. [PMID: 36272923 DOI: 10.1016/j.jht.2022.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 07/25/2022] [Accepted: 09/13/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Symptoms of hand osteoarthritis (OA), such as pain, reduced grip strength, loss of range of motion (ROM) and joint stiffness, can lead to impaired hand function and difficulty with daily activities. Rehabilitative interventions with orthoses are commonly in the treatment of hand OA to reduce pain, improve hand strength and ROM, provide support for improved function and help with joint stability. PURPOSE The objectives of this perception-based study were to evaluate the effect of a silicone wrist hand orthoses (SWHO) on pain and daily functioning. STUDY DESIGN This study is a qualitative descriptive study. The patient received outcome (PRO) questions in the study were based on the Patient Rated Wrist and/or Hand Evaluation (PRWHE), a 15-item questionnaire designed to measure wrist pain and disability in activities of daily living. METHODS Patients with OA using a SWHO were asked to complete a questionnaire about the effectiveness of the brace after wearing it for 3 weeks. Primary outcome measure was general daily functioning with and without the use of the SWHO. Secondary outcome measures were change in pain symptoms and limitations for certain activities with and without the aid. RESULTS The results of this large-scale PROM study of 551 patients on the effectiveness of SWHOs in patients with hand OA show an improvement in overall daily functioning of 77% and a 61% reduction in perceived pain. This study adds to the evidence reported by systematic reviews of conservative interventions for hand OA and further quantifies the effects of a tailor made SWHO. This study confirms that wearing a wrist orthosis has a particularly significant impact on the execution of static and repetitive wrist-straining activities. CONCLUSION The study on the effectiveness of a SWHO in patients with hand OA shows that the use of a SWHO contributes to general daily function, reduces pain and increases the breadth of potential daily activities. This study shows that the use of a SWHO appears to offer pain relief and suitable support to the joint.
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Tuncay Duruöz M, Öz N, Gürsoy DE, Hande Gezer H. Clinical aspects and outcomes in osteoarthritis. Best Pract Res Clin Rheumatol 2023; 37:101855. [PMID: 37524622 DOI: 10.1016/j.berh.2023.101855] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 07/11/2023] [Indexed: 08/02/2023]
Abstract
Osteoarthritis (OA) is the most prevalent type of arthritis worldwide, and its incidence significantly increases with age. It commonly affects the knees, hips, spine, big toes, and hands. OA can be identified through clinical examination, symptoms, and imaging methods. Its main symptoms include pain, stiffness, and limitations in joint movement. Examinations may reveal coarse crepitus, bony enlargement, and tenderness at the joint line. In severe cases of OA, rest pain, night pain, and deformity may occur. OA can lead to decreased physical activity, function, and quality of life due to symptoms such as pain and stiffness. To evaluate these impacts, patient-reported outcome measures (PROMs) are necessary. Various generic, disease-specific, and joint-specific PROMs have been developed and used in clinical practice to assess the outcomes of OA.
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Affiliation(s)
- Mehmet Tuncay Duruöz
- Marmara University School of Medicine, Physical Medicine, Rehabilitation Department, Rheumatology Division, Istanbul, Turkey; Eastern Mediterranean University, Faculty of Medicine, Famagusta, North Cyprus.
| | - Nuran Öz
- Marmara University School of Medicine, Physical Medicine, Rehabilitation Department, Rheumatology Division, Istanbul, Turkey
| | - Didem Erdem Gürsoy
- İstanbul Prof. Dr. Cemil Taşçıoğlu City Hospital, Physical Medicine and Rehabilitation Department, Rheumatology Clinic, Istanbul, Turkeye
| | - Halise Hande Gezer
- Marmara University School of Medicine, Physical Medicine, Rehabilitation Department, Rheumatology Division, Istanbul, Turkey
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17
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van Beest S, van de Stadt LA, Rosendaal FR, Kloppenburg M. Patients with clinically diagnosed hand OA not fulfilling the ACR classification criteria are in an earlier disease phase and more often have thumb base OA. OSTEOARTHRITIS AND CARTILAGE OPEN 2023; 5:100347. [PMID: 36942210 PMCID: PMC10023912 DOI: 10.1016/j.ocarto.2023.100347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 02/14/2023] [Indexed: 02/22/2023] Open
Abstract
Objective To investigate the performance of the American College of Rheumatology (ACR) classification criteria for hand osteoarthritis. Design Longitudinal data up to four years from a cohort of consecutive patients with primary hand osteoarthritis diagnosed by their rheumatologist (Hostas study) were used to classify presence or absence of hand osteoarthritis according to the 1990 ACR criteria (traditional format: one major and 4 minor ACR criteria) (ACR+/ACR-). Demographics, Australian/Canadian osteoarthritis hand index (AUSCAN) pain and function were obtained. Hand radiographs were scored according to Kellgren-Lawrence; radiographic osteoarthritis was defined as Kellgren-Lawrence ≥2 in ≥1 CMC1 joint or ≥2 DIP/PIP/MCP joints. Results Of 538 patients (mean age 61 years, 86.1% women) 485 (90.1%) fulfilled ACR criteria at baseline. Except for the minor criterion swelling of <3 MCP joints, all criteria differed between the groups. ACR- patients were younger, with higher BMI, a shorter time since diagnosis, and less bony enlargements, joint deformities and radiographic osteoarthritis, except for radiographic CMC1 osteoarthritis which was seen more often in ACR- patients. No difference in AUSCAN pain or function was seen between ACR- versus ACR+ patients. After follow-up 37/53 (69.8%) converted to ACR+, 2/53 (3.8%) did not, and 14/53 (26.4%) were lost to follow-up. Conclusions In clinical practice the majority of patients fulfill the ACR classification criteria, but those in an earlier disease phase, with less signs of hand osteoarthritis or with primarily thumb base osteoarthritis are less likely to fulfill them. New classification criteria also including earlier disease stages and with attention for hand osteoarthritis subtypes are required.
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Affiliation(s)
- Sjoerd van Beest
- Department of Rheumatology, Leiden University Medical Center, Leiden, the Netherlands
- Corresponding author. Department of Rheumatology Leiden University Medical Center, C1-R PO Box, 9600 2300, RC Leiden the Netherlands
| | - Lotte A. van de Stadt
- Department of Rheumatology, Leiden University Medical Center, Leiden, the Netherlands
| | - Frits R. Rosendaal
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Margreet Kloppenburg
- Department of Rheumatology, Leiden University Medical Center, Leiden, the Netherlands
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
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18
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Henry-Blake C, Marshall M, Treadwell K, Parmar S, Higgs J, Edwards JJ, Peat G. The use of plain radiography in diagnosing osteoarthritis: A systematic review and time trend analysis. Musculoskeletal Care 2023; 21:462-477. [PMID: 36426659 DOI: 10.1002/msc.1718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 11/17/2022] [Indexed: 06/16/2023]
Abstract
INTRODUCTION The National Institute for Health and Care Excellence (NICE) suggest there is no role for routine radiography in the diagnosis of osteoarthritis (OA). It is not known how consistent this recommendation is across international guidelines, or the impact of UK guidance on domestic OA X-ray request rates. METHODS A systematic search identified guideline recommendations on the role of radiography in OA diagnosis. Full texts underwent dual screening and appraisal using the AGREE II tool. A narrative synthesis was performed. Consultation data were extracted from a UK primary care database: the Consultations in Primary Care Archives (CiPCA). The annual proportion of X-ray requests per 100 OA consulters from 2000 to 2012 were calculated. Joinpoint regression analysis examined if there were changes in the trend of X-ray request rates and compared these with the publication dates of UK guidelines. RESULTS Eighteen evidence-based OA guidelines were included in the review. Eleven recommended a clinical diagnosis of OA without radiographic confirmation. Seven recommended routine radiography; these guidelines were predominantly for radiologists. A mean of 17.3 X-rays per 100 patients were requested in patients consulting for OA per year between 2000 and 2012. A statistically significant reduction in X-ray request rates was seen in 2003. CONCLUSION Recommendations on the role of radiography in OA vary between medical specialty and countries. UK guidelines appear to have had a limited impact on X-ray request rates in OA.
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Affiliation(s)
| | | | - Kane Treadwell
- School of Medicine, Keele University, Keele, Staffordshire, UK
| | - Simran Parmar
- School of Medicine, Keele University, Keele, Staffordshire, UK
| | - Jordan Higgs
- School of Medicine, Keele University, Keele, Staffordshire, UK
| | - John J Edwards
- School of Medicine, Keele University, Keele, Staffordshire, UK
| | - George Peat
- School of Medicine, Keele University, Keele, Staffordshire, UK
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Subhas N, Wu F, Fox MG, Nacey N, Aslam F, Blankenbaker DG, Caracciolo JT, DeJoseph DA, Frick MA, Jawetz ST, Said N, Sandstrom CK, Sharma A, Stensby JD, Walker EA, Chang EY. ACR Appropriateness Criteria® Chronic Extremity Joint Pain-Suspected Inflammatory Arthritis, Crystalline Arthritis, or Erosive Osteoarthritis: 2022 Update. J Am Coll Radiol 2023; 20:S20-S32. [PMID: 37236743 DOI: 10.1016/j.jacr.2023.02.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 02/27/2023] [Indexed: 05/28/2023]
Abstract
Evaluation for suspected inflammatory arthritis as a cause for chronic extremity joint pain often relies on imaging. It is essential that imaging results are interpreted in the context of clinical and serologic results to add specificity because there is significant overlap of imaging findings among the various types of arthritis. This document provides recommendations for imaging evaluation of specific types of inflammatory arthritis, including rheumatoid arthritis, seronegative spondyloarthropathy, gout, calcium pyrophosphate dihydrate disease (or pseudogout), and erosive osteoarthritis. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision process support the systematic analysis of the medical literature from peer reviewed journals. Established methodology principles such as Grading of Recommendations Assessment, Development, and Evaluation or GRADE are adapted to evaluate the evidence. The RAND/UCLA Appropriateness Method User Manual provides the methodology to determine the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances in which peer reviewed literature is lacking or equivocal, experts may be the primary evidentiary source available to formulate a recommendation.
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Affiliation(s)
| | - Fangbai Wu
- Research Author, Cleveland Clinic Foundation, Cleveland, Ohio.
| | - Michael G Fox
- Program Director and Panel Chair, Mayo Clinic Arizona, Phoenix, Arizona
| | - Nicholas Nacey
- Panel Vice-Chair, University of Virginia Health System, Charlottesville, Virginia
| | - Fawad Aslam
- Mayo Clinic, Scottsdale, Arizona, Rheumatologist
| | - Donna G Blankenbaker
- University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Jamie T Caracciolo
- Section Head, Musculoskeletal Imaging, Moffitt Cancer Center and University of South Florida Morsani College of Medicine, Tampa, Florida; and Chair, MSK-RADS (Bone) Committee
| | | | - Matthew A Frick
- Chair of Education, Department of Radiology, Chair of Musculoskeletal Imaging, Mayo Clinic, Rochester, Minnesota
| | | | - Nicholas Said
- Duke University Medical Center, Durham, North Carolina
| | - Claire K Sandstrom
- University of Washington Medical Center, Seattle, Washington; Committee on Emergency Radiology-GSER
| | - Akash Sharma
- Mayo Clinic, Jacksonville, Florida; Commission on Nuclear Medicine and Molecular Imaging
| | | | - Eric A Walker
- Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania and Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Eric Y Chang
- Specialty Chair, VA San Diego Healthcare System, San Diego, California
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Zhao T, Wang S, Liu W, Shen J, Dai Y, Shi M, Huang X, Wei Y, Li T, Zhang X, Xie Z, Wang N, Qin D, Li Z. Clinical efficacy of Yiqi Yangxue formula on knee osteoarthritis and unraveling therapeutic mechanism through plasma metabolites in rats. Front Genet 2023; 14:1096616. [PMID: 37091797 PMCID: PMC10113924 DOI: 10.3389/fgene.2023.1096616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 03/23/2023] [Indexed: 04/08/2023] Open
Abstract
Objective: To observe the clinical efficacy and safety of Yiqi Yangxue formula (YQYXF) on knee osteoarthritis (KOA), and to explore the underlying therapeutic mechanism of YQYXF through endogenous differential metabolites and their related metabolic pathways.Methods: A total of 61 KOA patients were recruited and divided into the treatment group (YQYXF, 30 cases) and the control group (celecoxib, Cxb, 31 cases). Effects of these two drugs on joint pain, swelling, erythrocyte sedimentation rate (ESR) and c-reactive protein (CRP) were observed, and their safety and adverse reactions were investigated. In animal experiments, 63 SD rats were randomly divided into normal control (NC) group, sham operation (sham) group, model (KOA) group, Cxb group, as well as low-dose (YL), medium-dose (YM), and high-dose groups of YQYXF (YH). The KOA rat model was established using a modified Hulth method. Ultra-high-performance liquid chromatography/Q Exactive HF-X Hybrid Quadrupole-Orbitrap Mass (UHPLC-QE-MS)-based metabolomics technology was used to analyze the changes of metabolites in plasma samples of rats. Comprehensive (VIP) >1 and t-test p < 0.05 conditions were used to screen the disease biomarkers of KOA, and the underlying mechanisms of YQYXF were explored through metabolic pathway enrichment analysis. The related markers of YQYXF were further verified by ELISA (enzyme-linked immunosorbent assay).Results: YQYXF can improve joint pain, swelling, range of motion, joint function, Michel Lequesen index of severity for osteoarthritis (ISOA) score, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, ESR, and CRP. No apparent adverse reactions were reported. In addition, YQYXF can improve cartilage damage in KOA rats, reverse the abnormal changes of 16 different metabolites, and exert an anti-KOA effect mainly through five metabolic pathways. The levels of reactive oxygen species (ROS) and glutathione (GSH) were significantly decreased after the treatment of YQYXF.Conclusion: YQYXF can significantly improve the clinical symptoms of KOA patients without obvious adverse reactions. It mainly improved KOA through modulating lipid metabolism-related biomarkers, reducing lipid peroxidation and oxidative stress.
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Affiliation(s)
- Ting Zhao
- The First School of Clinical Medicine, Yunnan University of Chinese Medicine, Kunming, China
| | - Shiqi Wang
- The First School of Clinical Medicine, Yunnan University of Chinese Medicine, Kunming, China
| | - Wenbin Liu
- The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi, China
| | - Jiayan Shen
- The First School of Clinical Medicine, Yunnan University of Chinese Medicine, Kunming, China
| | - Youwu Dai
- School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming, China
| | - Mingqin Shi
- School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming, China
| | - Xiaoyi Huang
- School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming, China
| | - Yuanyuan Wei
- School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming, China
| | - Tao Li
- Qujing Hospital Affiliated to Yunnan University of Traditional Chinese Medicine, Qujing, China
| | - Xiaoyu Zhang
- The First School of Clinical Medicine, Yunnan University of Chinese Medicine, Kunming, China
| | - Zhaohu Xie
- School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming, China
| | - Na Wang
- Institutes of Integrative Medicine, Fudan University, Shanghai, China
- *Correspondence: Zhaofu Li, ; Na Wang, ; Dongdong Qin,
| | - Dongdong Qin
- School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming, China
- *Correspondence: Zhaofu Li, ; Na Wang, ; Dongdong Qin,
| | - Zhaofu Li
- School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming, China
- *Correspondence: Zhaofu Li, ; Na Wang, ; Dongdong Qin,
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Magnussen HJ, Kjeken I, Pinxsterhuis I, Sjøvold TA, Hennig T, Thorsen E, Feiring M. Participation in healthcare consultations: A qualitative study from the perspectives of persons diagnosed with hand osteoarthritis. Health Expect 2023; 26:1276-1286. [PMID: 36916677 PMCID: PMC10154812 DOI: 10.1111/hex.13744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 02/22/2023] [Accepted: 02/22/2023] [Indexed: 03/16/2023] Open
Abstract
INTRODUCTION Scarce health resources and differing views between persons with hand osteoarthritis (OA) and health professionals concerning care preferences contribute to sustaining a gap between actual needs and existing clinical guidelines for hand OA. The aim of this study is to explore the experiences of persons diagnosed with hand OA in their encounters with health services and how those experiences influence negotiations and decision-making in hand OA care. METHODS Data from 21 qualitative interviews with persons diagnosed with hand OA were collected, transcribed verbatim and analysed using reflexive thematic analysis. RESULTS Three main themes were developed: symptoms are perceived as ordinary ageing in everyday life, consultations are shaped by trust in healthcare and the responsibilities of prioritisation and self-care govern interactions. CONCLUSION Ideas of ageing, professional knowledge and self-management dominate hand OA health encounters and contribute to shaping illness perceptions, preferences and opportunities to negotiate decisions in consultations. PATIENT OR PUBLIC CONTRIBUTION Two patient research partners with hand OA are members of the study project group. One of them is also a co-author of this manuscript.
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Affiliation(s)
- Hege Johanne Magnussen
- Department of Rehabilitation Science and Health Technology, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway.,Norwegian National Advisory Unit on Rehabilitation in Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
| | - Ingvild Kjeken
- Department of Rehabilitation Science and Health Technology, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway.,Norwegian National Advisory Unit on Rehabilitation in Rheumatology, REMEDY, Center for treatment of Rheumatic and Musculoskeletal Diseases, Diakonhjemmet Hospital, Oslo, Norway
| | - Irma Pinxsterhuis
- Department of Rehabilitation Science and Health Technology, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | | | | | - Eva Thorsen
- Lillehammer Rheumatism Hospital, Lillehammer, Norway
| | - Marte Feiring
- Department of Rehabilitation Science and Health Technology, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway.,Norwegian National Advisory Unit on Rehabilitation in Rheumatology, REMEDY, Center for treatment of Rheumatic and Musculoskeletal Diseases, Diakonhjemmet Hospital, Oslo, Norway
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22
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Jarque-Bou NJ, Gracia-Ibáñez V, Roda-Sales A, Bayarri-Porcar V, Sancho-Bru JL, Vergara M. Toward Early and Objective Hand Osteoarthritis Detection by Using EMG during Grasps. SENSORS (BASEL, SWITZERLAND) 2023; 23:2413. [PMID: 36904616 PMCID: PMC10006890 DOI: 10.3390/s23052413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 02/17/2023] [Accepted: 02/20/2023] [Indexed: 06/18/2023]
Abstract
The early and objective detection of hand pathologies is a field that still requires more research. One of the main signs of hand osteoarthritis (HOA) is joint degeneration, which causes loss of strength, among other symptoms. HOA is usually diagnosed with imaging and radiography, but the disease is in an advanced stage when HOA is observable by these methods. Some authors suggest that muscle tissue changes seem to occur before joint degeneration. We propose recording muscular activity to look for indicators of these changes that might help in early diagnosis. Muscular activity is often measured using electromyography (EMG), which consists of recording electrical muscle activity. The aim of this study is to study whether different EMG characteristics (zero crossing, wavelength, mean absolute value, muscle activity) via collection of forearm and hand EMG signals are feasible alternatives to the existing methods of detecting HOA patients' hand function. We used surface EMG to measure the electrical activity of the dominant hand's forearm muscles with 22 healthy subjects and 20 HOA patients performing maximum force during six representative grasp types (the most commonly used in ADLs). The EMG characteristics were used to identify discriminant functions to detect HOA. The results show that forearm muscles are significantly affected by HOA in EMG terms, with very high success rates (between 93.3% and 100%) in the discriminant analyses, which suggest that EMG can be used as a preliminary step towards confirmation with current HOA diagnostic techniques. Digit flexors during cylindrical grasp, thumb muscles during oblique palmar grasp, and wrist extensors and radial deviators during the intermediate power-precision grasp are good candidates to help detect HOA.
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Affiliation(s)
- Néstor J. Jarque-Bou
- Department of Mechanical Engineering and Construction, Universitat Jaume I, E12071 Castellón, Spain
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23
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Wang W, Shi H, Liu Y, Sun Y, Chen Y, Liu Z. Efficacy and safety of acupuncture for hand osteoarthritis: study protocol for a multi-center, randomized, sham-controlled clinical trial. J Orthop Surg Res 2023; 18:89. [PMID: 36747297 PMCID: PMC9901154 DOI: 10.1186/s13018-023-03570-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 01/31/2023] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Hand osteoarthritis (OA) is a prevalent disorder in the general population. Patients with hand OA often report symptoms of pain, stiffness, and functional limitations, which cause clinical burden and impact on quality of daily life. However, the efficacy of current therapies for hand OA is limited. Other therapies with better effects and less adverse events are in urgent need. Acupuncture is well known for analgesia and has been proved effective in treating basal thumb joint arthritis. This study aims to clarify the efficacy and safety of acupuncture treatment for clinical symptomatic improvement of hand OA. METHODS This will be a sham-controlled, randomized, multi-center clinical trial. A total of 340 participants will be recruited and randomly allocated to either traditional acupuncture group or sham acupuncture group. All participants will receive 12 treatment sessions over 4 weeks and 2 follow-up assessments in the following 3 months at week 8 and week 16. The primary outcome will be the proportion of responders at week 5. Secondary outcomes will include visual analog scale, Australian Canadian Osteoarthritis Hand Index, Functional Index for hand OA, the number of symptomatic joints, hand grip strength and pinch strength, global assessment, the World Health Organization Quality of Life abbreviated version and expectations. Safety will be evaluated during the whole process of the trial. All outcomes will be analyzed following the intention-to-treat principle. DISCUSSION This prospective trial will provide high-quality evidence on evaluating the efficacy and safety of acupuncture treatment for hand OA. Results of this trial might contribute in offering a new option to clinical recommendations. Trial registration ClinicalTrials.gov Identifier: NCT05267093. Registered 23 February 2022.
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Affiliation(s)
- Weiming Wang
- grid.410318.f0000 0004 0632 3409Department of Acupuncture and Moxibustion, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Hangyu Shi
- grid.410318.f0000 0004 0632 3409Department of Acupuncture and Moxibustion, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China ,grid.24695.3c0000 0001 1431 9176Beijing University of Chinese Medicine, Beijing, China
| | - Yan Liu
- grid.24695.3c0000 0001 1431 9176Key Laboratory of Chinese Internal Medicine of Ministry of Education, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Yuanjie Sun
- grid.410318.f0000 0004 0632 3409Department of Acupuncture and Moxibustion, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yu Chen
- New Zealand College of Chinese Medicine, Auckland, New Zealand
| | - Zhishun Liu
- Department of Acupuncture and Moxibustion, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
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24
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Alekseeva LI, Sharapova EP, Lila AM. Osteoarthritis of hand joints: prevalence, risk factors, phenotypes, diagnosis, treatment. MODERN RHEUMATOLOGY JOURNAL 2022. [DOI: 10.14412/1996-7012-2022-6-98-105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Osteoarthritis is the most common rheumatic disease, accompanied by constant pain and dysfunction of the joints, the progression of which leads to a deterioration in the quality of life and often to disability of patients. The article presents the prevalence, predictors of development and progression of osteoarthritis of the hand joints (OHJ). Clinical classification of OHJ, clinical picture depending on the localization of the process, topical features of involvement of the hand joints in different types of OHJ are given. Clinical, laboratory and instrumental methods for diagnosing of the disease, classification and diagnostic criteria are described, much attention is paid to modern principles of OHJ therapy in accordance with Russian clinical guidelines, as well as EULAR and ACR recommendations.
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Affiliation(s)
- L. I Alekseeva
- V.A. Nasonova Research Institute of Rheumatology, Moscow; Russian Medical Academy of Continuing Professional Education, Ministry of Health of Russia
| | | | - A. M. Lila
- V.A. Nasonova Research Institute of Rheumatology, Moscow; Russian Medical Academy of Continuing Professional Education, Ministry of Health of Russia
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25
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Wan J, Qian X, He Z, Zhu Z, Cheng P, Chen A. Epidemiological trends of hand osteoarthritis from 1990 to 2019: Estimates from the 2019 Global Burden of Disease study. Front Med (Lausanne) 2022; 9:922321. [PMID: 36579153 PMCID: PMC9790907 DOI: 10.3389/fmed.2022.922321] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Accepted: 11/14/2022] [Indexed: 12/14/2022] Open
Abstract
Background Hand osteoarthritis (OA) is a chronic progressive disease characterized by disabling pain in the hand, with a high clinical burden. This study is designed to assess the epidemiological patterns of hand OA from 1990 to 2019 and analyze its secular trends based on sex, age, and socio-demographic index (SDI) at global, regional, and national levels. Methods Data on the incidence and disability-adjusted life years (DALYs) of hand OA were extracted from the 2019 Global Burden of Disease (GBD), and their respective age-standardized rates (ASRs) were calculated. The estimated annual percentage changes (EAPCs) in ASR were calculated to assess the prevalent trends of the incidence and DALYs of hand OA over the recent three decades. The relationship between ASR and SDI was analyzed by Pearson's correlation analysis. Results The incidence of hand OA increased from 371.30 million in 1990 to 676.02 million in 2019, increasing by 82.07%, whereas its age-standardized incidence rate (ASIR) decreased, with a downward trend [EAPC = -0.34; 95% confidence interval: -0.39--0.28]. With the changes in age, the incidence of hand OA exhibited a unimodal distribution before 70 years of age, peaking at 50-54 years, while its incidence had an upward trend in the >70 years age groups. Overall, hand OA-related DALYs increased in the recent 30 years. Meanwhile, its annual age-standardized DALY rate decreased, with EAPCs of -0.35 (95% CI, -0.38 --0.32). The DALYs increased with age. In 2019, the ASIR and age-standardized DALY rate were positively associated with the SDI regions. The incidence and DALYs presented predominance in female patients. The burden of hand OA over the recent three decades displayed obvious geographical diversity. Conclusion The incident cases of hand OA increased globally from 1990 to 2019, while the ASIR and age-standardized DALY rate decreased. However, in many countries and regions, there was a rising trend of ASR related to incidence and DALYs. In addition, the prevalence revealed geographical, sex, and age diversity. Thus, governments and medical institutions should reallocate medical resources based on the epidemiological characteristics of hand OA.
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Affiliation(s)
- Junlai Wan
- Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaoyuan Qian
- Department of Urology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China
| | - Zhiyi He
- Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ziqing Zhu
- Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Peng Cheng
- Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China,Peng Cheng
| | - Anmin Chen
- Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China,*Correspondence: Anmin Chen
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26
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Wang J, Wang M, Qi Q, Wu Z, Wen J. High-frequency ultrasound in patients with seronegative rheumatoid arthritis. Sci Rep 2022; 12:21372. [PMID: 36494477 PMCID: PMC9734155 DOI: 10.1038/s41598-022-25958-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 11/23/2022] [Indexed: 12/13/2022] Open
Abstract
This study aimed to investigate the value of high-frequency ultrasound (HFUS) in differentiation of the seronegative rheumatoid arthritis (SNRA) and osteoarthritis (OA) and in the diagnosis of SNRA. 83 patients diagnosed with SNRA (SNRA group) and 40 diagnosed with OA (OA group) who received HFUS were retrospectively analyzed. The grayscale (GS) scores, power Doppler (PD) scores, and bone erosion (BE)scores were recorded, and added up to calculate the total scores of US variables. The correlations of the total scores of US variables with the 28-joint disease activity score (DAS28), erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were analyzed. The diagnostic efficacy of the total scores of US variables for SNRA was assessed. In the SNRA group, the detection rate of abnormal US findings in the joints and tendons by GS and PD as well as BE was higher than those in the OA group. There were significant differences between the two groups in GS scores and PD scores of joints and tendons, and BE scores of joints (P < 0.05). In the SNRA group, the total scores of most US variables were positively correlated with CRP, ESR, and DAS28 (P < 0.05), while such correlations were not observed in the OA group (P > 0.05). Among different US variables, the diagnostic value of total PD scores of the joints was the highest for SNRA. HFUS could be used to differentiate SNRA from OA and make a diagnosis of SNRA based on joint and tendon synovial sheath assessment.
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Affiliation(s)
- Junkui Wang
- grid.412633.10000 0004 1799 0733Ultrasound Department, First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052 China
| | - Miao Wang
- grid.412633.10000 0004 1799 0733Surgery Department, First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052 China
| | - Qinghua Qi
- grid.412633.10000 0004 1799 0733Ultrasound Department, First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052 China
| | - Zhibin Wu
- grid.412633.10000 0004 1799 0733Ultrasound Department, First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052 China
| | - Jianguo Wen
- grid.412633.10000 0004 1799 0733Henan Joint International Pediatric Urodynamic Center, The First Affiliated Hospital of Zhengzhou, Zhengzhou, 450052 China
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Auroux M, Merle B, Fontanges E, Duvert F, Lespessailles E, Chapurlat R. The disability associated with hand osteoarthritis is substantial in a cohort of post-menopausal women: the QUALYOR study. Osteoarthritis Cartilage 2022; 30:1526-1535. [PMID: 35995128 DOI: 10.1016/j.joca.2022.07.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 06/10/2022] [Accepted: 07/14/2022] [Indexed: 02/02/2023]
Abstract
OBJECTIVES Our primary aims were to assess current prevalence of HOA and the disability associated with this condition, in the group usually most affected, i.e., women older than 55. METHODS We performed hand radiographs, clinical examination, grip strength measurement, AUSCAN and COCHIN questionnaires in a cohort of postmenopausal women aged at least 55. Radiographic hand OA (RHOA) was defined as at least 2 affected joints among 30, grading 2 or more using the Kellgren Lawrence score but without any HOA symptom. Symptomatic HOA (OA ACR) was defined according to ACR criteria for hand OA. Moderate to severe symptomatic HOA was defined as having OA ACR and AUSCAN total score of >43/100. RESULTS We enrolled 1,189 participants. The mean age was 71.7 years. Inter-reader reliability of radiographs reading was good (ICC = 0.86) and intra-reader reliability was excellent (ICC = 0.97). Among the 1,189 women, 333 (28.0%) had RHOA, 482 (40.5%) patients fulfilled the ACR criteria for symptomatic HOA and 82 of these (17% of OA ACR population) had moderate to severe symptomatic HOA. The prevalence of symptomatic erosive osteoarthritis was 11.8%. Mean AUSCAN and Cochin scores were higher and grip strength lower in patients with symptomatic HOA compared to patient without HOA. Differences were more noticeable in patients with moderate to severe HOA. CONCLUSIONS We have assessed disability associated with HOA in greater detail than previously and found that a third of postmenopausal women had RHOA, two fifths had symptomatic HOA and one sixth of symptomatic patients had moderate to severe HOA related disability and a tenth had symptomatic erosive osteoarthritis, representing a substantial burden of disease in our population-based cohort.
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Affiliation(s)
- M Auroux
- Hôpital E Herriot, Hospices Civils de Lyon, 69437 Lyon Cedex 03 Lyon, France.
| | - B Merle
- INSERM UMR 1033, Université de Lyon, Hôpital E Herriot, 69437 Lyon Cedex 03, France
| | - E Fontanges
- Hôpital E Herriot, Hospices Civils de Lyon, 69437 Lyon Cedex 03 Lyon, France
| | - F Duvert
- Hôpital E Herriot, Hospices Civils de Lyon, 69437 Lyon Cedex 03 Lyon, France
| | - E Lespessailles
- Centre Hospitalier Régional d'Orléans, Université d'Orléans, Orléans, France
| | - R Chapurlat
- Hôpital E Herriot, Hospices Civils de Lyon, 69437 Lyon Cedex 03 Lyon, France; INSERM UMR 1033, Université de Lyon, Hôpital E Herriot, 69437 Lyon Cedex 03, France
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Chen L, Ren X, Li F, Deng H, Ding G, Yao W, Zhao L, Shen X. New smokeless moxibustion for knee osteoarthritis: A study protocol for a multicenter, single-blind, randomized controlled trial. Medicine (Baltimore) 2022; 101:e30700. [PMID: 36221329 PMCID: PMC9542915 DOI: 10.1097/md.0000000000030700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION Knee osteoarthritis (KOA) is a chronic inflammatory disease with high morbidity and disability. As the aging and obese population increase, so will the medical services for this disease. The purpose of this study is to compare the clinical efficacy of herbal activated carbon smokeless moxibustion and traditional moxibustion in the treatment of KOA and to determine the clinical efficacy of herbal activated carbon smokeless moxibustion in the treatment of KOA. METHODS/DESIGN This is a multicenter, two parallel-group, single-blind, randomized controlled trial. Eighty-eight subjects with KOA (Kellgren Lawrence grade II or III) will be recruited and randomly treated with smokeless moxibustion or traditional moxibustion in the ratio of 1:1. The smokeless moxibustion group will use plant herbal activated carbon smokeless moxa cone. The traditional moxibustion group will be treated with pure moxa cone. Subjects in both groups will receive treatment at the affected knee(s) at the acupuncture point ST35, EX-LE2, and EX-LE4. Subjects in both groups will receive 3 sessions per week of moxibustion for 4 weeks. The primary outcome are changes in the Western Ontario and McMaster Universities Osteoarthritis Index pain scores from baseline to week 24. Secondary outcomes include visual analog scale, 50 yards fast walking time, short-form heath survey 36, overall clinical efficacy evaluation, self-assessment of safety, treatment credibility and expectancy, and cytokines related to osteoarthritis in serum. DISCUSSION This randomized single-blind controlled trial takes traditional moxibustion as the control group to provide strict evidence for the clinical efficacy and safety of herbal activated carbon smokeless moxibustion in the treatment of KOA.
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Affiliation(s)
- Lusheng Chen
- Shanghai Key Laboratory of Acupuncture Mechanism and Acupoint Function, Department of Aeronautics and Astronautics, Fudan University, Shanghai, China
| | - Xiumei Ren
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Fengxing Li
- Acupuncture and Tuina School, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Haiping Deng
- Acupuncture and Tuina School, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Guanghong Ding
- Shanghai Key Laboratory of Acupuncture Mechanism and Acupoint Function, Department of Aeronautics and Astronautics, Fudan University, Shanghai, China
| | - Wei Yao
- Shanghai Key Laboratory of Acupuncture Mechanism and Acupoint Function, Department of Aeronautics and Astronautics, Fudan University, Shanghai, China
| | - Ling Zhao
- Acupuncture and Tuina School, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- *Correspondence: Ling Zhao and Xueyong Shen, Acupuncture and Tuina School, Shanghai University of Traditional Chinese Medicine, Shanghai, China (e-mail: ; )
| | - Xueyong Shen
- Acupuncture and Tuina School, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- *Correspondence: Ling Zhao and Xueyong Shen, Acupuncture and Tuina School, Shanghai University of Traditional Chinese Medicine, Shanghai, China (e-mail: ; )
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Sunk IG, Amoyo-Minar L, Niederreiter B, Soleiman A, Kainberger F, Smolen JS, Aletaha D, Bobacz K. Dorso-ventral osteophytes of interphalangeal joints correlate with cartilage damage and synovial inflammation in hand osteoarthritis: a histological/radiographical study. Arthritis Res Ther 2022; 24:226. [PMID: 36175909 PMCID: PMC9520866 DOI: 10.1186/s13075-022-02911-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 09/07/2022] [Indexed: 11/20/2022] Open
Abstract
Objective To detect dorsally located osteophytes (OP) on lateral x-ray views and to correlate their presence with the extent of structural joint damage, determined by histologic grading (cartilage damage and synovial inflammation) and radiographic scoring in hand osteoarthritis (HOA). Methods Distal interphalangeal (DIP) and proximal interphalangeal (PIP) joints were obtained from post mortem specimens (n = 40). Multiplanar plain x-rays were taken (dorso/palmar (dp) and lateral views). Radiographic OA was determined by the Kellgren and Lawrence classification. Joint samples were prepared for histological analysis and cartilage damage was graded according to the Mankin scoring system. Inflammatory changes of the synovial membrane were scored using the general synovitis score (GSS). Spearman’s correlation was applied to examine the relationship between histological and radiographical changes. Differences between groups were determined by Mann-Whitney test. Results Bony proliferations that were only detectable on lateral views but reminiscent of OPs on dp images were termed dorso-ventral osteophytes (dvOPs). All joints displaying dvOPs were classified as OA and the presence of dvOPs in DIP and PIP joints correlated with the extent of histological and radiographic joint damage, as well as with patient age. Joint damage in osteoarthritic DIP and PIP joints without any dvOPs was less severe compared to joints with dvOPs. Synovial inflammation was mainly present in joints displaying dvOPs and correlated with joint damage. Conclusion dvOPs are associated with increasing structural alterations in DIP and PIP joints and can be seen as markers of advanced joint damage. Detecting dvOPs can facilitate the diagnosis process and improve damage estimation in HOA.
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Affiliation(s)
- Ilse-Gerlinde Sunk
- Department of Internal Medicine III, Division of Rheumatology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Love Amoyo-Minar
- Department of Internal Medicine III, Division of Rheumatology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Birgit Niederreiter
- Department of Internal Medicine III, Division of Rheumatology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Afschin Soleiman
- Department of Pathology, Medical University of Vienna, Vienna, Austria
| | - Franz Kainberger
- Department of Radiology and Osteology, Medical University of Vienna, Vienna, Austria
| | - Josef S Smolen
- Department of Internal Medicine III, Division of Rheumatology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Daniel Aletaha
- Department of Internal Medicine III, Division of Rheumatology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Klaus Bobacz
- Department of Internal Medicine III, Division of Rheumatology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
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Terpstra SES, van de Stadt LA, Kloppenburg M. The management of hand osteoarthritis: The rheumatologist's perspective. J Hand Ther 2022; 35:322-331. [PMID: 36123279 DOI: 10.1016/j.jht.2022.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 08/12/2022] [Accepted: 08/18/2022] [Indexed: 02/09/2023]
Abstract
Hand osteoarthritis (OA) is treated by several medical professionals. In this review the rheumatologist's perspective will be conveyed. The rheumatologist tasks are to diagnose hand OA, exclude other causes of patient's complaints, and provide treatment. The rheumatologist therefore has a distinctive and important role in hand OA treatment. Although no disease modifying treatment exists, there are multiple options for managing hand OA in rheumatology practice, with the goal of achieving symptom relief and optimizing hand function. These treatments can be non-pharmacological or pharmacological. In this review we will provide a summary of evidence-based management options based on existing guidelines. Furthermore, we will describe common practice among rheumatologists for hand OA management. In order to do so, we performed a literature review of studies addressing treatment modality usage for hand OA. The review comprised 25 studies, which were heterogeneous in terms of treatment modality usage. In addition, a detailed description of care usage by patients in a Rheumatology outpatient clinic is given, based on data of our Hand OSTeoArthritis in Secondary care primary hand OA cohort. The large majority of these patients used any form of hand OA treatment (83%). Non-pharmacological treatment was less frequently used (47%) than pharmacological treatment (77%).
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Affiliation(s)
- Sietse E S Terpstra
- Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands.
| | - Lotte A van de Stadt
- Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
| | - Margreet Kloppenburg
- Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands; Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
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Duruöz MT, Erdem Gürsoy D, Tuncer T, Altan L, Ayhan F, Bal A, Bilgilisoy M, Cerrahoğlu L, Çapkın E, Çay HF, Çevik R, Durmaz B, Dülgeroğlu D, Gürer G, Gürsoy S, Hepgüler S, Hizmetli S, Kaçar C, Kaptanoğlu E, Kaya T, Ecesoy H, Alkan Melikoğlu M, Nas K, Nur H, Özçakır Ş, Sarıdoğan M, Sarıkaya S, Sezer İ, Sindel D, Şahin N, Şahin Ö, Faruk Şendur Ö, Taşçı Bozbaş G, Tıkız C, Uğurlu H. The clinical, functional, and radiological features of hand osteoarthritis: TLAR-osteoarthritis multi-center cohort study. Arch Rheumatol 2022; 37:375-382. [PMID: 36589604 PMCID: PMC9791555 DOI: 10.46497/archrheumatol.2022.9234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 10/24/2021] [Indexed: 01/03/2023] Open
Abstract
Objectives This study aims to evaluate the clinical, functional, and radiological features of hand osteoarthritis (OA) and to examine their relationships in different geographic samples of the Turkish population. Patients and methods Between April 2017 and January 2019, a total of 520 patients (49 males, 471 females; mean age: 63.6±9.8 years) with hand OA were included in the study from 26 centers across Turkey by the Turkish League Against Rheumatism (TLAR). The demographic characteristics, grip strengths with Jamar dynamometer, duration of hand pain (month), the severity of hand pain (Visual Analog Scale [VAS]), and morning stiffness were evaluated. The functional disability was evaluated with Duruöz Hand Index (DHI). The Kellgren-Lawrence (KL) OA scoring system was used to assess the radiological stage of hand OA. Results The DHI had significant correlations with VAS-pain (r=0.367, p<0.001), duration of pain (r=0.143, p=0.001) and bilateral handgrip strengths (r=-0.228, p=0.001; r=-0.303, p<0.001). Although DHI scores were similar between the groups in terms of the presence of hand deformity (p=0.125) or Heberden's nodes (p=0.640), the mean DHI scores were significantly higher in patients with Bouchard's nodes (p=0.015). The total number of nodes had no significant correlations with the VAS-pain and DHI score (p>0.05). The differences between the groups of radiological hand OA grades in terms of age (p=0.007), VAS-pain (p<0.001), duration of pain (p<0.001), and DHI (p<0.001) were significant. There were no significant differences between radiological hand OA grades according to the duration of the stiffness, grip strength, and BMI (p>0.05 for all). Conclusion In our population, the patients with hand OA had pain, functional disability, and weak grip strength. The functional impairment was significantly correlated with the severity of the pain, and the functional status was worse in high radiological hand OA grades.
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Affiliation(s)
- Mehmet Tuncay Duruöz
- Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Marmara University School of Medicine, Istanbul, Turkey
| | - Didem Erdem Gürsoy
- Department of Physical Medicine and Rehabilitation, Rheumatology Clinic, Prof. Dr. Cemil Taşcoğlu City Hospital, Istanbul, Turkey
| | - Tiraje Tuncer
- Department of Physical Medicine and Rehabilitation, Akdeniz University School of Medicine, Antalya, Turkey
| | - Lale Altan
- Department of Physical Medicine and Rehabilitation, Uludağ University School of Medicine, Bursa, Turkey
| | - Figen Ayhan
- Department of Physical Medicine and Rehabilitation, Atılım University School of Medicine, Ankara, Turkey
| | - Ajda Bal
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Meral Bilgilisoy
- Department of Physical Medicine and Rehabilitation, Antalya Training and Research Hospital, Antalya, Turkey
| | - Lale Cerrahoğlu
- Department of Physical Medicine and Rehabilitation, Celal Bayar University School of Medicine, Manisa, Turkey
| | - Erhan Çapkın
- Department of Physical Medicine and Rehabilitation, Karadeniz Technical University School of Medicine, Trabzon, Turkey
| | - Hasan Fatih Çay
- Department of Physical Medicine and Rehabilitation, Antalya Training and Research Hospital, Antalya, Turkey
| | - Remzi Çevik
- Department of Physical Medicine and Rehabilitation, Dicle University School of Medicine, Diyarbakır, Turkey
| | - Berrin Durmaz
- Department of Physical Medicine and Rehabilitation, Ege University School of Medicine, Izmir, Turkey
| | - Deniz Dülgeroğlu
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Gülcan Gürer
- Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Adnan Menderes University School of Medicine, Aydın, Turkey
| | - Savaş Gürsoy
- Department of Physical Medicine and Rehabilitation, Gaziantep University School of Medicine, Gaziantep, Turkey
| | - Simin Hepgüler
- Department of Physical Medicine and Rehabilitation, Ege University School of Medicine, Izmir, Turkey
| | - Sami Hizmetli
- Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Cumhuriyet University School of Medicine, Sivas, Turkey
| | - Cahit Kaçar
- Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Akdeniz University School of Medicine, Antalya, Turkey
| | - Ece Kaptanoğlu
- Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Başkent University Zübeyde Hanım Application and Research Center, Izmir, Turkey
| | - Taciser Kaya
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Izmir Faculty of Medicine, Izmir, Turkey
| | - Hilal Ecesoy
- Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Karamanoğlu Mehmetbey University School of Medicine, Karaman, Turkey
| | - Meltem Alkan Melikoğlu
- Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Atatürk University School of Medicine, Erzurum, Turkey
| | - Kemal Nas
- Department of Physical Medicine and Rehabilitation, Sakarya University School of Medicine, Sakarya, Turkey
| | - Hakan Nur
- Department of Physical Medicine and Rehabilitation, Akdeniz University School of Medicine, Antalya, Turkey
| | - Şüheda Özçakır
- Department of Physical Medicine and Rehabilitation, Uludağ University School of Medicine, Bursa, Turkey
| | - Merih Sarıdoğan
- Department of Physical Medicine and Rehabilitation, Istanbul University Cerrahpaşa School of Medicine, Istanbul, Turkey
| | - Selda Sarıkaya
- Department of Physical Medicine and Rehabilitation, Bülent Ecevit University School of Medicine, Zonguldak, Turkey
| | - İlhan Sezer
- Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Akdeniz University School of Medicine, Antalya, Turkey
| | - Dilşad Sindel
- Department of Physical Medicine and Rehabilitation, Istanbul University Istanbul School of Medicine, Istanbul, Turkey
| | - Nilay Şahin
- Department of Physical Medicine and Rehabilitation, Balıkesir University, Balıkesir, Turkey
| | - Özlem Şahin
- Department of Physical Medicine and Rehabilitation, Cumhuriyet University School of Medicine, Sivas, Turkey
| | - Ömer Faruk Şendur
- Department of Physical Medicine and Rehabilitation, Adnan Menderes University School of Medicine, Aydın, Turkey
| | - Gülnur Taşçı Bozbaş
- Department of Physical Medicine and Rehabilitation, Necmettin Erbakan University School of Medicine, Konya, Turkey
| | - Canan Tıkız
- Department of Physical Medicine and Rehabilitation, Celal Bayar University School of Medicine, Manisa, Turkey
| | - Hatice Uğurlu
- Department of Physical Medicine and Rehabilitation, Necmettin Erbakan University School of Medicine, Konya, Turkey
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Duarte-Salazar C, Marín-Arriaga N, Miranda-Duarte A. The High Clinical Burden of Erosive Hand Osteoarthritis is Associated with Clinical Findings, Pain, and Radiographic Severity. REUMATOLOGIA CLINICA 2022; 18:338-342. [PMID: 35680365 DOI: 10.1016/j.reumae.2021.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 03/04/2021] [Indexed: 06/15/2023]
Abstract
UNLABELLED Varying reports exist on the clinical impact of erosive hand osteoarthritis (EHOA) in terms of pain and articular function. Few studies have assessed the association of a patient's clinical features with the presence of more severe radiographic disease. The aim was to evaluate clinical and radiographic characteristics in EHOA comparing with non-erosive (NEHOA); to examine pain and functional impairment between EHOA and NEHOA; and correlate functional impairment with clinical findings, pain, and radiographic severity. METHODS 62 patients with EHOA and 57 with NEHO were included. Pain was assessed through Visual Analogue Scale (VAS) and Australian/Canadian Osteoarthritis Hand Index (AUSCAN) pain subdomain. Functioning was evaluated with the Health Assessment Questionnaire (HAQ) concerning hand function and AUSCAN. Radiographs were scored with the Kallman scale and subchondral erosions with the Verbruggen-Veys method. Student t-tests were used for comparing quantitative data, chi-squared tests for categorical variables, and Pearson or Spearman tests for assessing correlation. RESULTS Patients with EHOA reported significantly higher levels of pain on the VAS and AUSCAN (p<0.01). In EHOA, VAS positively correlated with the HAQ and AUSCAN scales (rho=0.68 and 0.77). In NEHOA, Visual Analogue Scale (VAS) positively and strongly correlated with HAQ and AUSCAN (rho=0.84 and 0.89). Nodes, Kallman score and erosions showed a positive but weak correlation with HAQ and AUSCAN in both groups. CONCLUSION Both EHOA and NEHOA participants had functional impairment, but the erosive subtype had higher clinical burden and increased joint damage. This higher clinical burden is attributed mainly to pain.
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Affiliation(s)
- Carolina Duarte-Salazar
- Departamento de Reumatología, Instituto Nacional de Rehabilitación "Luis Guillermo Ibarra Ibarra", Mexico City, Mexico.
| | - Norma Marín-Arriaga
- Departamento de Imagenología y Servicio de Resonancia Magnética, Instituto Nacional de Rehabilitación "Luis Guillermo Ibarra Ibarra", Mexico City, Mexico
| | - Antonio Miranda-Duarte
- Departamento de Genética, Instituto Nacional de Rehabilitación "Luis Guillermo Ibarra Ibarra", Mexico City, Mexico
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Gasperi N, Schreiber N, Bosch P, Adinolfi A, Kleyer A, Hagen M, Gasperi C, Weger M, Kiechl S, Willeit J, Schett G, Iagnocco A, Gasperi A, Mayr A, Dejaco C. Ultrasound-detected inflammation is more common in clinically manifest hand osteoarthritis than in painless bony enlarged finger joints: subanalysis of the population-based Bruneck study. Ther Adv Musculoskelet Dis 2022; 14:1759720X221096382. [PMID: 35586515 PMCID: PMC9109483 DOI: 10.1177/1759720x221096382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 03/28/2022] [Indexed: 11/30/2022] Open
Abstract
Purpose: The aim of this article is to examine the extent of structural and
inflammatory lesions by ultrasound in elderly subjects with hand
osteoarthritis (HOA) fulfilling the ACR classification criteria (Group A),
in subjects with painless enlarged finger joints (Group B), and in
individuals without clinical abnormalities at hands (Group C). Methods: This study was nested within the population-based, prospective Bruneck study;
293 subjects of ⩾65 years of age were assessed. Clinical and ultrasound
assessment was conducted at wrists and finger joints. Gray scale synovitis
(GSS), Power Doppler (PD), osteophytes, and erosions were scored
semiquantitatively (0–3). The Short Form Score for the Assessment and
Quantification of Chronic Rheumatic Affections of the Hands (SF-SACRAH), the
Health Assessment Questionnaire (HAQ), and the Functional Index for Hand
Osteoarthritis (FIHOA) were retrieved. Results: Most subjects had ⩾1 ultrasound abnormality, of which osteophytes were the
most prevalent finding in all groups (Group A: 100%, Group B: 99.4%, and
Group C: 93.9%). GSS and PD-signals were more common in Group A than in
Group B (94% versus 67% and 33% versus
13%, respectively). In Group C, GSS was observed in 39.4% of subjects. In
subjects with HOA, the SF-SACRAH correlated with osteophyte scores
(corrcoeff = 0.48), and the FIHOA correlated with the
osteophyte (corrcoeff = 0.42) and PD scores
(corrcoeff = 0.33). Conclusion: GSS and PD were more frequent in patients with symptomatic HOA than in cases
with painless bony enlargements and subjects without clinical joint
abnormalities. Functional restriction in HOA is associated with structural
and inflammatory ultrasound changes.
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Affiliation(s)
- Nina Gasperi
- Division of Rheumatology and Immunology, Medical University of Graz, Graz, Austria
| | - Nikolaus Schreiber
- Intensive Care Unit, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Philipp Bosch
- Division of Rheumatology and Immunology, Medical University of Graz, Graz, Austria
| | - Antonella Adinolfi
- Rheumatology Unit, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Arnd Kleyer
- Department of Internal Medicine 3-Rheumatology and Immunology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Universitätsklinikum Erlangen, Erlangen, Germany
| | - Melanie Hagen
- Department of Internal Medicine 3-Rheumatology and Immunology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Universitätsklinikum Erlangen, Erlangen, Germany
| | - Christiane Gasperi
- Department of Neurology, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Martin Weger
- Department of Internal Medicine, Bruneck Hospital, Bruneck, Italy
| | - Stefan Kiechl
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Johann Willeit
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Georg Schett
- Department of Internal Medicine 3-Rheumatology and Immunology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Universitätsklinikum Erlangen, Erlangen, Germany
| | | | - Arno Gasperi
- Department of Neurology, Bruneck Hospital, Bruneck, Italy
| | - Agnes Mayr
- Department of Laboratory Medicine, Bruneck Hospital, Bruneck, Italy
| | - Christian Dejaco
- Rheumatology Service, South Tyrolean Health Trust, Hospital of Bruneck, Spitalstraße 11, Bruneck 39031, Italy
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Graham J, Novosat T, Sun H, Piper BJ, Boscarino JA, Kern MS, Hayduk VA, Wright EA, Beck C, Robinson RL, Casey E, Hall J, Dorling P. Associations of Healthcare Utilization and Costs with Increasing Pain and Treatment Intensity Levels in Osteoarthritis Patients: An 18-Year Retrospective Study. Rheumatol Ther 2022; 9:1061-1078. [PMID: 35538392 PMCID: PMC9314498 DOI: 10.1007/s40744-022-00448-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 04/07/2022] [Indexed: 11/24/2022] Open
Abstract
Introduction Osteoarthritis (OA) is a complex disease, and prior studies have documented the health and economic burdens of patients with OA compared to those without OA. Our goal was to use two strategies to further stratify OA patients based on both pain and treatment intensity to examine healthcare utilization and costs using electronic records from 2001 to 2018 at a large integrated health system. Methods Adult patients with ≥1 pain numerical rating scale (NRS) and diagnosis of OA were included. Pain episodes of ≥90 days were defined as mild (0–3), moderate (4–6), or severe (7–10) based on initial NRS. Patients were initially classified as mild and moved to moderate-severe OA if any of eight treatment-based criteria were met. Outpatient visits (OP), emergency department visits (ED), inpatient days, and healthcare costs (both all-cause and OA-specific) were compared among pain levels and OA severity levels as frequencies and per-member-per-year rates, using generalized linear regression models adjusting for age, sex, and body mass index, with contrasts of p < 0.05 considered significant. Results We identified 127,656 patients, 92,576 with pain scores. Moderate and severe pain were associated with significantly higher rates of OA-related utilization and costs, and all-cause ED visits and pharmacy costs. Moderate-severe OA patients had significantly higher OA-related utilization and costs, and all-cause OP, ED and pharmacy costs. Conclusions Pain and treatment intensity were both strongly associated with OA-related utilization but not consistently with all-cause utilization. Our results provide promising evidence of better criteria and approaches for predicting disease burden and costs in the future. Supplementary Information The online version contains supplementary material available at 10.1007/s40744-022-00448-7.
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Affiliation(s)
- Jove Graham
- Center for Pharmacy Innovation and Outcomes, Geisinger, 100 N Academy Ave, Danville, PA, MC 44-00, USA.
| | | | - Haiyan Sun
- Biostatistics Core, Geisinger, Danville, PA, USA
| | - Brian J Piper
- Center for Pharmacy Innovation and Outcomes, Geisinger, 100 N Academy Ave, Danville, PA, MC 44-00, USA.,Department of Medical Education, Geisinger Commonwealth School of Medicine, Scranton, PA, USA
| | | | - Melissa S Kern
- Center for Pharmacy Innovation and Outcomes, Geisinger, 100 N Academy Ave, Danville, PA, MC 44-00, USA
| | - Vanessa A Hayduk
- Center for Pharmacy Innovation and Outcomes, Geisinger, 100 N Academy Ave, Danville, PA, MC 44-00, USA
| | - Eric A Wright
- Center for Pharmacy Innovation and Outcomes, Geisinger, 100 N Academy Ave, Danville, PA, MC 44-00, USA
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Wang W, Yu S, Long Z, Liu Y, Yan Y, Sun T, Liu Z. Electroacupuncture vs topical diclofenac sodium gel for patients with hand osteoarthritis: study protocol for a randomized controlled trial. J Orthop Surg Res 2022; 17:233. [PMID: 35413861 PMCID: PMC9004119 DOI: 10.1186/s13018-022-03125-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 04/05/2022] [Indexed: 11/25/2022] Open
Abstract
Background Hand osteoarthritis (OA) is a prevalent joint disorder and a great burden to both patients and society. While electroacupuncture (EA) and topical diclofenac sodium gel (DSG) are both currently used to treat OA, no head-to-head study of EA and topical DSG for hand OA exists. Thus, it remains unknown whether one intervention offers improved outcomes over the other. This study aims to compare the effects of EA and topical DSG in patients with hand OA. Methods A total of 108 participants with hand OA according to the American College of Rheumatology criteria will be recruited and randomly assigned to the EA group or topical DSG group with a 1:1 allocation ratio. Participants in the EA group will receive EA treatment thrice weekly for 4 weeks, followed by a 12-week follow-up. In the topical DSG group, topical DSG at a dose of 2 g over the affected joints per hand will be applied four times per day for 4 weeks. The outcomes will be measured at weeks 4, 8, and 16. The primary outcome will be the change in average overall finger joint pain intensity in the dominant hand from baseline to week 4. All outcome variables will be analyzed on an intention-to-treat principle. All statistical tests will be two-sided. Discussion This study will help determine which of the two treatment protocols, EA or topical DSG, is more effective for the clinical treatment of hand OA. Trial registration ClinicalTrials.gov identifier: NCT04402047. Registered 16 May 2020, https://clinicaltrials.gov/ct2/show/NCT04402047
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Affiliation(s)
- Weiming Wang
- Department of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences Guang'anmen Hospital, No. 5 Beixiange, Xicheng District, Beijing, 100053, China
| | - Shudan Yu
- Department of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences Guang'anmen Hospital, No. 5 Beixiange, Xicheng District, Beijing, 100053, China
| | - Zilin Long
- Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Yan Liu
- Key Laboratory of Chinese Internal Medicine of Ministry of Education, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China
| | - Yan Yan
- Department of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences Guang'anmen Hospital, No. 5 Beixiange, Xicheng District, Beijing, 100053, China
| | - Tianheng Sun
- Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Zhishun Liu
- Department of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences Guang'anmen Hospital, No. 5 Beixiange, Xicheng District, Beijing, 100053, China.
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Huang X, Chen Y, Peng Y, Gan M, Geng B, Zhu M, Ying Y. Serum levels of interleukin-34 and RANKL as multivariable predictors of bone erosion seen by ultrasonography in patients with ankylosing spondylitis. ASIAN BIOMED 2022; 16:89-98. [PMID: 37551285 PMCID: PMC10321159 DOI: 10.2478/abm-2022-0011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Background Ankylosing spondylitis (AS) is a chronic inflammatory arthritic disease, and sacroiliitis, enthesitis, and propensity for sacroiliac and spinal fusion are characteristic pathological features. Interleukin-34 (IL-34) plays a role in the induction and differentiation of osteoclasts. Other inflammatory factors are not directly involved in the induction and differentiation, but play an indirect role by modulating the level of receptor activator of nuclear factor-κB (RANKL) and other molecules during the process of inflammatory bone destruction in AS. However, to our knowledge, the relationship between enthesitis and bone erosion, and IL-34 and RANKL in AS has not yet been elucidated. Objective To determine the correlation between serum IL-34, RANKL, and disease severity including enthesitis and bone erosion in patients with AS and develop multivariable predictive model. Methods We conducted a cross-sectional study of 40 patients with AS, compared with 40 patients with osteoarthritis, and 40 healthy volunteers. Their serum levels of IL-34 and RANKL were measured using enzyme-linked immunosorbent assays (ELISAs). Enthesitis and bone erosion were assessed with real-time ultrasonography. Spearman rank correlation coefficients were determined to analyze the relationship between the variables. Multiple logistic regression was used to determine associations and receiver operating characteristic (ROC) curve analyses were conducted to determine the diagnostic performance of cytokine levels. Results In patients with AS, serum levels of IL-34 (878.9 ± 116.4 pg/mL) and RANKL (155.6 ± 13.8 pg/mL) were significantly (P < 0.01) higher than those in patients with osteoarthritis (626.6 ± 79.0 and 138.1 ± 15.3 pg/mL, respectively) or a healthy group (612.9 ± 61.1 and 104.9 ± 15.4 pg/mL, respectively). Serum levels of IL-34 were not significantly correlated with the levels of RANKL. In patients with AS, serum levels of IL-34 and RANKL adjusted for age and weight were significantly correlated with enthesitis (0.798, P < 0.01; 0.347, P < 0.05, respectively) and bone erosion (0.822, P < 0.01; 0.368, P < 0.05, respectively). The area under the ROC curve (AUC) for the serum levels of IL-34 was 0.995 between patients with AS and healthy individuals. When serum level of IL-34 was >697.1 pg/mL, the sensitivity (SE) was >99% and specificity (SP) was 95.0%. The AUC for IL-34 was 0.982 between patients with AS and patients with osteoarthritis. When serum IL-34 was >688.4 pg/mL, the SE was >99% and SP 85.0%. IL-34 correlation with the number of bone erosions of enthesis was rs = 0.795, P < 0.01. The AUC for serum RANKL was 0.993 between patients with AS and healthy individuals. When serum RANKL was >126.2 pg/mL, the SE was 97.5% and SP 97.5%. The AUC for serum RANKL was 0.798 between patients with AS and patients with osteoarthritis. When serum RANKL was >149.3 pg/mL, the SE was 70% and SP was 80.0%. Conclusions In patients with AS, serum levels of IL-34 and RANKL may be useful indicators of enthesitis, especially for bone erosions. IL-34 is associated with AS-associated enthesis damage and is a potential biomarker for predicting subsequent progression in patients with AS.
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Affiliation(s)
- Xianqian Huang
- Department of Rheumatology, Ningbo Hwa Mei (No. 2) Hospital, Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo, Zhejiang315010, China
| | - Yong Chen
- Department of Rheumatology, Ningbo Hwa Mei (No. 2) Hospital, Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo, Zhejiang315010, China
| | - Yong Peng
- Department of Rheumatology, Ningbo Hwa Mei (No. 2) Hospital, Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo, Zhejiang315010, China
| | - Minzhi Gan
- Department of Rheumatology, Ningbo Hwa Mei (No. 2) Hospital, Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo, Zhejiang315010, China
| | - Baoqing Geng
- Department of Rheumatology, Ningbo Hwa Mei (No. 2) Hospital, Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo, Zhejiang315010, China
| | - Mengya Zhu
- Department of Rheumatology, Ningbo Hwa Mei (No. 2) Hospital, Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo, Zhejiang315010, China
| | - Ying Ying
- Department of Rheumatology, Ningbo Hwa Mei (No. 2) Hospital, Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo, Zhejiang315010, China
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Guldberg-Møller J, Mogensen M, Ellegaard K, Zavareh A, Wakefield RJ, Tan AL, Boesen M, Dehmeshki J, Kubassova O, Dreyer L, Henriksen M, Kristensen LE. Multimodal imaging of the distal interphalangeal-joint synovio-entheseal complex in psoriatic arthritis (MIDAS): a cross-sectional study on the diagnostic accuracy of different imaging modalities comparing psoriatic arthritis to psoriasis and osteoarthritis. RMD Open 2022; 8:rmdopen-2021-002109. [PMID: 35347068 PMCID: PMC8961176 DOI: 10.1136/rmdopen-2021-002109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 03/07/2022] [Indexed: 11/08/2022] Open
Abstract
Objective Can ultrasound (US), MRI and X-ray applied to the distal interphalangeal (DIP)-joint and synovio-entheseal complex (SEC) discriminate between patients with psoriatic arthritis (PsA), skin psoriasis (PsO) and hand osteoarthritis (OA)? Methods In this prospective, cross-sectional study, patients with DIP-joint PsA and nail involvement (n=50), PsO with nail involvement (n=12); and OA (n=13); were consecutively recruited. Risk ratios (RR) were calculated for US, MRI and X-ray findings of the DIP-joint and SEC between diagnoses. Results New bone formation (NBF) in US and MRI was a hallmark of OA, reducing the risk of having PsA (RR 0.52 (95% CI 0.43 to 0.63) and 0.64 (95% CI 0.56 to 0.74). The OA group was different from PsA and PsO on all MRI and X-ray outcomes reflected in a lower RR of having PsA; RR ranging from 0.20 (95% CI 0.13 to 0.31) for MRI bone marrow oedema (BMO) to 0.85 (95% CI 0.80 to 0.90) in X-ray enthesitis. No outcome in US, MRI or X-ray was significantly associated with a higher risk of PsA versus PsO, although there was a trend to a higher degree of US erosions and NBF in PsA. 82% of PsA and 67% of PsO was treated with disease modifying antirheumatic drugs which commonly reflects the clinical setting. Conclusion High grade of US, MRI and X-ray NBF reduce the RR of having PsA compared with OA. In PsA versus PsO patients, there was a trend for US to demonstrate more structural changes in PsA although this did not reach significance.
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Affiliation(s)
- Jørgen Guldberg-Møller
- The Parker Institute, Frederiksberg, Denmark .,Department of Rheumatology, Slagelse Hospital, Slagelse, Denmark
| | - Mette Mogensen
- Department of Dermatology, Bispebjerg Hospital, Kobenhavn, Denmark
| | | | - Ali Zavareh
- Radiology Department, Guy's and St Thomas' Hospitals NHS Trust, London, UK
| | - Richard J Wakefield
- University of Leeds Leeds Institute of Rheumatic and Musculoskeletal Medicine, Leeds, UK
| | - Ai Lyn Tan
- University of Leeds Leeds Institute of Rheumatic and Musculoskeletal Medicine, Leeds, UK
| | - Mikael Boesen
- Department of Radiology, Bispebjerg Hospital, Kobenhavn, Denmark
| | | | | | - Lene Dreyer
- The Parker Institute, Frederiksberg, Denmark.,Department of Rheumatology, Aalborg University Hospital, Aalborg, North Denmark Region, Denmark
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Abstract
Osteoarthritis (OA) most commonly affects knee joints, and the next most commonly affected sites are the hands and hips. Three distinct hand OA phenotypes have been described: erosive hand OA (EHOA), nodal hand OA - also known as non-erosive hand OA (non-EHOA) - and first carpometacarpal joint OA. EHOA predominantly affects women and is the most aggressive form of hand OA, characterized by a severe clinical onset and progression, leading to joint damage, disability and reduction of quality of life. Clinical signs of inflammation associated with EHOA include the acute onset of pain, swelling and redness. Moreover, EHOA is characterized by radiographic features such as central erosion, saw-tooth and gull-wing lesions and, rarely, ankylosis. The aim of this Review is to report the latest findings on epidemiology, clinical features, pathology and aetiopathogenesis, biomarkers, imaging modalities and treatments for EHOA. The ongoing development of new hand OA classification criteria should facilitate standardization between studies.
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Wang Y, Hussain SM, Gan D, Lim YZ, Estee MM, Heritier S, Wluka AE, Cicuttini FM. Topical corticosteroid for treatment of hand osteoarthritis: study protocol for a randomised controlled trial. BMC Musculoskelet Disord 2021; 22:1036. [PMID: 34903211 PMCID: PMC8670184 DOI: 10.1186/s12891-021-04921-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 11/28/2021] [Indexed: 11/10/2022] Open
Abstract
Background Hand osteoarthritis is a common and disabling chronic joint disease with a lack of effective therapies. Emerging evidence suggests the role of local inflammation in causing pain in hand osteoarthritis. Corticosteroids are potent anti-inflammatory drugs used in many rheumatic diseases. The aim of this randomised, double-blind, placebo-controlled trial is to determine whether topical corticosteroid reduces pain over 6 weeks in patients with hand osteoarthritis. Methods One hundred participants with hand osteoarthritis will be recruited from the community in Melbourne, Australia, and randomly allocated in a 1:1 ratio to receive either topical Diprosone OV or placebo ointment administered 3 times daily on the painful hand joints for 6 weeks. The primary outcome is pain reduction (assessed by 100 mm visual analogue scale) at 6 weeks. The secondary outcomes include changes in pain and function assessed using Functional Index for Hand Osteoarthritis, Australian Canadian Osteoarthritis Hand Index, Michigan Hand Outcomes Questionnaire, and tender and swollen joint count at 6 weeks. Adverse events will be recorded. The primary analysis will be by intention to treat, including all participants in their randomised groups. Discussion This study will provide high-quality evidence to determine whether topical corticosteroid reduces pain over 6 weeks in patients with hand osteoarthritis, with major clinical and public health importance by informing clinical practice guidelines for the management of hand osteoarthritis and reducing the burden of the disabling disease. Trial registration Australian New Zealand Clinical Trials Registry (ANZCTR), ACTRN12620000599976. Registered 22 May 2020. Supplementary Information The online version contains supplementary material available at 10.1186/s12891-021-04921-2.
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Affiliation(s)
- Yuanyuan Wang
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Sultana Monira Hussain
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Desmond Gan
- Alfred Hospital, Melbourne, VIC, 3004, Australia
| | - Yuan Z Lim
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Mahnuma Mahfuz Estee
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Stephane Heritier
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Anita E Wluka
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Flavia M Cicuttini
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia.
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Shi Y, Fu K, Oo WM, Deveza LA, Wang X, Duong V, Robbins SR, Hunter DJ. Associations between radiographic features, clinical features and ultrasound of thumb-base osteoarthritis: A secondary analysis of the COMBO study. Int J Rheum Dis 2021; 25:38-46. [PMID: 34821056 PMCID: PMC9298930 DOI: 10.1111/1756-185x.14248] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 10/28/2021] [Accepted: 11/01/2021] [Indexed: 11/28/2022]
Abstract
Aim To investigate the associations of ultrasound and radiographic features of thumb‐base osteoarthritis (OA) with thumb‐base pain and hand function at baseline and 12 weeks. Method Data from a randomized controlled trial conducted in participants with symptomatic radiographic thumb‐base OA were analyzed. Participants who finished follow up were included in this secondary analysis. Pain and hand function were assessed using self‐reported measures. All participants underwent ultrasound examinations for synovitis, power Doppler signal (PDS), and osteophytes, and underwent radiography for osteophytes, joint space narrowing (JSN), and subchondral bone sclerosis at baseline. Hand pain and function were reassessed after the 12‐week follow up. The associations of ultrasound and radiographic findings with clinical features were further evaluated, using linear regression analyses, after adjustment for relevant confounding factors. Results A total of 166 participants (average age 66.2 years; 76.5% female) were included. At baseline, radiographic JSN and subchondral bone sclerosis were associated with hand function. There was a significant association between ultrasound‐detected PDS and patient's global assessment (PGA) at baseline. Baseline radiographic JSN was significantly associated with the changes in stiffness and PGA from baseline to 12 weeks. There was no association between ultrasound features and changes in the clinical outcomes over 12 weeks. Conclusion This study indicates that radiographic features significantly correlate with hand function, and ultrasound PDS is closely related to the PGA at baseline in thumb‐base OA. Radiographic JSN may be a predictor for stiffness and PGA in thumb‐base OA.
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Affiliation(s)
- Ying Shi
- Ultrasound Department, Shenzhen Longhua District Central Hospital, Shenzhen, China.,Ultrasound Department, The Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Kai Fu
- Rheumatology Department, Royal North Shore Hospital and Institute of Bone and Joint Research, Kolling Institute, University of Sydney, Sydney, New South Wales, Australia
| | - Win Min Oo
- Rheumatology Department, Royal North Shore Hospital and Institute of Bone and Joint Research, Kolling Institute, University of Sydney, Sydney, New South Wales, Australia
| | - Leticia A Deveza
- Rheumatology Department, Royal North Shore Hospital and Institute of Bone and Joint Research, Kolling Institute, University of Sydney, Sydney, New South Wales, Australia
| | - Xia Wang
- Rheumatology Department, Royal North Shore Hospital and Institute of Bone and Joint Research, Kolling Institute, University of Sydney, Sydney, New South Wales, Australia
| | - Vicky Duong
- Rheumatology Department, Royal North Shore Hospital and Institute of Bone and Joint Research, Kolling Institute, University of Sydney, Sydney, New South Wales, Australia
| | - Sarah R Robbins
- Rheumatology Department, Royal North Shore Hospital and Institute of Bone and Joint Research, Kolling Institute, University of Sydney, Sydney, New South Wales, Australia
| | - David J Hunter
- Rheumatology Department, Royal North Shore Hospital and Institute of Bone and Joint Research, Kolling Institute, University of Sydney, Sydney, New South Wales, Australia
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Wang Y, Teichtahl AJ, Jones G, Keen HI, Hill CL, Wluka AE, Kasza J, Cicuttini FM. METHODS - A randomised controlled trial of METhotrexate to treat Hand Osteoarthritis with Synovitis: study protocol for a randomised controlled trial. BMC Musculoskelet Disord 2021; 22:953. [PMID: 34781952 PMCID: PMC8591971 DOI: 10.1186/s12891-021-04842-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 11/04/2021] [Indexed: 11/23/2022] Open
Abstract
Background Hand osteoarthritis is a common and disabling problem without effective therapies. Accumulating evidence suggests the role of local inflammation in causing pain and structural progression in hand osteoarthritis, and hand osteoarthritis with synovitis is a commonly encountered clinical phenotype. Methotrexate is a well-established, low-cost, and effective treatment for inflammatory arthritis with a well-described safety profile. The aim of this multicentre, randomised, double-blind, placebo-controlled trial is to determine whether methotrexate reduces pain over 6 months in patients with hand osteoarthritis and synovitis. Methods Ninety-six participants with hand osteoarthritis and synovitis will be recruited through the Osteoarthritis Clinical Trial Network (Melbourne, Hobart, Adelaide, and Perth), and randomly allocated in a 1:1 ratio to receive either methotrexate 20 mg or identical placebo once weekly for 6 months. The primary outcome is pain reduction (assessed by 100 mm visual analogue scale) at 6 months. The secondary outcomes include changes in physical function and quality of life assessed using Functional Index for Hand Osteoarthritis, Australian Canadian Osteoarthritis Hand Index, Health Assessment Questionnaire, Michigan Hand Outcomes Questionnaire, Short-Form-36, tender and swollen joint count, and grip strength, and structural progression assessed using progression of synovitis and bone marrow lesions from magnetic resonance imaging and radiographic progression at 6 months. Adverse events will be recorded. The primary analysis will be by intention to treat, including all participants in their randomised groups. Discussion This study will provide high-quality evidence to address whether methotrexate has an effect on reducing pain over 6 months in patients with hand osteoarthritis and synovitis, with major clinical and public health importance. While a positive trial will inform international clinical practice guidelines for the management of hand osteoarthritis, a negative trial would be highly topical and change current trends in clinical practice. Trial registration Australian New Zealand Clinical Trials Registry (ANZCTR), ACTRN12617000877381. Registered 15 June 2017, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=373124
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Affiliation(s)
- Yuanyuan Wang
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Andrew J Teichtahl
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Graeme Jones
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, 7000, Australia
| | - Helen I Keen
- Rheumatology Group, School of Medicine, University of Western Australia, Perth, WA, 6009, Australia.,Department of Rheumatology, Fiona Stanley Hospital, Murdoch, WA, 6150, Australia
| | - Catherine L Hill
- The Queen Elizabeth Hospital, University of Adelaide, Woodville, SA, 5011, Australia.,Department of Medicine, University of Adelaide, Adelaide, SA, 5000, Australia
| | - Anita E Wluka
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Jessica Kasza
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Flavia M Cicuttini
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia.
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van Beest S, Kroon HM, Reijnierse M, Rosendaal FR, Kloppenburg M, Kroon FPB. Two-Year Changes in Magnetic Resonance Imaging Features and Pain in Thumb Base Osteoarthritis. Arthritis Care Res (Hoboken) 2021; 73:1628-1637. [PMID: 32558377 PMCID: PMC8596842 DOI: 10.1002/acr.24355] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 04/28/2020] [Accepted: 06/09/2020] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To investigate the two-year course of pain and osteoarthritic features on magnetic resonance imaging (MRI) in the thumb base. METHODS Patients in the Hand Osteoarthritis in Secondary Care (HOSTAS) cohort who had received radiographic examination, MRI, and clinical examination of the right thumb base at baseline and who had a 2-year follow-up period were studied. Pain on palpation of the thumb base was assessed on a 0-3 scale. MRIs were analyzed with the Outcome Measures in Rheumatology (OMERACT) thumb base osteoarthritis MRI scoring system for synovitis, bone marrow lesions (BMLs), subchondral bone defects, cartilage space loss, osteophytes, and subluxation. Radiographs were assessed for osteophytes and joint space narrowing. We studied the associations of changes in synovitis and BMLs with changes in pain using a logistic regression model adjusted for radiographic damage, with values expressed as odds ratios (ORs) and 95% confidence intervals (95% CIs). RESULTS Of 165 patients, 83% were women and the mean age was 60.7 years. At baseline, 65 patients had thumb base pain. At 2-year follow-up, pain had decreased in 32 patients and increased in 33 patients. MRI features remained stable in most patients. Structural MRI features generally deteriorated, while synovitis and BMLs improved in some individuals and deteriorated in others. Change in radiographic osteophytes rarely occurred (n = 10). Increased synovitis (odds ratio [OR] 3.4 [95% CI 1.3-9.3]) and increased BMLs (OR 5.1 [95% CI 2.1-12.6]) were associated with increased pain. Decreased BMLs appeared to be associated with decreased pain (OR 2.7 [95% CI 0.8-8.9]), and reductions in synovitis occurred too infrequently to calculate associations. CONCLUSION Over 2 years, thumb base pain fluctuated, while MRI features changed in a minority of patients with hand osteoarthritis. Changes in synovitis and BMLs were associated with changes in pain on palpation, even after adjustment for radiographic damage.
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Siviero P, Limongi F, Gesmundo A, Zambon S, Cooper C, Dennison EM, Edwards MH, van der Pas S, Timmermans EJ, van Schoor NM, Schaap LA, Dallmeier D, Denkinger MD, Peter R, Castell MV, Otero Á, Pedersen NL, Deeg DJH, Maggi S. Factors Associated With Functional Decline in Hand and Hip/Knee Osteoarthritis After One Year: Data From a Population-Based Study. Arthritis Care Res (Hoboken) 2021; 73:1343-1353. [PMID: 32770733 DOI: 10.1002/acr.24404] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 07/30/2020] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To investigate factors that together with hand or hip/knee osteoarthritis (OA) could contribute to functional decline over a year's time in elderly individuals. METHODS The data of 1,886 individuals between ages 65 and 85 years in a prospective, observational population-based study with 12-18 months of follow-up in the context of the European Project on Osteoarthritis were analyzed. The outcome measures were self-reported hand and hip/knee functional decline, evaluated using a minimum clinically important difference of 4 on the Australian/Canadian Hand OA Index and of 2 on the Western Ontario and McMaster Universities Osteoarthritis Index hip/knee physical function subscales, both normalized to 0-100. Using regression models adjusted for sex, age, country, and education level, the baseline factors considered were clinical hand or hip/knee OA, pain, analgesic/antiinflammatory medications, comorbidities, social isolation, income, walking time, grip strength, physical activity time, and medical/social care. RESULTS After a year, 453 participants were identified as having worse hand functionality and 1,389 as not worse. Hand OA, anxiety, walking time, and grip strength were risk factors for hand functional decline; pain was a confounder of the effect of hand OA. Analgesic/antiinflammatory medications mediated the combined effect of hip/knee OA plus pain on functional decline in the 554 individuals classified as having worse hip/knee functionality and the 1,291 persons who were not worse. Peripheral artery disease, obesity, and cognitive impairment were other baseline risk factors. CONCLUSION Study findings showed that together with emotional status and chronic physical and cognitive conditions, OA affects hand and hip/knee functional decline.
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Affiliation(s)
| | | | - Antonella Gesmundo
- University of Padua, Padua, and Ospedale Riabilitativo di Alta Specializzazione, Motta di Livenza, Treviso, Italy
| | | | - Cyrus Cooper
- University of Southampton and Southampton General Hospital, Southampton, UK
| | - Elaine M Dennison
- University of Southampton and Southampton General Hospital, Southampton, UK
| | - Mark H Edwards
- University of Southampton and Southampton General Hospital, Southampton, and Portsmouth Hospitals NHS Trust, Portsmouth, UK
| | - Suzan van der Pas
- Amsterdam UMC, Amsterdam Public Health Research Institute, and VU University Medical Center, Amsterdam, The Netherlands
| | - Erik J Timmermans
- Amsterdam UMC, Amsterdam Public Health Research Institute, and VU University Medical Center, Amsterdam, The Netherlands
| | - Natasja M van Schoor
- Amsterdam UMC, Amsterdam Public Health Research Institute, and VU University Medical Center, Amsterdam, The Netherlands
| | - Laura A Schaap
- Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | | | | | | | | | - Ángel Otero
- Universidad Autonoma de Madrid, Madrid, Spain
| | | | - Dorly J H Deeg
- Amsterdam UMC, Amsterdam Public Health Research Institute, and VU University Medical Center, Amsterdam, The Netherlands
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Shirinsky I, Shirinsky V, Filatova K, Yu Z, Chi Y, Thompson JY, Bleakley C. Curcuma longa (turmeric) or its active ingredients for osteoarthritis. Hippokratia 2021. [DOI: 10.1002/14651858.cd014683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Ivan Shirinsky
- Laboratory of Clinical Immunopharmacology; Federal State Budgetary Scientific Institution Research Institute of Fundamental and Clinical Immunology; Novosibirsk Russian Federation
| | - Valery Shirinsky
- Laboratory of Clinical Immunopharmacology; Federal State Budgetary Scientific Institution Research Institute of Fundamental and Clinical Immunology; Novosibirsk Russian Federation
| | - Katerina Filatova
- Laboratory of Clinical Immunopharmacology; Federal State Budgetary Scientific Institution Research Institute of Fundamental and Clinical Immunology; Novosibirsk Russian Federation
| | - Zeyu Yu
- Centre for Evidence-Based Chinese Medicine; Beijing University of Chinese Medicine; Beijing China
| | - Yuan Chi
- Yealth Network; Beijing Yealth Technology Co., Ltd; Beijing China
| | - Jacqueline Y Thompson
- Birmingham Acute Care Research Group, Institute of Inflammation and Ageing; University of Birmingham; Birmingham UK
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Current Epidemiology and Risk Factors for the Development of Hand Osteoarthritis. Curr Rheumatol Rep 2021; 23:61. [PMID: 34216294 DOI: 10.1007/s11926-021-01025-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/22/2021] [Indexed: 12/23/2022]
Abstract
PURPOSE OF REVIEW Hand osteoarthritis (hand OA), the most common peripheral arthritis in the world, is less studied than osteoarthritis (OA) of the knee and hip. However, it is uniquely situated to offer novel insight into OA as a disease process by removing weight-bearing as a confounder of systemic disease mechanisms. Here we review the epidemiology of hand OA and key risk factors for its development. RECENT FINDINGS Mounting evidence points to obesity as an important risk factor for hand OA development, with new evidence implicating a role for leptin and serum fatty acids. Disease progression in hand OA and specifically the erosive OA subtype may be associated with diabetes. New evidence supports an association between cardiovascular disease progression and symptomatic hand OA. Alcohol use may be associated with increased synovitis and erosive hand OA. Differences in ethnical distributions of hand OA have become more apparent, with a lower prevalence in Black patients compared to White patients. Novel genetic insights implicating the WNT gene pathway and IL-1β have led to novel potential targets in hand OA pathogenesis. Hand OA is a heterogeneous disease with many modifiable and non-modifiable risk factors that can determine disease severity and shed light on disease pathogenesis.
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Hand Erosive Osteoarthritis and Distal Interphalangeal Involvement in Psoriatic Arthritis: The Place of Conservative Therapy. J Clin Med 2021; 10:jcm10122630. [PMID: 34203754 PMCID: PMC8232729 DOI: 10.3390/jcm10122630] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 06/10/2021] [Accepted: 06/11/2021] [Indexed: 12/15/2022] Open
Abstract
Hand erosive osteoarthritis (HEOA) and Psoriatic Arthritis (PsA) with DIP involvement are common diseases affecting the hand. Both of them evolve with a progressive limitation in grip due to limited range of motion of the affected joints and stenosing tenosynovitis. Pharmacological options currently available (corticosteroids and clodronate or Idrossicloroquine) for the treatment of EHOA are mostly symptomatic and currently there are no effective drugs able to modify the course of the disease. In addition, data on drug effectiveness of PsA with DIP involvement are lacking. Conservative therapy should be considered in order to reduce pain and improve hand functionality. There are many studies debating a wide range of non-pharmacological intervention in the management of HEOA: joint protection program, range of motion and strengthening exercise, hand exercise with electromagnetic therapy, application of heat with paraffin wax or balneotherapy, occupational therapy and education. Concerning conservative treatment strategies to treat PsA, on the contrary, current evidence is still weak. Further research is needed to find the correct place of physical therapy to prevent stiffness and ankylosis due to the vicious circle of inflammation-pain-immobility-rigidity.
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Mohajer B, Kwee RM, Guermazi A, Berenbaum F, Wan M, Zhen G, Cao X, Haugen IK, Demehri S. Metabolic Syndrome and Osteoarthritis Distribution in the Hand Joints: A Propensity Score Matching Analysis From the Osteoarthritis Initiative. J Rheumatol 2021; 48:1608-1615. [PMID: 34329188 DOI: 10.3899/jrheum.210189] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/02/2021] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To investigate the metabolic syndrome (MetS) association with radiographic and symptomatic hand osteoarthritis (HOA). METHODS Using 1:2 propensity score matching for relevant confounders, we included 2509 participants (896 MetS positive and 1613 MetS negative) from the Osteoarthritis Initiative dataset. MetS and its components, according to the International Diabetes Federation criteria, were extracted from baseline data, and included hypertension, abdominal obesity, dyslipidemia, and diabetes. We scored distinct hand joints based on the modified Kellgren-Lawrence (mKL) grade of baseline radiographs, with HOA defined as mKL ≥ 2. In the cross-sectional analysis, we investigated the association between MetS and its components with radiographic HOA and the presence of nodal and erosive HOA phenotypes using regression models. In the longitudinal analysis, we performed Cox regression analysis for hand pain incidence in follow-up visits. RESULTS MetS was associated with higher odds of radiographic HOA, including the number of joints with OA (OR 1.32, 95% CI 1.08-1.62), the sum of joints mKLs (OR 2.42, 95% CI 1.24-4.71), mainly in distal interphalangeal joints (DIPs) and proximal interphalangeal joints (PIPs; OR 1.52, 95% CI 1.08-2.14 and OR 1.38, 95% CI 1.09-1.75, respectively), but not metacarpophalangeal (MCP) and first carpometacarpal (CMC1) joints. Hand pain incidence during follow-up was higher with MetS presence (HR 1.25, 95% CI 1.07-1.47). The erosive HOA phenotype and joints' nodal involvement were more frequent with MetS (OR 1.40, 95% CI 1.01-1.97 and OR 1.28, 95% CI 1.02-1.60, respectively). CONCLUSION MetS, a potentially modifiable risk factor, is associated with radiographic DIP and PIP OA and longitudinal hand pain incidence while sparing MCPs and CMC1s. Nodal and erosive HOA phenotypes are associated with MetS, suggestive of possible distinct pathophysiology.
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Affiliation(s)
- Bahram Mohajer
- This research was supported by the National Institutes of Health (NIH) National Institute on Aging under award number P01AG066603. The Osteoarthritis Initiative (OAI), a collaborative project between public and private sectors, includes 5 contracts: N01-AR-2-2258, N01-AR-2-2259, N01-AR-2-2260, N01-AR-2-2261, and N01-AR-2-2262. The OAI is conducted by the OAI project investigators and is financially supported by the National Institutes of Health (NIH). Private funding partners are Merck Research Laboratories, Novartis Pharmaceuticals Corporation, GlaxoSmithKline, and Pfizer Inc. In preparing this manuscript, publicly available OAI project datasets were used. The results of this work do not necessarily reflect the opinions of the OAI project investigators, the NIH, or the private funding partners. B. Mohajer, MD, MPH, S. Demehri, MD, Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; R.M. Kwee, MD, Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA, and Department of Radiology, Zuyderland Medical Center, Heerlen/Sittard/ Geleen, the Netherlands; A. Guermazi, MD, PhD, Department of Radiology, Boston University School of Medicine, Boston, Massachusetts, USA; F. Berenbaum, MD, PhD, Department of Rheumatology, Sorbonne Université, INSERM CRSA, AP-HP Hospital Saint Antoine, Paris, France; M. Wan, PhD, G. Zhen, MD, X. Cao, PhD, Department of Orthopedic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; I.K. Haugen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway. AG has received funding from MerckSerono, AstraZeneca, Galapagos, Pfizer, Roche, TissueGene ( for consultation), and Boston Imaging Core Lab (as the president and stockholder). SD has received funding from Toshiba Medical Systems ( for consultation) and grants from the GE Radiology Research Academic Fellowship and Carestream Health ( for a clinical trial study). IH has received funding from the Southeastern Norway Health Authority. None of the authors have any conflicting personal or financial relationships that could have influenced the results of this study. The other authors have no competing interests to declare. Address correspondence to Dr. B. Mohajer, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 601 N Caroline St, JHOC 5165, Baltimore, MD 21287, USA. . Accepted for publication June 2, 2021
| | - Robert M Kwee
- This research was supported by the National Institutes of Health (NIH) National Institute on Aging under award number P01AG066603. The Osteoarthritis Initiative (OAI), a collaborative project between public and private sectors, includes 5 contracts: N01-AR-2-2258, N01-AR-2-2259, N01-AR-2-2260, N01-AR-2-2261, and N01-AR-2-2262. The OAI is conducted by the OAI project investigators and is financially supported by the National Institutes of Health (NIH). Private funding partners are Merck Research Laboratories, Novartis Pharmaceuticals Corporation, GlaxoSmithKline, and Pfizer Inc. In preparing this manuscript, publicly available OAI project datasets were used. The results of this work do not necessarily reflect the opinions of the OAI project investigators, the NIH, or the private funding partners. B. Mohajer, MD, MPH, S. Demehri, MD, Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; R.M. Kwee, MD, Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA, and Department of Radiology, Zuyderland Medical Center, Heerlen/Sittard/ Geleen, the Netherlands; A. Guermazi, MD, PhD, Department of Radiology, Boston University School of Medicine, Boston, Massachusetts, USA; F. Berenbaum, MD, PhD, Department of Rheumatology, Sorbonne Université, INSERM CRSA, AP-HP Hospital Saint Antoine, Paris, France; M. Wan, PhD, G. Zhen, MD, X. Cao, PhD, Department of Orthopedic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; I.K. Haugen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway. AG has received funding from MerckSerono, AstraZeneca, Galapagos, Pfizer, Roche, TissueGene ( for consultation), and Boston Imaging Core Lab (as the president and stockholder). SD has received funding from Toshiba Medical Systems ( for consultation) and grants from the GE Radiology Research Academic Fellowship and Carestream Health ( for a clinical trial study). IH has received funding from the Southeastern Norway Health Authority. None of the authors have any conflicting personal or financial relationships that could have influenced the results of this study. The other authors have no competing interests to declare. Address correspondence to Dr. B. Mohajer, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 601 N Caroline St, JHOC 5165, Baltimore, MD 21287, USA. . Accepted for publication June 2, 2021
| | - Ali Guermazi
- This research was supported by the National Institutes of Health (NIH) National Institute on Aging under award number P01AG066603. The Osteoarthritis Initiative (OAI), a collaborative project between public and private sectors, includes 5 contracts: N01-AR-2-2258, N01-AR-2-2259, N01-AR-2-2260, N01-AR-2-2261, and N01-AR-2-2262. The OAI is conducted by the OAI project investigators and is financially supported by the National Institutes of Health (NIH). Private funding partners are Merck Research Laboratories, Novartis Pharmaceuticals Corporation, GlaxoSmithKline, and Pfizer Inc. In preparing this manuscript, publicly available OAI project datasets were used. The results of this work do not necessarily reflect the opinions of the OAI project investigators, the NIH, or the private funding partners. B. Mohajer, MD, MPH, S. Demehri, MD, Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; R.M. Kwee, MD, Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA, and Department of Radiology, Zuyderland Medical Center, Heerlen/Sittard/ Geleen, the Netherlands; A. Guermazi, MD, PhD, Department of Radiology, Boston University School of Medicine, Boston, Massachusetts, USA; F. Berenbaum, MD, PhD, Department of Rheumatology, Sorbonne Université, INSERM CRSA, AP-HP Hospital Saint Antoine, Paris, France; M. Wan, PhD, G. Zhen, MD, X. Cao, PhD, Department of Orthopedic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; I.K. Haugen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway. AG has received funding from MerckSerono, AstraZeneca, Galapagos, Pfizer, Roche, TissueGene ( for consultation), and Boston Imaging Core Lab (as the president and stockholder). SD has received funding from Toshiba Medical Systems ( for consultation) and grants from the GE Radiology Research Academic Fellowship and Carestream Health ( for a clinical trial study). IH has received funding from the Southeastern Norway Health Authority. None of the authors have any conflicting personal or financial relationships that could have influenced the results of this study. The other authors have no competing interests to declare. Address correspondence to Dr. B. Mohajer, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 601 N Caroline St, JHOC 5165, Baltimore, MD 21287, USA. . Accepted for publication June 2, 2021
| | - Francis Berenbaum
- This research was supported by the National Institutes of Health (NIH) National Institute on Aging under award number P01AG066603. The Osteoarthritis Initiative (OAI), a collaborative project between public and private sectors, includes 5 contracts: N01-AR-2-2258, N01-AR-2-2259, N01-AR-2-2260, N01-AR-2-2261, and N01-AR-2-2262. The OAI is conducted by the OAI project investigators and is financially supported by the National Institutes of Health (NIH). Private funding partners are Merck Research Laboratories, Novartis Pharmaceuticals Corporation, GlaxoSmithKline, and Pfizer Inc. In preparing this manuscript, publicly available OAI project datasets were used. The results of this work do not necessarily reflect the opinions of the OAI project investigators, the NIH, or the private funding partners. B. Mohajer, MD, MPH, S. Demehri, MD, Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; R.M. Kwee, MD, Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA, and Department of Radiology, Zuyderland Medical Center, Heerlen/Sittard/ Geleen, the Netherlands; A. Guermazi, MD, PhD, Department of Radiology, Boston University School of Medicine, Boston, Massachusetts, USA; F. Berenbaum, MD, PhD, Department of Rheumatology, Sorbonne Université, INSERM CRSA, AP-HP Hospital Saint Antoine, Paris, France; M. Wan, PhD, G. Zhen, MD, X. Cao, PhD, Department of Orthopedic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; I.K. Haugen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway. AG has received funding from MerckSerono, AstraZeneca, Galapagos, Pfizer, Roche, TissueGene ( for consultation), and Boston Imaging Core Lab (as the president and stockholder). SD has received funding from Toshiba Medical Systems ( for consultation) and grants from the GE Radiology Research Academic Fellowship and Carestream Health ( for a clinical trial study). IH has received funding from the Southeastern Norway Health Authority. None of the authors have any conflicting personal or financial relationships that could have influenced the results of this study. The other authors have no competing interests to declare. Address correspondence to Dr. B. Mohajer, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 601 N Caroline St, JHOC 5165, Baltimore, MD 21287, USA. . Accepted for publication June 2, 2021
| | - Mei Wan
- This research was supported by the National Institutes of Health (NIH) National Institute on Aging under award number P01AG066603. The Osteoarthritis Initiative (OAI), a collaborative project between public and private sectors, includes 5 contracts: N01-AR-2-2258, N01-AR-2-2259, N01-AR-2-2260, N01-AR-2-2261, and N01-AR-2-2262. The OAI is conducted by the OAI project investigators and is financially supported by the National Institutes of Health (NIH). Private funding partners are Merck Research Laboratories, Novartis Pharmaceuticals Corporation, GlaxoSmithKline, and Pfizer Inc. In preparing this manuscript, publicly available OAI project datasets were used. The results of this work do not necessarily reflect the opinions of the OAI project investigators, the NIH, or the private funding partners. B. Mohajer, MD, MPH, S. Demehri, MD, Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; R.M. Kwee, MD, Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA, and Department of Radiology, Zuyderland Medical Center, Heerlen/Sittard/ Geleen, the Netherlands; A. Guermazi, MD, PhD, Department of Radiology, Boston University School of Medicine, Boston, Massachusetts, USA; F. Berenbaum, MD, PhD, Department of Rheumatology, Sorbonne Université, INSERM CRSA, AP-HP Hospital Saint Antoine, Paris, France; M. Wan, PhD, G. Zhen, MD, X. Cao, PhD, Department of Orthopedic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; I.K. Haugen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway. AG has received funding from MerckSerono, AstraZeneca, Galapagos, Pfizer, Roche, TissueGene ( for consultation), and Boston Imaging Core Lab (as the president and stockholder). SD has received funding from Toshiba Medical Systems ( for consultation) and grants from the GE Radiology Research Academic Fellowship and Carestream Health ( for a clinical trial study). IH has received funding from the Southeastern Norway Health Authority. None of the authors have any conflicting personal or financial relationships that could have influenced the results of this study. The other authors have no competing interests to declare. Address correspondence to Dr. B. Mohajer, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 601 N Caroline St, JHOC 5165, Baltimore, MD 21287, USA. . Accepted for publication June 2, 2021
| | - Gehua Zhen
- This research was supported by the National Institutes of Health (NIH) National Institute on Aging under award number P01AG066603. The Osteoarthritis Initiative (OAI), a collaborative project between public and private sectors, includes 5 contracts: N01-AR-2-2258, N01-AR-2-2259, N01-AR-2-2260, N01-AR-2-2261, and N01-AR-2-2262. The OAI is conducted by the OAI project investigators and is financially supported by the National Institutes of Health (NIH). Private funding partners are Merck Research Laboratories, Novartis Pharmaceuticals Corporation, GlaxoSmithKline, and Pfizer Inc. In preparing this manuscript, publicly available OAI project datasets were used. The results of this work do not necessarily reflect the opinions of the OAI project investigators, the NIH, or the private funding partners. B. Mohajer, MD, MPH, S. Demehri, MD, Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; R.M. Kwee, MD, Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA, and Department of Radiology, Zuyderland Medical Center, Heerlen/Sittard/ Geleen, the Netherlands; A. Guermazi, MD, PhD, Department of Radiology, Boston University School of Medicine, Boston, Massachusetts, USA; F. Berenbaum, MD, PhD, Department of Rheumatology, Sorbonne Université, INSERM CRSA, AP-HP Hospital Saint Antoine, Paris, France; M. Wan, PhD, G. Zhen, MD, X. Cao, PhD, Department of Orthopedic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; I.K. Haugen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway. AG has received funding from MerckSerono, AstraZeneca, Galapagos, Pfizer, Roche, TissueGene ( for consultation), and Boston Imaging Core Lab (as the president and stockholder). SD has received funding from Toshiba Medical Systems ( for consultation) and grants from the GE Radiology Research Academic Fellowship and Carestream Health ( for a clinical trial study). IH has received funding from the Southeastern Norway Health Authority. None of the authors have any conflicting personal or financial relationships that could have influenced the results of this study. The other authors have no competing interests to declare. Address correspondence to Dr. B. Mohajer, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 601 N Caroline St, JHOC 5165, Baltimore, MD 21287, USA. . Accepted for publication June 2, 2021
| | - Xu Cao
- This research was supported by the National Institutes of Health (NIH) National Institute on Aging under award number P01AG066603. The Osteoarthritis Initiative (OAI), a collaborative project between public and private sectors, includes 5 contracts: N01-AR-2-2258, N01-AR-2-2259, N01-AR-2-2260, N01-AR-2-2261, and N01-AR-2-2262. The OAI is conducted by the OAI project investigators and is financially supported by the National Institutes of Health (NIH). Private funding partners are Merck Research Laboratories, Novartis Pharmaceuticals Corporation, GlaxoSmithKline, and Pfizer Inc. In preparing this manuscript, publicly available OAI project datasets were used. The results of this work do not necessarily reflect the opinions of the OAI project investigators, the NIH, or the private funding partners. B. Mohajer, MD, MPH, S. Demehri, MD, Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; R.M. Kwee, MD, Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA, and Department of Radiology, Zuyderland Medical Center, Heerlen/Sittard/ Geleen, the Netherlands; A. Guermazi, MD, PhD, Department of Radiology, Boston University School of Medicine, Boston, Massachusetts, USA; F. Berenbaum, MD, PhD, Department of Rheumatology, Sorbonne Université, INSERM CRSA, AP-HP Hospital Saint Antoine, Paris, France; M. Wan, PhD, G. Zhen, MD, X. Cao, PhD, Department of Orthopedic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; I.K. Haugen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway. AG has received funding from MerckSerono, AstraZeneca, Galapagos, Pfizer, Roche, TissueGene ( for consultation), and Boston Imaging Core Lab (as the president and stockholder). SD has received funding from Toshiba Medical Systems ( for consultation) and grants from the GE Radiology Research Academic Fellowship and Carestream Health ( for a clinical trial study). IH has received funding from the Southeastern Norway Health Authority. None of the authors have any conflicting personal or financial relationships that could have influenced the results of this study. The other authors have no competing interests to declare. Address correspondence to Dr. B. Mohajer, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 601 N Caroline St, JHOC 5165, Baltimore, MD 21287, USA. . Accepted for publication June 2, 2021
| | - Ida K Haugen
- This research was supported by the National Institutes of Health (NIH) National Institute on Aging under award number P01AG066603. The Osteoarthritis Initiative (OAI), a collaborative project between public and private sectors, includes 5 contracts: N01-AR-2-2258, N01-AR-2-2259, N01-AR-2-2260, N01-AR-2-2261, and N01-AR-2-2262. The OAI is conducted by the OAI project investigators and is financially supported by the National Institutes of Health (NIH). Private funding partners are Merck Research Laboratories, Novartis Pharmaceuticals Corporation, GlaxoSmithKline, and Pfizer Inc. In preparing this manuscript, publicly available OAI project datasets were used. The results of this work do not necessarily reflect the opinions of the OAI project investigators, the NIH, or the private funding partners. B. Mohajer, MD, MPH, S. Demehri, MD, Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; R.M. Kwee, MD, Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA, and Department of Radiology, Zuyderland Medical Center, Heerlen/Sittard/ Geleen, the Netherlands; A. Guermazi, MD, PhD, Department of Radiology, Boston University School of Medicine, Boston, Massachusetts, USA; F. Berenbaum, MD, PhD, Department of Rheumatology, Sorbonne Université, INSERM CRSA, AP-HP Hospital Saint Antoine, Paris, France; M. Wan, PhD, G. Zhen, MD, X. Cao, PhD, Department of Orthopedic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; I.K. Haugen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway. AG has received funding from MerckSerono, AstraZeneca, Galapagos, Pfizer, Roche, TissueGene ( for consultation), and Boston Imaging Core Lab (as the president and stockholder). SD has received funding from Toshiba Medical Systems ( for consultation) and grants from the GE Radiology Research Academic Fellowship and Carestream Health ( for a clinical trial study). IH has received funding from the Southeastern Norway Health Authority. None of the authors have any conflicting personal or financial relationships that could have influenced the results of this study. The other authors have no competing interests to declare. Address correspondence to Dr. B. Mohajer, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 601 N Caroline St, JHOC 5165, Baltimore, MD 21287, USA. . Accepted for publication June 2, 2021
| | - Shadpour Demehri
- This research was supported by the National Institutes of Health (NIH) National Institute on Aging under award number P01AG066603. The Osteoarthritis Initiative (OAI), a collaborative project between public and private sectors, includes 5 contracts: N01-AR-2-2258, N01-AR-2-2259, N01-AR-2-2260, N01-AR-2-2261, and N01-AR-2-2262. The OAI is conducted by the OAI project investigators and is financially supported by the National Institutes of Health (NIH). Private funding partners are Merck Research Laboratories, Novartis Pharmaceuticals Corporation, GlaxoSmithKline, and Pfizer Inc. In preparing this manuscript, publicly available OAI project datasets were used. The results of this work do not necessarily reflect the opinions of the OAI project investigators, the NIH, or the private funding partners. B. Mohajer, MD, MPH, S. Demehri, MD, Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; R.M. Kwee, MD, Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA, and Department of Radiology, Zuyderland Medical Center, Heerlen/Sittard/ Geleen, the Netherlands; A. Guermazi, MD, PhD, Department of Radiology, Boston University School of Medicine, Boston, Massachusetts, USA; F. Berenbaum, MD, PhD, Department of Rheumatology, Sorbonne Université, INSERM CRSA, AP-HP Hospital Saint Antoine, Paris, France; M. Wan, PhD, G. Zhen, MD, X. Cao, PhD, Department of Orthopedic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; I.K. Haugen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway. AG has received funding from MerckSerono, AstraZeneca, Galapagos, Pfizer, Roche, TissueGene ( for consultation), and Boston Imaging Core Lab (as the president and stockholder). SD has received funding from Toshiba Medical Systems ( for consultation) and grants from the GE Radiology Research Academic Fellowship and Carestream Health ( for a clinical trial study). IH has received funding from the Southeastern Norway Health Authority. None of the authors have any conflicting personal or financial relationships that could have influenced the results of this study. The other authors have no competing interests to declare. Address correspondence to Dr. B. Mohajer, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 601 N Caroline St, JHOC 5165, Baltimore, MD 21287, USA. . Accepted for publication June 2, 2021
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Translation, cultural adaptation and reproducibility of a Portuguese version of the Functional Index for Hand OsteoArthritis (FIHOA). Adv Rheumatol 2021; 61:30. [PMID: 34090513 DOI: 10.1186/s42358-021-00189-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 05/20/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Functional Index for Hand Osteoarthritis (FIHOA) is a simple, reliable, and reproducible specific instrument to evaluate hand OA that can be applied both in clinical practice and research protocols. In order to be used in Brazil, FIHOA has to be translated into Portuguese, culturally adapted and have the reliability of the translated FIHOA version tested, which is the purpose of this study. METHODS The FIHOA was translated into Brazilian Portuguese and administered to 68 patients with hand OA recruited between May 2019 and February 2020. The test-retest was applied to 32 patients and the reliability was assessed using Spearman's correlation coefficient and intraclass correlation coefficient (ICC). The internal consistency reliability was evaluated using Cronbach's alpha. External construction validity was assessed using the Spearman's correlation test between FIHOA and pain, assessed with a Visual Analogue Scale (VAS), the Cochin Hand Functional Scale (CHFS) and Health Assessment Questionnaire (HAQ). RESULTS The 30 participants that initially answered the translated version of the FiHOA did not report difficulties in understanding or interpreting the translated version. The test-retest reliability for the total score was strong (r = 0.86; ICC = 0.89). Mean differences (1.37 ± 0.68) using Bland Altman's analysis did not significantly differ from zero and no systematic bias was observed. Cronbach's alpha was also high (0.89) suggesting a strong internal coherence in the test items. There were also correlations between FIHOA and the CHFS (r = 0.88), HAQ (r = 0.64) and pain in the hands both at rest (r = 0.55) and in motion (r = 0.44). CONCLUSION The translation of the FIHOA into Brazilian Portuguese proved a valid instrument for measuring the functional capacity of patients with hand OA who understand Brazilian Portuguese.
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Umezawa Y. Psoriatic arthritis. J Dermatol 2021; 48:741-749. [PMID: 34060132 DOI: 10.1111/1346-8138.15954] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 04/15/2021] [Accepted: 04/16/2021] [Indexed: 12/11/2022]
Abstract
Psoriatic arthritis (PsA) is a chronic inflammatory arthritis associated with psoriasis. It is found in approximately 10% of psoriatic patients in Japan. PsA mainly affects the peripheral joints, spine, and/or sacroiliac joints. Left untreated, there is progressive, irreversible bone destruction leading to joint deformation and dysfunction. Before the era of biologic treatments, the diagnosis of PsA was difficult and available treatments were limited. Over time the pathology of PsA has become better understood, and many treatments now exist. Early detection and treatment of impending joint deformities are necessary to avoid impairment of PsA patients' quality of life. Most patients develop the arthritis following the onset of the skin manifestations of psoriasis. The process of diagnosing PsA sometimes encounters difficulties because some patients may not show radiographic findings in the early stage, and may have normal levels of C-reactive protein and matrix metalloproteinase-3. For these cases, approaches such as magnetic resonance imaging or ultrasound imaging, as well as symptom questionnaires, are helpful. Currently, non-steroidal anti-inflammatory drugs, disease-modifying antirheumatic drugs, and several biologics are the main treatments for PsA, which when used with an aggressive approach, will result in better patient outcomes.
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Affiliation(s)
- Yoshinori Umezawa
- Department of Dermatology, The Jikei University School of Medicine, Tokyo, Japan
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50
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Zeng T, Tan L, Wu Y, Yu J. 14-3-3η Protein in Rheumatoid Arthritis: Promising Diagnostic Marker and Independent Risk Factor for Osteoporosis. Lab Med 2021; 51:529-539. [PMID: 32080735 DOI: 10.1093/labmed/lmaa001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Early identification and disease monitoring are challenges facing rheumatologists in the management of rheumatoid arthritis (RA). METHODS We utilized enzyme-linked immunosorbent assay (ELISA) to determine 14-3-3η and anticyclic citrullinated peptide antibody (anti-CCP) levels, with rheumatoid factor (RF) level detected by rate nephelometry. The diagnostic value of each index was determined via receiver operating characteristic (ROC) curve, and the association between 14-3-3η and osteoporosis was assessed using multiple logistic regression analysis. RESULTS Serum levels of 14-3-3η were 3.26 ng per mL in patients with RA. These levels were helpful in identifying patients with the disease, with the area under the curve (AUC) being 0.879 and 0.853, respectively, from all healthy control individuals and patients with RA. Combining 14-3-3η with RF or anti-CCP increased the diagnostic rate. Logistic regression analysis identified 14-3-3η as an independent risk factor for RA-related osteoporosis (odds ratio [OR], 1.503; 95% confidence interval [CI], 1.116-2.025; P <.01). CONCLUSIONS Serum 14-3-3η detection by itself or combined with other serum indices was helpful in differentiating patients with RA. Also, it was a promising biomarker for disease monitoring in RA.
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Affiliation(s)
- Tingting Zeng
- The First Affiliated Hospital of Nanchang University
| | - Liming Tan
- Key Laboratory of Laboratory Medicine in Jiangxi Province, Department of Clinical Laboratory, the Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Yang Wu
- Key Laboratory of Laboratory Medicine in Jiangxi Province, Department of Clinical Laboratory, the Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Jianlin Yu
- Key Laboratory of Laboratory Medicine in Jiangxi Province, Department of Clinical Laboratory, the Second Affiliated Hospital of Nanchang University, Nanchang, China
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