title: The prevalence of erosive osteoarthritis in carpometacarpal joints and its clinical burden in symptomatic community-dwelling adults.
abstract: OBJECTIVE
  To estimate the prevalence of erosive disease in first carpometacarpal joints (CMCJs) and investigate its clinical impact compared with radiographic thumb base (TB) osteoarthritis (OA).
  
  
  METHODS
  Standardized assessments with hand radiographs were performed in participants of two population-based cohort studies in North Staffordshire with hand symptoms lasting ≥1 day in the past month. Erosive disease was defined as the presence of eroded or remodeled phase in ≥1 interphalangeal joint (IPJ) or first CMCJ following the Verbruggen-Veys classification. Hand pain and function were assessed with Australian/Canadian Hand Osteoarthritis Index (AUSCAN). Prevalence was estimated by dividing the number of persons with erosive lesions by population size. Linear and logistic regression analyses were used to contrast clinical determinants between persons with erosions and with radiographic TB OA. Results were presented as mean differences and odds ratios (ORs) with 95% confidence intervals (95% CI), adjusted for age, sex and radiographic severity.
  
  
  RESULTS
  1,076 participants were studied (60% women, mean age 64.7 years (SD 8.3); 24 persons had erosive disease in the TB. The prevalence of erosive disease in first CMCJs was 2.2% (95% CI 1.4, 3.3). Only 0.5% (95% CI 0.2, 1.2) had erosive disease affecting IPJs and first CMCJs combined. More persons with erosive disease of first CMCJs reported pain in their TB than persons with radiographic TB OA, AUSCAN pain and function scores were similar.
  
  
  CONCLUSIONS
  Erosive disease of first CMCJs was present in 2.2% of subjects with hand pain and was often not accompanied by erosions in IPJs. Erosive disease was associated with TB pain, but not with the level of pain, when compared with radiographic TB OA.
authors.affiliation: Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands. Electronic address: w.y.kwok@lumc.nl.
authors.forename: W Y
authors.initials: WY
authors.lastname: Kwok
authors.affiliation: Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: M
authors.initials: M
authors.lastname: Kloppenburg
authors.affiliation: Arthritis Research UK Primary Care Centre, Keele University, Keele, Staffordshire, United Kingdom.
authors.forename: M
authors.initials: M
authors.lastname: Marshall
authors.affiliation: Arthritis Research UK Primary Care Centre, Keele University, Keele, Staffordshire, United Kingdom.
authors.forename: E
authors.initials: E
authors.lastname: Nicholls
authors.affiliation: Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: F R
authors.initials: FR
authors.lastname: Rosendaal
authors.affiliation: Arthritis Research UK Primary Care Centre, Keele University, Keele, Staffordshire, United Kingdom.
authors.forename: G
authors.initials: G
authors.lastname: Peat
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D052737:Carpometacarpal Joints / Q000000981:diagnostic imaging / Q000473:pathology*; D016022:Case-Control Studies; D015331:Cohort Studies; D016001:Confidence Intervals; D005260:Female; D005500:Follow-Up Studies; D018737:Hand Strength; D006801:Humans; D057187:Independent Living; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010003:Osteoarthritis / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000473:pathology*; D010147:Pain Measurement; D015995:Prevalence; D011446:Prospective Studies; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology; D012111:Residence Characteristics; D018570:Risk Assessment; D012737:Sex Factors; D018434:Sickness Impact Profile; D013933:Thumb / Q000000981:diagnostic imaging* / Q000473:pathology
keywords: Erosions; Function; Hand osteoarthritis; Pain; Thumb base