Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands.
Ann Rheum Dis. 2011 Oct;70(10):1835-7. doi: 10.1136/ard.2010.147553. Epub 2011 Jul 8.
To study the associations between structural abnormalities on ultrasound (US) or conventional x-rays (CR) and pain in hand osteoarthritis (HOA).
In 55 consecutive patients with HOA (mean age 61 years, 86% women) fulfilling the American College of Rheumatology criteria, pain in 30 separate hand joints was assessed upon palpation; osteophytes were assessed by US and CR and joint space narrowing (JSN) by CR. Associations between structural abnormalities and pain per joint were analysed using generalised estimated equations to account for patient effects and adjusted for age, sex, body mass index, US inflammatory features and other remaining structural abnormalities.
In 1649 joints, 69% and 46% had osteophytes on US and CR, respectively and 47% had JSN. Osteophytes and JSN showed independent associations with pain per joint adjusted: OR for osteophytes: 4.8 (95% CI 3.1 to 7.5) for US and 4.1 (95% CI 2.4 to 7.1) for CR; for JSN: 4.2 (95% CI 2.0 to 9.0).
Osteophytes and JSN are independently associated with pain in individual HOA joints, taking into account patient effects.
研究超声(US)或常规 X 射线(CR)结构异常与手部骨关节炎(HOA)疼痛之间的关系。
在 55 例符合美国风湿病学会标准的连续手部 HOA 患者(平均年龄 61 岁,86%为女性)中,对 30 个单独手部关节的触诊疼痛进行评估;使用 US 和 CR 评估骨赘,使用 CR 评估关节间隙狭窄(JSN)。使用广义估计方程分析每个关节的结构异常与疼痛之间的关系,以考虑患者的影响,并根据年龄、性别、体重指数、US 炎症特征和其他剩余的结构异常进行调整。
在 1649 个关节中,分别有 69%和 46%在 US 和 CR 上有骨赘,47%有 JSN。骨赘和 JSN 与疼痛之间存在独立的相关性,调整后比值比(OR)为:US 上的骨赘为 4.8(95%CI 3.1 至 7.5),CR 上的骨赘为 4.1(95%CI 2.4 至 7.1);对于 JSN:4.2(95%CI 2.0 至 9.0)。
在考虑患者影响的情况下,骨赘和 JSN 与个别 HOA 关节的疼痛独立相关。