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Associations Between Radiographic and Ultrasound‐Detected Features in Hand Osteoarthritis and Local Pressure Pain Thresholds
Author(s) -
Steen Pettersen Pernille,
Neogi Tuhina,
Magnusson Karin,
Hammer Hilde Berner,
Uhlig Till,
Kvien Tore K.,
Haugen Ida K.
Publication year - 2020
Publication title -
arthritis and rheumatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.106
H-Index - 314
eISSN - 2326-5205
pISSN - 2326-5191
DOI - 10.1002/art.41199
Subject(s) - medicine , synovitis , osteoarthritis , body mass index , confidence interval , sensitization , visual analogue scale , joint pain , ultrasound , arthritis , physical therapy , radiology , pathology , alternative medicine , immunology
Objective Pain sensitization contributes to the complex osteoarthritis (OA) pain experience. The relationship between imaging features of hand OA and clinically assessed pain sensitization is largely unexplored. This study was undertaken to examine the association of structural and inflammatory features of hand OA with local pressure pain thresholds (PPTs) in the Nor‐Hand study. Methods The cross‐sectional relationship of severity of structural radiographic features of hand OA (measured according to the Kellgren/Lawrence scale [grade 0–4] and the absence or presence of erosive joint disease) as well as ultrasound‐detected hand joint inflammation (assessed by gray‐scale synovitis [grade 0–3] and the absence or presence of power Doppler activity) to the PPTs of 2 finger joints was examined by multilevel regression analyses adjusted for age, sex, and body mass index, using beta values with 95% confidence intervals (95% CIs). Results A total of 570 joints in 285 participants included in the Nor‐Hand study were assessed. Greater structural and inflammatory severity was associated with lower PPTs, with adjusted beta values of −0.5 (95% CI −0.6, −0.4) per Kellgren/Lawrence grade increase, −1.4 (95% CI −1.8, −0.9) for erosive versus non‐erosive joints, −0.7 (95% CI −0.9, −0.6) per gray‐scale synovitis grade increase, and −1.5 (95% CI −1.8, −1.1) for joints with power Doppler activity on ultrasound versus those without. Conclusion Greater severity of structural pathologic features and hand joint inflammation was associated with lower PPTs in the finger joints of patients with hand OA, indicating pain sensitization. Our results indicate that pain sensitization might be driven by structural and inflammatory pathology in hand OA.