In thumb base osteoarthritis structural damage is more strongly associated with pain than synovitis

Kroon, Féline P B; Beest, S. van; Ermurat, Selime; Kortekaas, M.C.; Bloem, Johan L.; Reijnierse, M.; Rosendaal, Frits R.; Kloppenburg, Margreet

doi:10.1016/j.joca.2018.04.009

Cited by 35 publications

(46 citation statements)

References 30 publications

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“…Several previous studies focused on the association between X-ray scores and pain in patients with CMC-1 OA. However, different methods are available to score X-rays [35] and the available literature is conflicting [6,7,[36][37][38][39]. Several radiographic OA features including erosions and sclerosis have been linked to pain levels [36,39], while Dahaghin et al [7] in a large population study (n ¼ 3906) reported that radiographic OA was poorly correlated with pain.…”

Section: Discussionmentioning

confidence: 99%

Psychological factors are more strongly associated with pain than radiographic severity in non-invasively treated first carpometacarpal osteoarthritis

Hoogendam

Tsehaie

Wouters

et al. 2019

Disability and Rehabilitation

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Background: The aim of this study was to investigate to what extent psychological factors are related to pain levels prior to non-invasive treatment in patients with osteoarthritis of the first carpometacarpal joint. Methods: We included patients (n ¼ 255) at the start of non-invasive treatment for osteoarthritis of the first carpometacarpal joint who completed the Michigan Hand Outcome Questionnaire. Psychological distress, pain catastrophizing behavior and illness perception was measured. X-rays were scored on presence of scaphotrapeziotrapezoid osteoarthritis. We used hierarchical linear regression analysis to determine to what extent pain levels could be explained by patient characteristics, X-ray scores, and psychological factors. Results: Patient characteristics and X-ray scores accounted for only 6% of the variation in pre-treatment pain levels. After adding the psychological factors to our model, 47% of the variance could be explained. Conclusions: Our results show that psychological factors are more strongly related to pain levels prior to non-invasive treatment in patients with osteoarthritis of the first carpometacarpal joint than patient characteristics and X-ray scores, which implies the important role of these factors in the reporting of symptoms. More research is needed to determine whether psychological factors will also affect treatment outcomes for patients treated non-invasively for osteoarthritis of the first carpometacarpal joint. ä IMPLICATIONS FOR REHABILITATION Pain is the most important complaint for patients with osteoarthritis of the first carpometacarpal joint. Psychological factors are strongly associated with pain levels prior to treatment. Pain catastrophizing behavior appears to be a promising target for complementary treatment in patients with osteoarthritis of the first carpometacarpal joint.

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Section: Discussionmentioning

confidence: 99%

Psychological factors are more strongly associated with pain than radiographic severity in non-invasively treated first carpometacarpal osteoarthritis

Hoogendam

Tsehaie

Wouters

et al. 2019

Disability and Rehabilitation

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“…Other studies have also demonstrated that MRI is a reliable and reproducible method for detecting HOA changes in the interphalangeal joints [23] and thumb base first carpometacarpal joint [30]. Interestingly, in thumb base OA, structural damage was more strongly associated with pain than synovitis [30].…”

Section: Correlation Of Mri Changes With Plain Radiographymentioning

confidence: 94%

“…The mean age for all studies was 64.4 [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32]. Most studies (n = 13) were performed on both genders, although the majority of the subjects in each study were female.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Only two studies [26,32] had female subjects only and one study did not report the gender of the participants [25]. Of these studies, 13 were from observational cohort studies: the Hand OSTeoarthritis in secondary care (HOSTAS) [27,[29][30][31] the Oslo hand OA cohort [18-23, 25, 32] and a clinical trial: the digital osteoarthritis in refractory hand OA (DORA) study [28]. All articles examined BMLs and various subchondral features using MRI.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…All articles examined BMLs and various subchondral features using MRI. The strength of the magnetic field was 1.5 T in four studies [27,29,26,30]. Eight studies used a 1.0 T system [18-23, 25, 32] whereas one study [28] used the 0.2 T system in two patients only.…”

Section: Study Characteristicsmentioning

confidence: 99%

See 2 more Smart Citations

Evaluating the Relation between Bone Marrow Lesions and Synovitis with Pain and Structural Damage in Hand Osteoarthritis

Sofat¹,

Koushesh²

2019

Osteoarthritis Biomarkers and Treatments

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Osteoarthritis (OA) is the most prevalent arthritis worldwide and is a condition affecting the whole joint. Changes in subchondral bone, cartilage integrity and synovitis are recognised during OA progression. Although advances have been made in our understanding of OA pathophysiology, there are no current treatments that delay or halt the progression of the disease. Treatments are largely based upon physical therapies to improve function, anti-inflammatory agents for pain symptoms and joint replacement surgery for late stage disease in large weight bearing joints. There is an urgent need to better understand the pathophysiology of OA that could translate into improved treatments for this condition. In recent years, more advanced imaging techniques including magnetic resonance imaging (MRI) have led to an improved understanding of changes at the bone-cartilage interface in OA, with recognition that loss of integrity at the cartilage-bone junction and development of bone marrow lesions (BMLs) in the subchondral bone are associated with OA pain in large epidemiological studies. In this book chapter, we review the evidence for the role of BMLs and synovitis, particularly in the pathophysiology of hand OA. Based on a systematic review of the literature, we have identified 15 articles reported on BMLs and synovitis in hand OA, which will be discussed in this chapter.

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Associations Between Ultrasound‐Detected Synovitis, Pain, and Function in Interphalangeal and Thumb Base Osteoarthritis: Data From the Nor‐Hand Cohort

Fjellstad

Mathiessen

Slatkowsky-Christensen

et al. 2020

Arthritis Care & Research

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Objective. To explore whether ultrasound-detected gray-scale synovitis and power Doppler activity in the interphalangeal and first carpometacarpal (CMC1) joints are associated with pain and physical function in patients with hand osteoarthritis (OA). Methods. A total of 290 patients with hand OA underwent an ultrasound examination of the bilateral interphalangeal and CMC1 joints. Using logistic regression analyses with generalized estimating equations, we examined whether grade 0-3 gray-scale synovitis and power Doppler activity were associated with pain in the same joint. Using linear regression analyses, we examined whether the degree of inflammation was associated with numeric rating scale and Australian/Canadian (AUSCAN) Osteoarthritis Hand Index hand pain, AUSCAN physical function, and grip strength scores. Analyses were made separately for interphalangeal and CMC1 joints, and adjusted for age, sex, body mass index, psychosocial factors, use of analgesics, and presence of osteophytes. Results. At joint level, increasing gray-scale synovitis severity was associated with higher odds of pain upon palpation in both the interphalangeal (grade 2-3; odds ratio [OR] 3.17 [95% confidence interval (95% CI) 2.35, 4.28]) and CMC1 joints (grade 2-3; OR 4.40 [95% CI 2.10, 9.24]). Similar associations were found for power Doppler activity and joint pain in the previous 24 hours and 6 weeks. Power Doppler activity in CMC1 was also related to overall hand pain/physical function and lower grip strength. Conclusion. Inflammation in both the interphalangeal and CMC1 joints was associated with pain in the same joint. However, associations with hand pain, reduced physical function, and lower grip strength were only present for inflammation in the CMC1 joints, suggesting that lowering CMC1 inflammation is an important treatment target. ClinicalTrials.gov identifier: NCT03083548.

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In thumb base osteoarthritis structural damage is more strongly associated with pain than synovitis

Abstract: Ultrasonographic and MRI inflammatory features were often present in the thumb base. Osteophytes were more strongly associated with thumb base pain than inflammatory features, in contrast to findings in finger OA studies, supporting thumb base osteoarthritis as a distinct phenotype.

Cited by 35 publications

References 30 publications

Psychological factors are more strongly associated with pain than radiographic severity in non-invasively treated first carpometacarpal osteoarthritis

Psychological factors are more strongly associated with pain than radiographic severity in non-invasively treated first carpometacarpal osteoarthritis

Evaluating the Relation between Bone Marrow Lesions and Synovitis with Pain and Structural Damage in Hand Osteoarthritis

Associations Between Ultrasound‐Detected Synovitis, Pain, and Function in Interphalangeal and Thumb Base Osteoarthritis: Data From the Nor‐Hand Cohort

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