Kwok W Y, Kloppenburg M, Marshall M, Nicholls E, Rosendaal F R, Peat G
Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands.
Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands.
Osteoarthritis Cartilage. 2014 Jun;22(6):756-63. doi: 10.1016/j.joca.2014.03.012. Epub 2014 Mar 28.
To estimate the prevalence of erosive disease in first carpometacarpal joints (CMCJs) and investigate its clinical impact compared with radiographic thumb base (TB) osteoarthritis (OA).
Standardized assessments with hand radiographs were performed in participants of two population-based cohort studies in North Staffordshire with hand symptoms lasting ≥1 day in the past month. Erosive disease was defined as the presence of eroded or remodeled phase in ≥1 interphalangeal joint (IPJ) or first CMCJ following the Verbruggen-Veys classification. Hand pain and function were assessed with Australian/Canadian Hand Osteoarthritis Index (AUSCAN). Prevalence was estimated by dividing the number of persons with erosive lesions by population size. Linear and logistic regression analyses were used to contrast clinical determinants between persons with erosions and with radiographic TB OA. Results were presented as mean differences and odds ratios (ORs) with 95% confidence intervals (95% CI), adjusted for age, sex and radiographic severity.
1,076 participants were studied (60% women, mean age 64.7 years (SD 8.3); 24 persons had erosive disease in the TB. The prevalence of erosive disease in first CMCJs was 2.2% (95% CI 1.4, 3.3). Only 0.5% (95% CI 0.2, 1.2) had erosive disease affecting IPJs and first CMCJs combined. More persons with erosive disease of first CMCJs reported pain in their TB than persons with radiographic TB OA, AUSCAN pain and function scores were similar.
Erosive disease of first CMCJs was present in 2.2% of subjects with hand pain and was often not accompanied by erosions in IPJs. Erosive disease was associated with TB pain, but not with the level of pain, when compared with radiographic TB OA.
评估第一掌腕关节（CMCJ）侵蚀性疾病的患病率，并与影像学检查显示的拇指基底（TB）骨关节炎（OA）相比较，研究其临床影响。
对北斯塔福德郡两项基于人群的队列研究的参与者进行标准化手部X光片评估，这些参与者在过去一个月内手部症状持续≥1天。侵蚀性疾病根据Verbruggen-Veys分类法定义为在≥1个指间关节（IPJ）或第一掌腕关节中存在侵蚀或重塑期。使用澳大利亚/加拿大手部骨关节炎指数（AUSCAN）评估手部疼痛和功能。患病率通过侵蚀性病变患者人数除以总人数来估算。采用线性和逻辑回归分析对比有侵蚀性病变者与影像学检查显示TB OA者之间的临床决定因素。结果以平均差异和比值比（OR）及95%置信区间（95%CI）表示，并对年龄、性别和影像学严重程度进行了校正。
共研究了1076名参与者（60%为女性，平均年龄64.7岁（标准差8.3））；24人在TB处有侵蚀性疾病。第一掌腕关节侵蚀性疾病的患病率为2.2%（95%CI 1.4，3.3）。仅有0.5%（95%CI 0.2，1.2）的人侵蚀性疾病同时累及IPJ和第一掌腕关节。与影像学检查显示TB OA的人相比，更多第一掌腕关节有侵蚀性疾病的人报告其TB处疼痛，AUSCAN疼痛和功能评分相似。
手部疼痛的受试者中2.2%存在第一掌腕关节侵蚀性疾病，且通常不累及IPJ的侵蚀。与影像学检查显示的TB OA相比，侵蚀性疾病与TB疼痛相关，但与疼痛程度无关。
