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A study of observational cohorts shows that disability and pain are far worse in rheumatoid arthritis of the hand than in erosive osteoarthritis affecting the hands, contrary to previous reports that symptoms of RA and OA are comparable.
Kwok WY, Kloppenburg M, Marshall M, et al., Comparison of clinical burden between patients with erosive hand osteoarthritis and inflammatory arthritis in symptomatic community-dwelling adults: the Keele clinical assessment studies. Rheumatology (2013) doi: 10.1093/rheumatology/ket267 First published online: September 17, 2013.
Patients with erosive hand osteoarthritis (hand OA) have more pain and disability than their peers with radiographic OA – but there’s no comparison with the greater hand pain and disability that those with inflammatory rheumatoid arthritis (RA) endure, researchers in the UK say.
Previous data from rheumatology practices where OA patients often predominate – with some signs similar to RA like pain, swelling, redness, warmth and limited function of the interphalangeal joints (IJPs) -- suggest a similar clinical burden among those with hand symptoms of OA and inflammatory RA.
However, a study finds a far heavier burden of pain and disability among 44 patients with inflammatory RA who reported hand symptoms than among 1,076 with erosive and radiographic hand OA in two British cohorts (60% women, mean age 64.8).
Participants all reported having episodes of hand pain at least once per month. Those with erosive OA reported more hand pain, stiffness, functional limitations, and lesser grip power and pinch ability than people with radiographic hand OA. But when compared with inflammatory RA, those with erosive OA experienced less pain and fewer limitations.
The prevalence of erosive OA in this UK data is more or less in line with with estimates elsewhere, and at least twice as common among women as among men.