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手部骨关节炎中的掌指关节损伤及其与机械因素的关联:来自数字队列骨关节炎设计手部骨关节炎队列的结果

Metacarpophalangeal Joint Impairment in Hand Osteoarthritis and Its Association With Mechanical Factors: Results From the Digital Cohort Osteoarthritis Design Hand Osteoarthritis Cohort.

作者信息

Kouki Inès, Tuffet Sophie, Crema Michel D, Rousseau Alexandra, Richette Pascal, Dougados Maxime, Berenbaum Francis, Sellam Jérémie, Courties Alice

机构信息

Sorbonne University, Saint-Antoine Hospital, Assistance Publique-Hôpitaux de Paris, and CRSA Inserm UMRS_938, Paris, France.

Sorbonne University, Saint-Antoine Hospital, and Assistance Publique-Hôpitaux de Paris, Paris, France.

出版信息

Arthritis Care Res (Hoboken). 2022 Oct;74(10):1696-1703. doi: 10.1002/acr.24642. Epub 2022 Jul 16.

Abstract

OBJECTIVE

To determine the prevalence, distribution, and characteristics associated with radiographic metacarpophalangeal (MCP) joint osteoarthritis (OA).

METHODS

This was a cross-sectional study of baseline data from the Digital Cohort Osteoarthritis Design, a French monocentric cohort including patients with symptomatic hand OA. We evaluated the prevalence of radiographic MCP joint OA, defined as ≥2 MCP joints with a Kellgren/Lawrence score of ≥2. We compared the prevalence of MCP joint OA in the dominant and nondominant hands. Associations between radiographic MCP joint OA and patient characteristics were studied using univariable and multivariable logistic regression.

RESULTS

Radiographic MCP joint OA was present in 138 of the 425 patients (32.5%) but was not severe. Patients with MCP joint OA had a mean age of 69.2 ± 6.9 years, a body mass index of 25 ± 4.2 kg/m , and 86.2% were women. MCP joint OA was more frequent in the dominant hand and predominated at the first and second MCP joints. In the multivariable analysis, MCP joint OA was associated with older age (odds ratio [OR] 1.05 [95% confidence interval (95% CI) 1.01, 1.10] for each year), manual occupation (OR 3.74 [95% CI 1.21, 11.54]), scaphotrapezial OA (OR 2.18 [95% CI 1.27, 3.72]), and a high number of proximal interphalangeal joints with radiographic OA. MCP joint OA was not associated with metabolic syndrome or hand OA symptoms.

CONCLUSION

In this cross-sectional study using a hospital-based hand OA cohort, radiographic MCP joint OA was frequent and associated with structural hand OA features rather than with symptom severity. Our results suggest that the involvement of MCP joints in hand OA is predominantly related to mechanical rather than systemic factors in this population.

摘要

目的

确定影像学掌指(MCP)关节骨关节炎(OA)的患病率、分布情况及相关特征。

方法

这是一项对数字队列骨关节炎设计的基线数据进行的横断面研究,该研究为法国单中心队列研究,纳入有症状手部OA患者。我们评估了影像学MCP关节OA的患病率,其定义为≥2个MCP关节的Kellgren/Lawrence评分≥2。我们比较了优势手和非优势手中MCP关节OA的患病率。使用单变量和多变量逻辑回归研究影像学MCP关节OA与患者特征之间的关联。

结果

425例患者中有138例(32.5%)存在影像学MCP关节OA,但并不严重。MCP关节OA患者的平均年龄为69.2±6.9岁,体重指数为25±4.2kg/m²,86.2%为女性。MCP关节OA在优势手中更常见,且在第一和第二MCP关节处占主导。在多变量分析中,MCP关节OA与年龄较大(每年的比值比[OR]为1.05[95%置信区间(95%CI)为1.01,1.10])、体力劳动职业(OR为3.74[95%CI为1.21,11.54])、舟大多角骨OA(OR为2.18[95%CI为1.27,3.72])以及大量存在影像学OA的近端指间关节有关。MCP关节OA与代谢综合征或手部OA症状无关。

结论

在这项使用基于医院的手部OA队列的横断面研究中,影像学MCP关节OA很常见,且与手部OA的结构特征相关,而非与症状严重程度相关。我们的结果表明,在该人群中,手部OA中MCP关节的受累主要与机械因素而非全身因素有关。

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