Factors associated with radiographic progression of hand osteoarthritis over 2 years

To characterise radiographic progression over 2 years and associated characteristics in patients with hand osteoarthritis.

Baseline and year 2 data from the Hand OSTeoArthritis in Secondary (HOSTAS) care cohort were used, including patients from a rheumatology outpatient clinic.We collected demographics, disease and patient characteristics and MRI scans of the right hand. Erosive disease was classified using the Verbruggen-Veys system.Dorso-volar hand radiographs were scored blinded, paired, in chronological order, with the Osteoarthritis Research Society International system (osteophytes and joint space narrowing (JSN), scored 0-3/0-1, depending on the joint) per joint (sum score 0-88), with high to excellent reliability. We used the smallest detectable changes to classify progressors (all joints, thumb-base joints and IP joints).Associations between progression and characteristics were analysed with logistic regression.

Among 417 patients (mean age 61 years, 86% female), 272 (65%) showed osteophyte progression (median sum score (IQR) change 1 (0-2)) and 135 (32%) JSN progression (median sum score (IQR) change 1 (0-2)). Both osteophyte and JSN progressors had more radiographic damage at baseline. Associations were found between baseline erosive disease or bone marrow lesions and osteophyte progression in IP joints, and between female sex and osteophyte progression in thumb-base joints. The association of baseline osteophytes with change in osteophytes was strongest in younger females.

Over 2 years, a considerable proportion of patients demonstrated radiographic progression. Progressors were especially those with erosive disease, more radiographic damage (most pronounced in younger females) and bone marrow lesions at baseline.