title: Radiographic features of hand osteoarthritis in adult Kashin-Beck Disease (KBD): the Yongshou KBD study.
abstract: OBJECTIVE
  Kashin-Beck Disease (KBD) is a rare and severe osteoarthropathy endemic to China. We evaluated the frequency and patterns of hand radiographic osteoarthritis (rOA) in adults with and without KBD.
  
  
  METHODS
  Han Chinese (N = 438) from Yongshou County of central China underwent right hand radiography for determining case status. Presence of KBD was based on characteristic radiographic deformities of articular ends of bones including articular surface depression, carpal crowding, any subchondral bone deformities in the proximal end of phalanges or first metacarpal bone, or the distal ends of metacarpal bones 2-5, and any bony enlargement with deformity of the distal ends of phalanges. Hand rOA severity was determined by osteophyte (OST), joint space narrowing (JSN), and Kellgren and Lawrence (KL) grades.
  
  
  RESULTS
  This study included 127 KBD and 311 non-KBD adults of similar mean age (39 years) and body mass index (BMI) (21 kg/m(2)). Inter- and intra-rater reliability for radiographic determination of case status and rOA features was high (kappa 0.72-0.96). Compared to non-KBD, KBD adults had significantly more severe hand rOA of the thumb, distal interphalangeal (DIP), proximal interphalangeal (PIP) and metacarpophalangeal (MCP) joints. Only KBD adults had end-stage carpometacapal (CMC) disease. In KBD, DIPs and PIPs were more affected than MCPs and the frequency of OSTs was significantly higher in PIPs than DIPs.
  
  
  CONCLUSIONS
  Compared with age-matched adults from the same area and farming occupation, KBD hand rOA was more widespread and severe, particularly of PIPs and CMCs. The ability to differentiate adult KBD from non-KBD hand rOA will facilitate genetic analyses of the vast majority of affected individuals.
authors.affiliation: Institute of Endemic Diseases, School of Public Health, Xi'an Jiaotong University Medical Center, Xi'an, Shaanxi, PR China; Key Laboratory of Environment and Genes Related to Diseases, Xi'an Jiaotong University Medical Center, Ministry of Education, Xi'an, Shaanxi, PR China; Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, NC, USA. Electronic address: fuqiangmed@outlook.com.
authors.forename: Q
authors.initials: Q
authors.lastname: Fu
authors.affiliation: Institute of Endemic Diseases, School of Public Health, Xi'an Jiaotong University Medical Center, Xi'an, Shaanxi, PR China; Key Laboratory of Environment and Genes Related to Diseases, Xi'an Jiaotong University Medical Center, Ministry of Education, Xi'an, Shaanxi, PR China. Electronic address: caojl@mail.xjtu.edu.cn.
authors.forename: J
authors.initials: J
authors.lastname: Cao
authors.affiliation: Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: J B
authors.initials: JB
authors.lastname: Renner
authors.affiliation: Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Medicine and Orthopaedics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: J M
authors.initials: JM
authors.lastname: Jordan
authors.affiliation: Connective Tissue Biology Laboratories, School of Biosciences, Cardiff University, UK.
authors.forename: B
authors.initials: B
authors.lastname: Caterson
authors.affiliation: Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: V
authors.initials: V
authors.lastname: Duance
authors.affiliation: Institute of Endemic Diseases, School of Public Health, Xi'an Jiaotong University Medical Center, Xi'an, Shaanxi, PR China; Key Laboratory of Environment and Genes Related to Diseases, Xi'an Jiaotong University Medical Center, Ministry of Education, Xi'an, Shaanxi, PR China.
authors.forename: M
authors.initials: M
authors.lastname: Luo
authors.affiliation: Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, NC, USA; Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA. Electronic address: vbk@duke.edu.
authors.forename: V B
authors.initials: VB
authors.lastname: Kraus
mesh_terms: D000328:Adult; D005260:Female; D005384:Finger Joint / Q000000981:diagnostic imaging; D050823:Hand Joints / Q000000981:diagnostic imaging*; D006801:Humans; D057767:Kashin-Beck Disease / Q000150:complications / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000000981:diagnostic imaging* / Q000209:etiology; D011859:Radiography; D012720:Severity of Illness Index; D013933:Thumb / Q000000981:diagnostic imaging
keywords: Diagnosis; Hand; Kashin-Beck Disease; Osteoarthritis; Radiographic