Ramonda Roberta, Frallonardo Paola, Musacchio Estella, Vio Stefania, Punzi Leonardo
Rheumatology Unit, Department of Medicine DIMED, University of Padua, Via Giustiniani, 2, 35128, Padua, Italy,
Clin Rheumatol. 2014 Jan;33(1):11-9. doi: 10.1007/s10067-013-2404-2. Epub 2013 Oct 8.
Hand osteoarthritis (OA) is a common disease frequently affecting middle-aged women. Prevalence estimates for OA vary widely depending on the age and sex of the population studied, the assessment tools used, and the specific joint sites analyzed OA is characterized by the degradation of articular cartilage, subchondral bone changes and osteophyte formation at the joint margins leading to joint failure. The pathogenesis of the disease and its evolution are multifactorial involving biomechanical, metabolic, hormonal, and genetic factors. Moreover, the role of inflammation has recently been advanced as pivotal in OA onset and progression. In particular, an uncommon variant of hand OA, erosive hand OA, is characterized by inflammatory and degenerative interphalangeal proximal and distal joints. The diagnosis of different types of hand OA is centered on clinical and laboratory investigations which can distinguish the peculiar aspects of these forms. Joint and bone assessments in hand OA are widely studied but there is no agreement with regard to established parameters to make a definitive diagnosis. This report focuses on the laboratory and clinimetric assessments that can be used to distinguish hand OA subtypes and addresses the debatable association with low bone mineral density in osteoporosis.
手部骨关节炎（OA）是一种常见疾病，常影响中年女性。OA的患病率估计差异很大，这取决于所研究人群的年龄和性别、所使用的评估工具以及所分析的特定关节部位。OA的特征是关节软骨退化、软骨下骨改变以及关节边缘骨赘形成，最终导致关节功能丧失。该疾病的发病机制及其演变是多因素的，涉及生物力学、代谢、激素和遗传因素。此外，炎症在OA发病和进展中的关键作用最近也得到了进一步认识。特别是，手部OA的一种罕见变体——侵蚀性手部OA，其特征是指间近端和远端关节出现炎症和退变。不同类型手部OA的诊断主要基于临床和实验室检查，这些检查可以区分这些类型的独特方面。手部OA的关节和骨骼评估已得到广泛研究，但在用于明确诊断的既定参数方面尚未达成共识。本报告重点关注可用于区分手部OA亚型的实验室和临床测量评估，并探讨与骨质疏松症中低骨密度的争议性关联。
