Leiden University Medical Center, Leiden, The Netherlands, and Flevoziekenhuis, Almere, The Netherlands.
Leiden University Medical Center, Leiden, The Netherlands.
Arthritis Rheumatol. 2016 Feb;68(2):392-7. doi: 10.1002/art.39438.
To investigate the association between features of ultrasound-detected inflammation and development of erosive disease in patients with hand osteoarthritis (OA) over 2.3 years of followup.
The study group comprised 56 consecutive patients with hand OA (mean age 61 years, 86% female) fulfilling the American College of Rheumatology criteria. Effusion, synovial thickening, and power Doppler signal in all interphalangeal (IP) joints were assessed with ultrasonography, using standardized methods, at baseline and followup. Radiographs were scored at both time points for osteophytes/joint space narrowing using the Osteoarthritis Research Society International method and for erosive disease (E phase [erosive] and R phase [remodeling]) using the method described by Verbruggen and Veys. Erosion development was defined as progression from N phase (normal) to E phase or R phase. Joints that were in E phase or R phase at baseline were excluded. Associations were analyzed using generalized estimating equations with adjustment for age, sex, body mass index, and baseline structural abnormalities.
At baseline, 51 IP joints (in 18 patients) and at followup 89 IP joints (in 26 patients) had erosions; thus, erosions developed in 38 IP joints. Moderate/severe synovial thickening and a power Doppler signal at baseline were associated with erosion development (adjusted odds ratio [OR] 8.8, 95% confidence interval [95% CI] 2.4-32.3 and OR 7.1, 95% CI 1.9-26.9, respectively). Persistent inflammation was particularly associated with the development of erosions.
Ultrasound-detected features of inflammation are associated with the development of erosions in patients with hand OA, suggesting that inflammation plays a role in the pathogenesis of hand OA and could be a therapeutic target.
在 2.3 年的随访中，研究超声检测炎症特征与手部骨关节炎（OA）患者侵蚀性疾病发展之间的关系。
研究组包括 56 例连续手部 OA 患者（平均年龄 61 岁，86%为女性），符合美国风湿病学会标准。使用标准化方法在基线和随访时评估所有指间关节（IP）的积液、滑膜增厚和功率多普勒信号。在这两个时间点，使用 Osteoarthritis Research Society International 方法对骨赘/关节间隙狭窄进行评分，使用 Verbruggen 和 Veys 描述的方法对侵蚀性疾病（E 期[侵蚀性]和 R 期[重塑]）进行评分。侵蚀性疾病的发展定义为从 N 期（正常）进展为 E 期或 R 期。基线时处于 E 期或 R 期的关节被排除在外。使用广义估计方程分析与年龄、性别、体重指数和基线结构异常相关的相关性。
基线时 51 个 IP 关节（18 个患者）和随访时 89 个 IP 关节（26 个患者）有侵蚀性疾病，因此有 38 个 IP 关节出现侵蚀性疾病。基线时中度/重度滑膜增厚和功率多普勒信号与侵蚀性疾病的发展相关（调整后的优势比[OR] 8.8，95%置信区间[95%CI] 2.4-32.3 和 OR 7.1，95%CI 1.9-26.9）。持续性炎症与侵蚀性疾病的发展尤其相关。
超声检测到的炎症特征与手部 OA 患者的侵蚀性疾病的发展有关，这表明炎症在手部 OA 的发病机制中起作用，可能成为治疗靶点。
