通过摄影诊断的手部骨关节炎（HOASCORE）的年龄相关患病率。
Age related prevalence of hand osteoarthritis diagnosed by photography (HOASCORE).
作者信息
Jonsson Helgi
机构信息
Department of Rheumatology, Landspitalinn University Hospital, University of Iceland, Fossvogur IS 108, Reykjavik, Iceland.
出版信息
BMC Musculoskelet Disord. 2017 Dec 2;18(1):508. doi: 10.1186/s12891-017-1870-0.
BACKGROUND
Hand photography has been used in a number of studies to determine the presence and severity of hand osteoarthritis (HOA). The aim of this study was to present age and gender specific prevalences of HOA diagnosed by this method.
METHODS
Six thousand three hundred forty three photographs (from 3676 females and 2667 males aged 40-96) were scored for hand osteoarthritis by a 0-3 grade (0 = no evidence of OA, 1 = possible OA, 2 = definite OA and 3 = severe OA) for each of the three main sites, distal interphalangeal joints (DIP), proximal interphalangeal joints (PIP) and thumb base (CMC1). An aggregate score of 0-9 was thus obtained (HOASCORE) to reflect the severity of HOA in each case.
RESULTS
DIP joints were most commonly affected, followed by the thumb base and the PIP joints. Having definite DIP joint OA starts at a younger age compared with the other two sites, and there is a marked female preponderance in the age groups from 55 to 69, but after 70 the gender differences are less marked and the prevalence is fairly stable. PIP joint prevalence also indicates a female preponderance from 60 to 79. Thumb base OA has a more marked female preponderance and a rising prevalence thoughout life. The prevalence of individuals with no evidence of photographic OA (HOASCORE = 0) drops from 88% to 57% between the age categories 40-49 and 50-54 and decreased to 33% in the 70-74 age group with a slower decline after that age. DIP and PIP prevalence were strongly associated with each other with an OR of 16.6(12.8-21.5),p < 0.001 of having definite OA at the other site. This was less marked for the thumb base with an OR of 2.2(1.8-2.7, p < 0.001), and 2.7(2.0-3.5, p < 0.001) of having definite DIP or PIP HOA respectively.
CONCLUSIONS
The prevalence of hand OA in DIP, PIP and thumb base joints obtained by the photographic HOASCORE method is higher in women and increases after the age of fifty. These results are in line with those obtained by clinical examination and radiography. The advantage of the method lies in easy applicability and low cost.
背景
手部摄影已在多项研究中用于确定手部骨关节炎（HOA）的存在及严重程度。本研究的目的是呈现通过该方法诊断出的HOA的年龄和性别特异性患病率。
方法
对6343张照片（来自3676名40 - 96岁女性和2667名40 - 96岁男性）进行手部骨关节炎评分，对三个主要部位，即远端指间关节（DIP）、近端指间关节（PIP）和拇指基部（CMC1），每个部位按0 - 3级评分（0 =无骨关节炎证据，1 =可能有骨关节炎，2 =肯定有骨关节炎，3 =严重骨关节炎）。由此获得0 - 9的总分（HOASCORE）以反映每个病例中HOA的严重程度。
结果
DIP关节最常受累，其次是拇指基部和PIP关节。与其他两个部位相比，肯定的DIP关节骨关节炎发病年龄较轻，在55至69岁年龄组中女性占明显优势，但70岁以后性别差异不明显且患病率相当稳定。PIP关节患病率在60至79岁之间也显示女性占优势。拇指基部骨关节炎女性占优势更明显且一生中患病率不断上升。无摄影骨关节炎证据（HOASCORE = 0）的个体患病率在40 - 49岁和50 - 54岁年龄组之间从88%降至57%，在70 - 74岁年龄组降至33%，此后下降速度较慢。DIP和PIP患病率彼此密切相关，在另一部位有肯定骨关节炎的比值比（OR）为16.6（12.8 - 21.5），p < 0.001。拇指基部的相关性较弱，有肯定DIP或PIP HOA的OR分别为2.2（1.8 - 2.7，p < 0.001）和2.7（2.0 - 3.5，p < 0.001）。
结论
通过摄影HOASCORE方法得出的DIP、PIP和拇指基部关节的手部骨关节炎患病率女性更高，且在50岁以后增加。这些结果与通过临床检查和X线摄影获得的结果一致。该方法的优点在于易于应用且成本低。
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