Prevalence, incidence and progression of hand osteoarthritis in the general population: the Framingham Osteoarthritis Study

Abstract

Objectives: To describe the prevalence and longitudinal course of radiographic, erosive and symptomatic hand osteoarthritis (HOA) in the general population.

Methods: Framingham osteoarthritis (OA) study participants obtained bilateral hand radiographs at baseline and 9-year follow-up. The authors defined radiographic HOA at joint level as Kellgren-Lawrence grade (KLG)≥2, erosive HOA as KLG≥2 plus erosion and symptomatic HOA as KLG≥2 plus pain/aching/stiffness. Presence of HOA at individual level was defined as ≥1 affected joint. The prevalence was age-standardised (US 2000 Population 40-84 years).

Results: Mean (SD) baseline age was 58.9 (9.9) years (56.5% women). The age-standardised prevalence of HOA was only modestly higher in women (44.2%) than men (37.7%), whereas the age-standardised prevalence of erosive and symptomatic OA was much higher in women (9.9% vs 3.3%, and 15.9% vs 8.2%). The crude incidence of HOA over 9-year follow-up was similar in women (34.6%) and men (33.7%), whereas the majority of those women (96.4%) and men (91.4%) with HOA at baseline showed progression during follow-up. Incident metacarpophalangeal and wrist OA were rare, but occurred more frequently and from an earlier age in men than women. Development of erosive disease occurred mainly in those with non-erosive HOA at baseline (as opposed to those without HOA), and was more frequent in women (17.3%) than men (9.6%).

Conclusions: The usual female predominance of prevalent and incident HOA was less clear for radiographic HOA than for symptomatic and erosive HOA. With an ageing population, the impact of HOA will further increase.

Conflict of interest statement

Competing interests None.

Figures

Figure 1

Prevalence (%) of radiographic hand osteoarthritis (HOA) in men and women across age categories at baseline. The proportions with non-erosive and erosive HOA are shown in bright and dark grey colours respectively.

Figure 2

Prevalence (%) of radiographic hand osteoarthritis in the individual joints at baseline in men (left side of the circle) and women (right side of the circle).

Figure 3

Frequency (%) of men and women with incident radiographic hand osteoarthritis (HOA) over a period of 9 years. The proportions with incident non-erosive and erosive HOA are shown in bright and dark grey colours respectively.