Clinical and radiographic distribution of structural damage in erosive and nonerosive hand osteoarthritis

Olga Addimanda, Luana Mancarella, Paolo Dolzani, Leonardo Punzi, Antonella Fioravanti, Elettra Pignotti, Riccardo Meliconi

Research output: Contribution to journalArticlepeer-review


Objective. To characterize the clinical and radiographic joint phenotype in erosive hand osteoarthritis (EHOA) and non-EHOA. Methods. A total of 446 patients with HOA (233 with EHOA and 213 with non-EHOA) were evaluated. Demographic (sex and age at disease onset), clinical (body mass index and distribution of nodes), and radiographic features (Kellgren/Lawrence and Kallman's scores obtained from radiographs of both hands) from all patients were recorded. Results. Patients with EHOA had a significantly earlier disease onset. Clinical and radiographic distribution of structural damage in the distal interphalangeal (DIP), proximal interphalangeal (PIP), and first carpometacarpal joints was similar in EHOA and non-EHOA. EHOA patients showed higher percentages of nodes and more severe radiographic scores; the more severe radiographic score of joints with nodes was due to both osteophytes and joint space narrowing (JSN). A direct correlation between osteophytes and JSN scores was observed. Central erosions (CE) were more prevalent in the DIP joints than in the PIP joints. Gull-wing pattern of CE was prevalent in the DIP joints, whereas saw-tooth pattern was prevalent in the PIP joints. Marginal erosions (ME) were present in 100% of EHOA patients and in 80% of non-EHOA patients. An ordinal correlation between the presence of ME and osteophyte score was found. Conclusion. We found quantitative, but not topographic, differences in structural damage between EHOA and non-EHOA. Heberden's nodes, severe radiologic scores, and CE were concentrated in the second, third, and fifth DIP joints of both hands. ME were also present in the majority of non-EHOA patients.

Original languageEnglish
Pages (from-to)1046-1053
Number of pages8
JournalArthritis Care and Research
Issue number7
Publication statusPublished - Jul 2012

ASJC Scopus subject areas

  • Rheumatology


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