Hand Osteoarthritis Is a Lifetime Risk

July 5, 2017

Risk estimates stratified by various factors further illustrate the significant burden of symptomatic OA.

The lifetime risk of symptomatic hand osteoarthritis is nearly 40%, researchers reported. The risk is higher in women than in men and varies with other factors.

Data from the Johnston County Osteoarthritis Project, a population-based cohort of adults, were evaluated in the study, published online May 8 in Arthritis & Rheumatology.

Led by Jin Qin, Sc.D. of the CDC, the investigators had two goals: (1) estimate a person’s lifetime risk of symptomatic hand osteoarthritis and (2) stratify this risk by age, sex, race, education, obesity, occupational factors, history of hand injury, and other potentially influential factors.

“Our lifetime risk estimates of symptomatic hand OA, together with those previously ascertained for knee OA and hip OA, further illustrate the significant burden of symptomatic OA,” wrote Qin and colleagues.

Despite beliefs that osteoarthritis is a disease of older adults, hand osteoarthritis often presents during middle age. All of the symptoms-including stiffness, achiness, and decreased grip strength-can lead to impaired hand function and disability for performing daily life functions.

Only a few studies have examined the prevalence and incidence of hand osteoarthritis. Current estimates for adults from various countries who have hand osteoarthritis range from 3% to 8%. In the Framingham Osteoarthritis Study, the 9-year cumulative incidence of symptomatic osteoarthritis was 7%.

Lifetime risk has been estimated for cancer, heart disease, and other chronic conditions. To date, the lifetime risk of symptomatic hand osteoarthritis has not been well reported.

The study

This ongoing population-based prospective cohort study included African American and white adults age ≥ 45 years who were residents of townships in Johnston County, North Carolina. The parent study was designed to monitor the occurrence and natural history of osteoarthritis among residents. The cohort had 4 data collection time points, including baseline and 3 follow-up cycles. The present study represents data collected from 2218 adults during 2 follow-up cycles.

Radiographs were obtained during clinic visits by a standard protocol that involved bilateral posteroanterior views of the hands. A musculoskeletal radiologist reviewed the images using standard atlases for features of radiographic osteoarthritis at each of the 30 joints in both hands.

Symptomatic hand osteoarthritis was defined as the presence of both radiographic osteoarthritis and self-reported symptoms in the same hand. Lifetime risk was defined as the proportion of the population in whom symptomatic hand osteoarthritis would develop in at least 1 hand by age 85 years.

Findings

In total, 352 study participants had symptomatic hand osteoarthritis in at least 1 hand. The overall lifetime risk of symptomatic hand osteoarthritis was 39.8% (95% CI, 34.4–45.3%).

The lifetime risk of symptomatic hand osteoarthritis was almost 1 in 2 for women (47.2%, 95% CI, 40.6–53.9%) compared with 1 in 4 for men (24.6%, 95% CI, 19.5–30.5%).

Lifetime risk of symptomatic hand osteoarthritis was 12.2 percentage points higher in whites than in African Americans (P=0.031).

Among obese persons, the lifetime risk of symptomatic hand osteoarthritis was 47.1% (95% CI, 37.8–56.7%), compared with 36.1% (95% CI 29.7–42.9%) in nonobese persons (P=0.063).

“These findings underscore the need for increased use of public health and clinical prevention and intervention measures to address and mitigate the impact of symptomatic hand OA on individuals and society,” said Qin and the study team. “There are effective and inexpensive public health interventions as well as other nonpharmacologic strategies and pharmacologic therapies that may help manage OA symptoms, maintain better function, and improve quality of life.”

Disclosures:

This research was supported by the CDC and the National Institute of Arthritis and Musculoskeletal and Skin Diseases.

References:

Qin, J., Barbour, K. E., Murphy, L. B., et al. “Lifetime Risk of Symptomatic Hand Osteoarthritis: The Johnston County Osteoarthritis Project.” Arthritis Rheumatol. 2017;69:1204-1212. doi: 10.1002/art.40097. Epub 2017 May 8.