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inflammatory erosive osteoarthritis

Epidemiology: - 10% in patients with symptomatic hand osteoarthritis - preferentially affects women Pathology: - proliferative changes accompany joint erosion Clinical manifestations: - episodic inflammation of the proximal interphalangeal joints (Bouchard's nodes) & distal interphalangeal joints (Heberden's nodes) - erythema, edema, tenderness, pain - joint deformities - one or two joints are generally inflammed during an attack - between attacks, findings are consistent with osteoarthritis - squaring of the carpometacarpal joint may be noted - generally does not affect wrist or elbows Laboratory: - erythrocyte sedimentation rate generally not elevated - serum C-reative protein generally not elevated - rheumatoid factor is negative - cyclic citrullinated peptide Ab is negative Radiology: - X-ray of hands - erosive changes demonstrable radiographically - central erosions or cystic changes of proximal interphalangeal joints & distal interphalangeal joints - erosive changes in carpometacarpal joints may be noted - collapse of subchondral bone [1] - numerous osteophytes - 'gull-wing deformity' of distal interphalangeal joints - marginal sclerosis & osteophytes on the distal side of joints - centrally-eroded or collapsed & thinned proximal side of joint

Related

Bouchard's node Heberden's node

General

osteoarthritis (OA)

References

  1. Medical Knowledge Self Assessment Program (MKSAP) 11,16,17,18,19. American College of Physicians, Philadelphia 1998,2012,2015, 2018, 2022. - Medical Knowledge Self Assessment Program (MKSAP) 19 Board Basics. An Enhancement to MKSAP19. American College of Physicians, Philadelphia 2022
  2. Punzi L, Frigato M, Frallonardo P, Ramonda R. Inflammatory osteoarthritis of the hand. Best Pract Res Clin Rheumatol. 2010 Jun;24(3):301-12 PMID: 20534365
  3. Kwok WY, Kloppenburg M, Rosendaal FR Erosive hand osteoarthritis: its prevalence and clinical impact in the general population and symptomatic hand osteoarthritis. Ann Rheum Dis. 2011 Jul;70(7):1238-42 PMID: 21474485