title: Prevalence, incidence and progression of hand osteoarthritis in the general population: the Framingham Osteoarthritis Study.
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway. haugen_ida@hotmail.com
authors.forename: Ida K
authors.initials: IK
authors.lastname: Haugen
authors.forename: Martin
authors.initials: M
authors.lastname: Englund
authors.forename: Piran
authors.initials: P
authors.lastname: Aliabadi
authors.forename: Jingbo
authors.initials: J
authors.lastname: Niu
authors.forename: Margaret
authors.initials: M
authors.lastname: Clancy
authors.forename: Tore K
authors.initials: TK
authors.lastname: Kvien
authors.forename: David T
authors.initials: DT
authors.lastname: Felson
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D018450:Disease Progression; D004812:Epidemiologic Methods; D005260:Female; D050823:Hand Joints / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D015994:Incidence; D008297:Male; D008404:Massachusetts / Q000453:epidemiology; D008875:Middle Aged; D010003:Osteoarthritis / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000473:pathology; D015995:Prevalence; D011859:Radiography; D017678:Sex Distribution