title: Clinical and radiographic distribution of structural damage in erosive and nonerosive hand osteoarthritis.
abstract: 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Rizzoli Orthopedic Institute, Bologna, Italy.
authors.forename: Olga
authors.initials: O
authors.lastname: Addimanda
authors.forename: Luana
authors.initials: L
authors.lastname: Mancarella
authors.forename: Paolo
authors.initials: P
authors.lastname: Dolzani
authors.forename: Leonardo
authors.initials: L
authors.lastname: Punzi
authors.forename: Antonella
authors.initials: A
authors.lastname: Fioravanti
authors.forename: Elettra
authors.initials: E
authors.lastname: Pignotti
authors.forename: Riccardo
authors.initials: R
authors.lastname: Meliconi
mesh_terms: D000368:Aged; D052737:Carpometacarpal Joints / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D005384:Finger Joint / Q000000981:diagnostic imaging / Q000473:pathology; D050823:Hand Joints / Q000000981:diagnostic imaging* / Q000473:pathology*; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000000981:diagnostic imaging* / Q000473:pathology*; D054850:Osteophyte / Q000000981:diagnostic imaging / Q000473:pathology; D011859:Radiography; D012189:Retrospective Studies; D012720:Severity of Illness Index