Radiographic joint space width in individuals with hand osteoarthritis: Are their "healthy" joints really healthy?

Alexander Mathiessen; Immanuel Onuoha; Rebecca Luh; Jeffrey B Driban; Mary B Roberts; Charles B Eaton; Timothy E McAlindon; Jeffrey Duryea

doi:10.1016/j.joca.2023.10.004

Radiographic joint space width in individuals with hand osteoarthritis: Are their "healthy" joints really healthy?

Osteoarthritis Cartilage. 2023 Oct 20:S1063-4584(23)00947-0. doi: 10.1016/j.joca.2023.10.004. Online ahead of print.

Authors

Alexander Mathiessen¹, Immanuel Onuoha², Rebecca Luh², Jeffrey B Driban³, Mary B Roberts⁴, Charles B Eaton⁵, Timothy E McAlindon³, Jeffrey Duryea²

Affiliations

¹ Brigham and Women's Hospital, Boston, MA, USA; Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway. Electronic address: alexander_mathiessen@hotmail.com.
² Brigham and Women's Hospital, Boston, MA, USA.
³ Tufts Medical Center, Boston, MA, USA.
⁴ Center for Primary Care and Prevention, Kent Hospital, Warwick, RI, USA.
⁵ Department of Family Medicine Warren Alpert Medical School of Brown University, Providence, RI, USA; Department of Epidemiology, School of Public Health of Brown University, Providence, RI, USA.

PMID: 37865135
DOI: 10.1016/j.joca.2023.10.004

Abstract

Objectives: We aimed to investigate the systemic nature of hand osteoarthritis (OA). We hypothesized that people who suffer from hand OA would display narrower radiographic joint space width (JSW) - not only in joints with apparent radiographic OA but also in their unaffected "healthy" joints.

Method: We examined 3394 participants from the Osteoarthritis Initiative with available dominant hand radiographs at baseline. Cases were defined as having interphalangeal OA (IPOA) based on a Kellgren and Lawrence (KL) score of ≥2 in two or more finger joints, whereas controls did not have IPOA. We used custom software to make JSW measurements of the metacarpophalangeal, proximal interphalangeal, and distal interphalangeal joints in fingers 2-5 per hand. In joint-level analyses, we included only KL score=0, allowing us to compare all joints without IPOA in cases and controls. We used generalized estimating equation models to compare JSW between both groups, adjusted for age, gender, metacarpal length, and joint type.

Results: Finger joints without radiographic OA had significantly narrower JSW in the IPOA group compared to finger joints in the control group (p < 0.001). The differences were significant across all joint types and for both total JSW measurements as well as for central and lateral sub-regions within each joint group (p < 0.001).

Conclusion: Unaffected finger joints in people with IPOA had narrower joint space than joints of healthy controls. This implies a systemic nature of hand OA, in which people may have a predisposition for general cartilage deterioration.

Keywords: Cartilage; Hand OA; Joint space width; Radiographs.