Symmetry and clustering of symptomatic hand osteoarthritis in elderly men and women: the Framingham Study

Abstract

Objective. While symmetry and clustering of radiographic hand osteoarthritis (OA) have been described in middle‐aged women, these have not been studied in elderly individuals and similar investigations are lacking for symptomatic hand OA. The goal of this study was to study patterns of joint involvement in symptomatic hand OA among elderly Caucasian men and women. Methods. Using data from the Framingham Osteoarthritis Study, we defined a joint as having symptomatic OA if it had symptoms and radiographic OA (Kellgren and Lawrence grade ≥2). We assessed clustering of symptomatic OA using a χ²‐test and evaluated the interrelationship of occurrence of symptomatic OA among different joints with generalized estimating equations. Results. Of 976 subjects (age 71–99 yr, 36% men) examined, symptomatic OA more often affected multiple hand joints in an individual than would be expected by chance (PConclusion. Our study demonstrates that symptomatic OA often affects multiple hand joints, and is more likely to cluster by row than by ray. The disease also occurs in a remarkably symmetrical pattern, especially in women.