Association Between Race and Radiographic, Symptomatic, and Clinical Hand Osteoarthritis: A Propensity Score–Matched Study Using Osteoarthritis Initiative Data

Abstract

Objective. To determine the associations between Black race and the presence of radiographic, symptomatic, and clinical hand osteoarthritis (OA).Methods. Using available hand radiographs from the Osteoarthritis Initiative cohort (total 4,699; n = 849 Black subjects [18.1%], n = 3,850 non-Black subjects [81.9%]), a propensity score-matching method was used to match Black subjects with non-Black subjects for known potential risk factors of hand OA (age, sex, body mass index, smoking status, cardiovascular disease, osteoporosis, excessive occupation-or recreation-related hand use, and knee OA). Posteroanterior radiographs of subjects' dominant hands were reviewed by a musculoskeletal radiologist in a blinded manner. To assess the severity of hand OA, the modified Kellgren/Lawrence (K/L) radiographic OA scoring scale (grades 0-4) was used, and the presence of erosive OA in the hand joints was recorded. Associations between race and the severity of hand OA (measured as the summed modified K/L grade), presence of radiographic hand OA (modified K/L grade ≥2), presence of erosive hand OA, presence of symptomatic hand OA (radiographic OA with hand pain), and presence of clinical hand OA (indicated by clinical findings of Heberden's nodes in the hands) were studied using regression models. In these models, beta coefficients or odds ratios (ORs) with 95% confidence intervals (95% CIs) were calculated for the associations between Black race and any of these radiographic and symptomatic hand OA phenotypes.Results. Black subjects had less severe hand OA (β = -1.93 [95% CI -2.53, -1.34]), as well as a lower risk of developing radiographic hand OA (OR 0.79 [95% CI 0.66, 0.94]), erosive hand OA (OR 0.23 [95% CI 0.11, 0.47]), symptomatic hand OA (OR 0.63 [95% CI 0.49, 0.82]), and clinical hand OA (OR 0.49 [95% CI 0.41, 0.60]), as compared to non-Black subjects.Conclusion. In contrast to the well-established association between Black race and knee or hip OA, the findings of this study suggest that the risk of hand OA is lower in Black subjects compared to non-Black subjects, which is not mediated by known hand OA risk factors. Future studies are warranted to determine the mediating protective factors for hand OA among Black subjects.

Prevalence, Incidence, and Progression of Radiographic and Symptomatic Hand Osteoarthritis: The Osteoarthritis Initiative

“…Our finding of a lower risk of hand OA in Black participants is consistent with the findings of the Johnston County study (15) but differs from those of a study of a young‐to‐middle‐aged cohort in southeastern Michigan (5). A recent cross‐sectional analysis of the OAI found lower odds of hand OA in Black participants, consistent with our findings for prevalent hand OA, and we now extend these findings to incidence and progression of radiographic and symptomatic hand OA (39).…”

Mapping knowledge landscapes and emerging trends of the links between osteoarthritis and osteoporosis: A bibliometric analysis

“…The above is of great significance for other scholars to discover the relationship between OA and OP. While the main contribution of professor Guermazi A was the role of radiological techniques in the assessment of OA ( 67 – 69 ). But as shown in Figure 5A , these top three published authors do not form an obvious network trend among each other, and the centrality is relatively low and were all <0.1, which indicates that they have little contact with each other, their work has very little influence on each other, and they do not carry out excessive academic exchanges.…”

Early Detection of First Carpometacarpal Joint Osteoarthritis Using Magnetic Resonance Imaging Assessment in Women With High Hypermobility Scores

“…Genetic, racial, and sex-based factors have been linked with development of hand OA. 25 The identification of risk factors or predisposing circumstances toward development of OA may have limited immediate or prophylactic utility in care of patients currently; however, given the prevalence and impact of OA in the general population, there is clear need for improved therapeutic options and ideally disease-modifying or disease interruption options. With the dedicated research efforts ongoing in this field, the possibility of effective interventions for at-risk patients in the future is not unrealistic.…”