Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Review Article
  • Published:

Erosive hand osteoarthritis: latest findings and outlook

Abstract

Osteoarthritis (OA) most commonly affects knee joints, and the next most commonly affected sites are the hands and hips. Three distinct hand OA phenotypes have been described: erosive hand OA (EHOA), nodal hand OA — also known as non-erosive hand OA (non-EHOA) — and first carpometacarpal joint OA. EHOA predominantly affects women and is the most aggressive form of hand OA, characterized by a severe clinical onset and progression, leading to joint damage, disability and reduction of quality of life. Clinical signs of inflammation associated with EHOA include the acute onset of pain, swelling and redness. Moreover, EHOA is characterized by radiographic features such as central erosion, saw-tooth and gull-wing lesions and, rarely, ankylosis. The aim of this Review is to report the latest findings on epidemiology, clinical features, pathology and aetiopathogenesis, biomarkers, imaging modalities and treatments for EHOA. The ongoing development of new hand OA classification criteria should facilitate standardization between studies.

Key points

  • Erosive hand osteoarthritis (EHOA) is a severe form of hand OA, and evidence suggests that it is characterized by genetic predisposition involving HLA, IL1B and SERPINA1 genes.

  • The radiological hallmark of EHOA is central erosion of the joint, and both radiography and ultrasonography are useful tools for the detection of EHOA.

  • Serological and synovial-fluid biomarkers such as soluble IL-2 receptor and myeloperoxidase are identifiable in EHOA, confirming the role of inflammation in this aggressive form.

  • EHOA biomarkers that are useful in clinical practice have not yet been identified.

  • EHOA is characterized by the presence of signs of inflammation, which correlates with symptoms and the appearance of bone erosions.

  • Currently, no specific treatments are available to slow disease progression in EHOA.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Fig. 1: Features of erosive hand osteoarthritis.
Fig. 2: Clinical features of erosive hand osteoarthritis.
Fig. 3: Radiological features of erosive hand osteoarthritis and comparison with other arthritis types.

Similar content being viewed by others

References

  1. Vina, E. R. & Kwoh, C. K. Epidemiology of osteoarthritis: literature update. Curr. Opin. Rheumatol. 30, 160–167 (2018).

    PubMed  PubMed Central  Google Scholar 

  2. Cross, M. et al. The global burden of hip and knee osteoarthritis: estimates from the global burden of disease 2010 study. Ann. Rheum. Dis. 73, 1323–1330 (2014).

    PubMed  Google Scholar 

  3. Belluzzi, E. et al. Contribution of infrapatellar fat pad and synovial membrane to knee osteoarthritis pain. Biomed. Res. Int. 2019, 6390182 (2019).

    PubMed  PubMed Central  Google Scholar 

  4. Martel-Pelletier, J. et al. Osteoarthritis. Nat. Rev. Dis. Prim. 2, 16072 (2016).

    PubMed  Google Scholar 

  5. Hunter, D. J. & Bierma-Zeinstra, S. Osteoarthritis. Lancet 393, 1745–1759 (2019).

    CAS  PubMed  Google Scholar 

  6. Marshall, M., Watt, F. E., Vincent, T. L. & Dziedzic, K. Hand osteoarthritis: clinical phenotypes, molecular mechanisms and disease management. Nat. Rev. Rheumatol. 14, 641–656 (2018).

    PubMed  Google Scholar 

  7. Ramonda, R., Frallonardo, P., Musacchio, E., Vio, S. & Punzi, L. Joint and bone assessment in hand osteoarthritis. Clin. Rheumatol. 33, 11–19 (2014).

    PubMed  Google Scholar 

  8. Punzi, L., Ramonda, R. & Sfriso, P. Erosive osteoarthritis. Best Pract. Res. Clin. Rheumatol. 18, 739–758 (2004).

    PubMed  Google Scholar 

  9. Altman, R. et al. The American College of Rheumatology criteria for the classification and reporting of osteoarthritis of the hand. Arthritis Rheum. 33, 1601–1610 (1990).

    CAS  PubMed  Google Scholar 

  10. Haugen, I. K. et al. Development of classification criteria for hand osteoarthritis: comparative analyses of persons with and without hand osteoarthritis. RMD Open 6, e001265 (2020).

    PubMed  PubMed Central  Google Scholar 

  11. Zhang, W. et al. EULAR evidence-based recommendations for the diagnosis of hand osteoarthritis: report of a task force of ESCISIT. Ann. Rheum. Dis. 68, 8–17 (2009).

    CAS  PubMed  Google Scholar 

  12. Punzi, L., Frigato, M., Frallonardo, P. & Ramonda, R. Inflammatory osteoarthritis of the hand. Best Pract. Res. Clin. Rheumatol. 24, 301–312 (2010).

    PubMed  Google Scholar 

  13. Belhorn, L. R. & Hess, E. V. Erosive osteoarthritis. Semin. Arthritis Rheum. 22, 298–306 (1993).

    CAS  PubMed  Google Scholar 

  14. Crain, D. C. Interphalangeal osteoarthritis: characterized by painful, inflammatory episodes resulting in deformity of the proximal and distal articulations. JAMA 175, 1049–1053 (1961).

    CAS  PubMed  Google Scholar 

  15. Ehrlich, G. E. Inflammatory osteoarthritis. I. The clinical syndrome. J. Chronic Dis. 25, 317–328 (1972).

    CAS  PubMed  Google Scholar 

  16. Ehrlich, G. E. Osteoarthritis beginning with inflammation: definitions and correlations. JAMA 232, 157–159 (1975).

    CAS  PubMed  Google Scholar 

  17. Verbruggen, G., Goemaere, S. & Veys, E. M. Systems to assess the progression of finger joint osteoarthritis and the effects of disease modifying osteoarthritis drugs. Clin. Rheumatol. 21, 231–243 (2002).

    CAS  PubMed  Google Scholar 

  18. Verbruggen, G. & Veys, E. M. Numerical scoring systems for the progression of osteoarthritis of the finger joints. Rev. Rhum. Engl. Ed. 62, 27s–32s (1995).

    CAS  PubMed  Google Scholar 

  19. Marshall, M. et al. Erosive osteoarthritis: a more severe form of radiographic hand osteoarthritis rather than a distinct entity? Ann. Rheum. Dis. 74, 136–141 (2015).

    PubMed  Google Scholar 

  20. Haugen, I. K. et al. Synovitis and radiographic progression in non-erosive and erosive hand osteoarthritis: is erosive hand osteoarthritis a separate inflammatory phenotype? Osteoarthritis Cartilage 24, 647–654 (2016).

    CAS  PubMed  Google Scholar 

  21. Kortekaas, M. C., Kwok, W. Y., Reijnierse, M., Stijnen, T. & Kloppenburg, M. Brief report: association of inflammation with development of erosions in patients with hand osteoarthritis: a prospective ultrasonography study. Arthritis Rheumatol. 68, 392–397 (2016).

    PubMed  Google Scholar 

  22. Mancarella, L. et al. Ultrasound detected inflammation is associated with the development of new bone erosions in hand osteoarthritis: a longitudinal study over 3.9 years. Osteoarthritis Cartilage 23, 1925–1932 (2015).

    CAS  PubMed  Google Scholar 

  23. Haugen, I. K. et al. Increasing synovitis and bone marrow lesions are associated with incident joint tenderness in hand osteoarthritis. Ann. Rheum. Dis. 75, 702–708 (2016).

    CAS  PubMed  Google Scholar 

  24. Iagnocco, A. et al. High resolution ultrasonography in detection of bone erosions in patients with hand osteoarthritis. J. Rheumatol. 32, 2381–2383 (2005).

    PubMed  Google Scholar 

  25. Kortekaas, M. C., Kwok, W. Y., Reijnierse, M., Huizinga, T. W. & Kloppenburg, M. In erosive hand osteoarthritis more inflammatory signs on ultrasound are found than in the rest of hand osteoarthritis. Ann. Rheum. Dis. 72, 930–934 (2013).

    PubMed  Google Scholar 

  26. Vlychou, M., Koutroumpas, A., Malizos, K. & Sakkas, L. I. Ultrasonographic evidence of inflammation is frequent in hands of patients with erosive osteoarthritis. Osteoarthritis Cartilage 17, 1283–1287 (2009).

    CAS  PubMed  Google Scholar 

  27. Grainger, A. J. et al. MR imaging of erosions in interphalangeal joint osteoarthritis: is all osteoarthritis erosive? Skeletal Radiol. 36, 737–745 (2007).

    CAS  PubMed  Google Scholar 

  28. Haugen, I. K. et al. MRI findings predict radiographic progression and development of erosions in hand osteoarthritis. Ann. Rheum. Dis. 75, 117–123 (2016).

    PubMed  Google Scholar 

  29. Ramonda, R. et al. Serological markers of erosive hand osteoarthritis. Eur. J. Int. Med. 24, 11–15 (2013).

    CAS  Google Scholar 

  30. Oliviero, F., Ramonda, R., & Punzi, L. New horizons in osteoarthritis. Swiss Med. Wkly. 140, w13098 (2010).

    CAS  PubMed  Google Scholar 

  31. Stern, A. G. et al. Association of erosive hand osteoarthritis with a single nucleotide polymorphism on the gene encoding interleukin-1 beta. Osteoarthritis Cartilage 11, 394–402 (2003).

    CAS  PubMed  Google Scholar 

  32. Ramonda, R. et al. Immunogenetic aspects of erosive osteoarthritis of the hand in patients from northern Italy. Scand. J. Rheumatol. 40, 139–144 (2011).

    CAS  PubMed  Google Scholar 

  33. Punzi, L. et al. Coll21–, Coll21–NO2 and myeloperoxidase serum levels in erosive and non-erosive osteoarthritis of the hands. Osteoarthritis Cartilage 20, 557–561 (2012).

    CAS  PubMed  Google Scholar 

  34. Kwok, W. Y. et al. Erosive hand osteoarthritis: its prevalence and clinical impact in the general population and symptomatic hand osteoarthritis. Ann. Rheum. Dis. 70, 1238 (2011).

    CAS  PubMed  Google Scholar 

  35. Bijsterbosch, J. et al. Clinical burden of erosive hand osteoarthritis and its relationship to nodes. Ann. Rheum. Dis. 69, 1784–1788 (2010).

    CAS  PubMed  Google Scholar 

  36. Pattrick, M., Aldridge, S., Hamilton, E., Manhire, A. & Doherty, M. A controlled study of hand function in nodal and erosive osteoarthritis. Ann. Rheum. Dis. 48, 978–982 (1989).

    CAS  PubMed  PubMed Central  Google Scholar 

  37. Cobby, M., Cushnaghan, J., Creamer, P., Dieppe, P. & Watt, I. Erosive osteoarthritis: is it a separate disease entity? Clin. Radiol. 42, 258–263 (1990).

    CAS  PubMed  Google Scholar 

  38. Cavasin, F. et al. [Prevalence of erosive osteoarthritis of the hand in a population from Venetian area]. Reumatismo 56, 46–50 (2004).

    CAS  PubMed  Google Scholar 

  39. Wittoek, R., Cruyssen, B. V. & Verbruggen, G. Predictors of functional impairment and pain in erosive osteoarthritis of the interphalangeal joints: comparison with controlled inflammatory arthritis. Arthritis Rheum. 64, 1430–1436 (2012).

    PubMed  Google Scholar 

  40. Kwok, W. Y. 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 52, 2260–2267 (2013).

    PubMed  PubMed Central  Google Scholar 

  41. Marshall, M. et al. Subsets of symptomatic hand osteoarthritis in community-dwelling older adults in the United Kingdom: prevalence, inter-relationships, risk factor profiles and clinical characteristics at baseline and 3-years. Osteoarthritis Cartilage 21, 1674–1684 (2013).

    CAS  PubMed  PubMed Central  Google Scholar 

  42. Kwok, W. Y. et al. The prevalence of erosive osteoarthritis in carpometacarpal joints and its clinical burden in symptomatic community-dwelling adults. Osteoarthritis Cartilage 22, 756–763 (2014).

    CAS  PubMed  PubMed Central  Google Scholar 

  43. Haugen, I. K. et al. Prevalence, incidence and progression of hand osteoarthritis in the general population: the Framingham Osteoarthritis Study. Ann. Rheum. Dis. 70, 1581–1586 (2011).

    PubMed  Google Scholar 

  44. McAlindon, T. E. et al. Erosive hand osteoarthritis: incidence and predictive characteristics among participants in the osteoarthritis initiative. Arthritis Rheumatol. 73, 2015–2024 (2021).

    PubMed  Google Scholar 

  45. Doherty, M., Hutton, C., & Bayliss, M. T. in Oxford Textbook of Rheumatology Vol.2 (eds Isenberg, D. A., Maddison, P. J., Woo, P. & Glass, D. N.) 959–983 (Oxford Medical Publications, 1993).

  46. Punzi, L., Favero, M., Frallonardo, P. & Ramonda, R. Time to redefine erosive osteoarthritis. RMD Open 1, e000105 (2015).

    PubMed  PubMed Central  Google Scholar 

  47. Keats, T. E., Johnstone, W. H. & O’Brien, W. M. Large joint destruction in erosive osteoarthritis. Skeletal Radiol. 6, 267–269 (1981).

    CAS  PubMed  Google Scholar 

  48. Marks, P. H. & Donaldson, M. L. Inflammatory cytokine profiles associated with chondral damage in the anterior cruciate ligament-deficient knee. Arthroscopy 21, 1342–1347 (2005).

    PubMed  Google Scholar 

  49. Kalichman, L. & Hunter, D. J. Lumbar facet joint osteoarthritis: a review. Semin. Arthritis Rheum. 37, 69–80 (2007).

    PubMed  Google Scholar 

  50. Duarte-Salazar, C., Marín-Arriaga, N. & Miranda-Duarte, A. The high clinical burden of erosive hand osteoarthritis is associated with clinical findings, pain, and radiographic severity. Reumatol. Clin. https://doi.org/10.1016/j.reuma.2021.03.002 (2021).

    Article  PubMed  Google Scholar 

  51. Visser, A. W. et al. Instruments measuring pain, physical function, or patient’s global assessment in hand osteoarthritis: a systematic literature search. J. Rheumatol. 42, 2118–2134 (2015).

    PubMed  Google Scholar 

  52. Perrotta, F. M., Scriffignano, S., De Socio, A. & Lubrano, E. An assessment of hand erosive osteoarthritis: correlation of radiographic severity with clinical, functional and laboratory findings. Rheumatol. Ther. 6, 125–133 (2019).

    PubMed  PubMed Central  Google Scholar 

  53. Michon, M., Maheu, E. & Berenbaum, F. Assessing health-related quality of life in hand osteoarthritis: a literature review. Ann. Rheum. Dis. 70, 921–928 (2011).

    CAS  PubMed  Google Scholar 

  54. Bodhani, A. R., Suryavanshi, M., Medema, J. & Fuldeore, M. Health related quality of life among patients with erosive hand osteoarthritis in The United States. Osteoarthritis Cartilage 24, S238 (2016).

    Google Scholar 

  55. Peter, J. B., Pearson, C. M. & Marmor, L. Erosive osteoarthritis of the hands. Arthritis Rheum. 9, 365–388 (1966).

    CAS  PubMed  Google Scholar 

  56. Favero, M., Perino, G., Valente, M. L., Tiengo, C. & Ramonda, R. Radiological and histological analysis of two replaced interphalangeal joints with active subchondral bone resorption in erosive hand osteoarthritis: a novel mechanism? Skeletal Radiol. 46, 385–391 (2017).

    PubMed  Google Scholar 

  57. Pritzker, K. P. et al. Osteoarthritis cartilage histopathology: grading and staging. Osteoarthritis Cartilage 14, 13–29 (2006).

    CAS  PubMed  Google Scholar 

  58. Scanzello, C. R. et al. Synovial inflammation in patients undergoing arthroscopic meniscectomy: molecular characterization and relationship to symptoms. Arthritis Rheum. 63, 391–400 (2011).

    PubMed  PubMed Central  Google Scholar 

  59. Stecher, R. M. & Hersh, A. H. Heberden’s nodes: the mechanism of inheritance in hypertrophic arthritis of the fingers. J. Clin. Invest. 23, 699–704 (1944).

    CAS  PubMed  PubMed Central  Google Scholar 

  60. Cicuttini, F. M. & Spector, T. D. Genetics of osteoarthritis. Ann. Rheum. Dis. 55, 665–667 (1996).

    CAS  PubMed  PubMed Central  Google Scholar 

  61. Fernández-Moreno, M., Rego, I., Carreira-Garcia, V. & Blanco, F. J. Genetics in osteoarthritis. Curr. Genomics 9, 542–547 (2008).

    PubMed  PubMed Central  Google Scholar 

  62. Hämäläinen, S. et al. Genetic influences on hand osteoarthritis in Finnish women — a replication study of candidate genes. PLoS One 9, e97417–e97417 (2014).

    PubMed  PubMed Central  Google Scholar 

  63. Ross, J. M. et al. Association of heterozygous hemochromatosis C282Y gene mutation with hand osteoarthritis. J. Rheumatol. 30, 121–125 (2003).

    CAS  PubMed  Google Scholar 

  64. Carroll, G. J. HFE gene mutations are associated with osteoarthritis in the index or middle finger metacarpophalangeal joints. J. Rheumatol. 33, 741–743 (2006).

    CAS  PubMed  Google Scholar 

  65. Hämäläinen, S., Solovieva, S., Vehmas, T., Leino-Arjas, P. & Hirvonen, A. Variations in the TNFα gene and their interactions with the IL4R and IL10 genes in relation to hand osteoarthritis. BMC Musculoskelet. Disord. 15, 311 (2014).

    PubMed  PubMed Central  Google Scholar 

  66. Zhu, X. et al. Association of aspartic acid repeat polymorphism in the asporin gene with osteoarthritis of knee, hip, and hand: a PRISMA-compliant meta-analysis. Medicine 97, e0200 (2018).

    CAS  PubMed  PubMed Central  Google Scholar 

  67. Zhai, G. et al. A genome-wide association study suggests that a locus within the ataxin 2 binding protein 1 gene is associated with hand osteoarthritis: the Treat-OA consortium. J. Med. Genet. 46, 614–616 (2009).

    CAS  PubMed  Google Scholar 

  68. Kerkhof, H. J. et al. A genome-wide association study identifies an osteoarthritis susceptibility locus on chromosome 7q22. Arthritis Rheum. 62, 499–510 (2010).

    CAS  PubMed  PubMed Central  Google Scholar 

  69. Taipale, M., Solovieva, S., Leino-Arjas, P. & Männikkö, M. Functional polymorphisms in asporin and CILP together with joint loading predispose to hand osteoarthritis. BMC Genet. 18, 108 (2017).

    PubMed  PubMed Central  Google Scholar 

  70. Pattrick, M., Manhire, A., Ward, A. M. & Doherty, M. HLA-A, B antigens and alpha 1-antitrypsin phenotypes in nodal generalised osteoarthritis and erosive osteoarthritis. Ann. Rheum. Dis. 48, 470–475 (1989).

    CAS  PubMed  PubMed Central  Google Scholar 

  71. Punzi, L., Bertazzolo, N., Pianon, M., Michelotto, M. & Todesco, S. Soluble interleukin 2 receptors and treatment with hydroxychloroquine in erosive osteoarthritis. J. Rheumatol. 23, 1477–1478 (1996).

    CAS  PubMed  Google Scholar 

  72. Strand, M. P., Neogi, T., Niu, J., Felson, D. T. & Haugen, I. K. Association between metabolic syndrome and radiographic hand osteoarthritis: data from a community-based longitudinal cohort study. Arthritis Care Res. 70, 469–474 (2018).

    CAS  Google Scholar 

  73. Magnusson, K. et al. Diabetes is associated with increased hand pain in erosive hand osteoarthritis: data from a population-based study. Arthritis Care Res. 67, 187–195 (2015).

    Google Scholar 

  74. Marshall, M. et al. Metabolic risk factors and the incidence and progression of radiographic hand osteoarthritis: a population-based cohort study. Scand. J. Rheumatol. 48, 52–63 (2019).

    CAS  PubMed  Google Scholar 

  75. Addimanda, O. et al. Clinical associations in patients with hand osteoarthritis. Scand. J. Rheumatol. 41, 310–313 (2012).

    CAS  PubMed  Google Scholar 

  76. Bray, C. et al. Erythrocyte sedimentation rate and C-reactive protein measurements and their relevance in clinical medicine. WMJ 115, 317–321 (2016).

    PubMed  Google Scholar 

  77. Olejârovâ, M., Kupka, K., Pavelka, K., Gatterovâ, J. & Stolfa, J. Comparison of clinical, laboratory, radiographic, and scintigraphic findings in erosive and nonerosive hand osteoarthritis: results of a two-year study. Jt. Bone Spine 67, 107–112 (2000).

    Google Scholar 

  78. Punzi, L. et al. Value of C reactive protein in the assessment of erosive osteoarthritis of the hand. Ann. Rheum. Dis. 64, 955–957 (2005).

    CAS  PubMed  PubMed Central  Google Scholar 

  79. Mathiessen, A., Østerås, N., Kvien, T., Hammer, H. & Haugen, I. Erosive status has no effect on systemic inflammatory biomarkers in hand osteoarthritis. Osteoarthritis Cartilage 24, S422 (2016).

    Google Scholar 

  80. Rovetta, G., Monteforte, P., Grignolo, M. C., Brignone, A. & Buffrini, L. Hematic levels of type I collagen C-telopeptide in erosive versus nonerosive osteoarthritis of the hands. Int. J. Tissue React. 25, 25–28 (2003).

    CAS  PubMed  Google Scholar 

  81. Silvestri, T., Pulsatelli, L., Dolzani, P., Punzi, L. & Meliconi, R. Analysis of cartilage biomarkers in erosive and non-erosive osteoarthritis of the hands. Osteoarthritis Cartilage 12, 843–845 (2004).

    PubMed  Google Scholar 

  82. Filková, M. et al. Serum hyaluronic acid as a potential marker with a predictive value for further radiographic progression of hand osteoarthritis. Osteoarthritis Cartilage 17, 1615–1619 (2009).

    PubMed  Google Scholar 

  83. Fioravanti, A., Tenti, S., Pulsatelli, L. & Addimanda, O. Could myeloperoxidase represent a useful biomarker for erosive osteoarthritis of the hand? Scand. J. Rheumatol. 47, 515–517 (2018).

    CAS  PubMed  Google Scholar 

  84. Davies, M. J. & Hawkins, C. L. The role of myeloperoxidase in biomolecule modification, chronic inflammation, and disease. Antioxid. Redox Signal. 32, 957–981 (2020).

    CAS  PubMed  Google Scholar 

  85. Fioravanti, A. et al. Can adipokines serum levels be used as biomarkers of hand osteoarthritis? Biomarkers 23, 265–270 (2018).

    CAS  PubMed  Google Scholar 

  86. Laiguillon, M.-C. et al. Expression and function of visfatin (Nampt), an adipokine-enzyme involved in inflammatory pathways of osteoarthritis. Arthritis Res. Ther. 16, R38 (2014).

    PubMed  PubMed Central  Google Scholar 

  87. Zhang, Z. et al. Resistin induces expression of proinflammatory cytokines and chemokines in human articular chondrocytes via transcription and messenger RNA stabilization. Arthritis Rheum. 62, 1993–2003 (2010).

    CAS  PubMed  PubMed Central  Google Scholar 

  88. Kropackova, T. et al. Lower serum clusterin levels in patients with erosive hand osteoarthritis are associated with more pain. BMC Musculoskelet. Disord. 19, 264 (2018).

    PubMed  PubMed Central  Google Scholar 

  89. Oliviero, F. et al. Levels of inflammatory cytokines and metalloproteinases are increased in knee synovial fluid of patients with concomitant erosive hand osteoarthritis. Clin. Exp. Rheumatol. 38, 800 (2020).

    PubMed  Google Scholar 

  90. Martel, W., Stuck, K. J., Dworin, A. & Hylland, R. Erosive osteoarthritis and psoriatic arthritis: a radiologic comparison in the hand, wrist, and foot. AJR Am. J. Roentgenol. 134, 125–135 (1980).

    CAS  PubMed  Google Scholar 

  91. Addimanda, O. et al. Clinical and radiographic distribution of structural damage in erosive and nonerosive hand osteoarthritis. Arthritis Care Res. 64, 1046–1053 (2012).

    Google Scholar 

  92. Kellgren, J. H. & Lawrence, J. S. The epidemiology of chronic rheumatism in Atlas of Standard Radiographs (ed. Kellgren, J. H.) 10–11 (FA Davis, Philadelphia, 1963).

  93. Kallman, D. A., Wigley, F. M., Scott, W. W. Jr., Hochberg, M. C. & Tobin, J. D. New radiographic grading scales for osteoarthritis of the hand. Reliability for determining prevalence and progression. Arthritis Rheum. 32, 1584–1591 (1989).

    CAS  PubMed  Google Scholar 

  94. Altman, R. D. & Gold, G. E. Atlas of individual radiographic features in osteoarthritis, revised. Osteoarthritis Cartilage 15, A15–A16 (2007).

    Google Scholar 

  95. Altman, R. D. et al. Radiographic assessment of progression in osteoarthritis. Arthritis Rheum. 30, 1214–1225 (1987).

    CAS  PubMed  Google Scholar 

  96. Altman, R. D., Hochberg, M., Murphy, W. A. Jr., Wolfe, F. & Lequesne, M. Atlas of individual radiographic features in osteoarthritis. Osteoarthritis Cartilage 3, 3–70 (1995).

    PubMed  Google Scholar 

  97. Grassi, W., Filippucci, E., Farina, A. & Cervini, C. Sonographic imaging of the distal phalanx. Semin. Arthritis Rheum. 29, 379–384 (2000).

    CAS  PubMed  Google Scholar 

  98. Vlychou, M., Koutroumpas, A., Malizos, K. & Sakkas, L. I. Ultrasonographic evidence of inflammation is frequent in hands of patients with erosive osteoarthritis. Osteoarthritis Cartilage 17, 1283–1287 (2009).

    CAS  PubMed  Google Scholar 

  99. Ramonda, R. et al. A recently developed MRI scoring system for hand osteoarthritis: its application in a clinical setting. Clin. Rheumatol. 35, 2079–2086 (2016).

    PubMed  Google Scholar 

  100. Mancarella, L. et al. Ultrasound-detected synovitis with power Doppler signal is associated with severe radiographic damage and reduced cartilage thickness in hand osteoarthritis. Osteoarthritis Cartilage 18, 1263–1268 (2010).

    CAS  PubMed  Google Scholar 

  101. Hayashi, D., Roemer, F. W. & Guermazi, A. Recent advances in research imaging of osteoarthritis with focus on MRI, ultrasound and hybrid imaging. Clin. Exp. Rheumatol. 36, 43–52 (2018).

    PubMed  Google Scholar 

  102. Scanzello, C. R. & Goldring, S. R. The role of synovitis in osteoarthritis pathogenesis. Bone 51, 249–257 (2012).

    CAS  PubMed  PubMed Central  Google Scholar 

  103. Haugen, I. K. et al. Hand osteoarthritis and MRI: development and first validation step of the proposed Oslo Hand Osteoarthritis MRI score. Ann. Rheum. Dis. 70, 1033–1038 (2011).

    PubMed  Google Scholar 

  104. Liu, R. et al. Bone marrow lesions on magnetic resonance imaging in hand osteoarthritis are associated with pain and interact with synovitis. Osteoarthritis Cartilage 25, 1093–1099 (2017).

    CAS  PubMed  Google Scholar 

  105. Haugen, I. K. et al. Iterative development and reliability of the OMERACT hand osteoarthritis MRI scoring system. J. Rheumatol. 41, 386–391 (2014).

    PubMed  Google Scholar 

  106. Haugen, I. K. et al. The longitudinal reliability and responsiveness of the OMERACT Hand Osteoarthritis Magnetic Resonance Imaging Scoring System (HOAMRIS). J. Rheumatol. 42, 2486–2491 (2015).

    PubMed  Google Scholar 

  107. Allado, E. et al. Assessment of structural lesions, synovitis and bone marrow lesions in erosive hand osteoarthritis on MRI (0.3 T) compared to the radiographic anatomical Verbruggen-Veys score. PLoS One 15, e0234972 (2020).

    CAS  PubMed  PubMed Central  Google Scholar 

  108. Ulas, S. T. et al. Susceptibility-weighted MR imaging to improve the specificity of erosion detection: a prospective feasibility study in hand arthritis. Skeletal Radiol. 48, 721–728 (2019).

    PubMed  Google Scholar 

  109. Kloppenburg, M. et al. Phase IIa, placebo-controlled, randomised study of lutikizumab, an anti-interleukin-1alpha and anti-interleukin-1beta dual variable domain immunoglobulin, in patients with erosive hand osteoarthritis. Ann. Rheum. Dis. 78, 413–420 (2019).

    CAS  PubMed  Google Scholar 

  110. Kloppenburg, M. Hand osteoarthritis-nonpharmacological and pharmacological treatments. Nat. Rev. Rheumatol. 10, 242–251 (2014).

    CAS  PubMed  Google Scholar 

  111. Kloppenburg, M. et al. 2018 update of the EULAR recommendations for the management of hand osteoarthritis. Ann. Rheum. Dis. 78, 16–24 (2019).

    PubMed  Google Scholar 

  112. Kroon, F. P. B., Carmona, L., Schoones, J. W. & Kloppenburg, M. Efficacy and safety of non-pharmacological, pharmacological and surgical treatment for hand osteoarthritis: a systematic literature review informing the 2018 update of the EULAR recommendations for the management of hand osteoarthritis. RMD Open 4, e000734 (2018).

    PubMed  PubMed Central  Google Scholar 

  113. Utsinger, P. D., Resnick, D., Shapiro, R. F. & Wiesner, K. B. Roentgenologic, immunologic, and therapeutic study of erosive (inflammatory) osteoarthritis. Arch. Intern. Med. 138, 693–697 (1978).

    CAS  PubMed  Google Scholar 

  114. Favero, M. et al. Efficacy and safety of ultrasound-guided intra-articular glucocorticoid injection in erosive hand osteoarthritis. Pain Med. 22, 1229–1232 (2021).

    PubMed  Google Scholar 

  115. Favero, M., Ramonda, R. & Rossato, M. Efficacy of intra-articular corticosteroid injection in erosive hand osteoarthritis: infrared thermal imaging. Rheumatology 56, 86 (2017).

    PubMed  Google Scholar 

  116. Kolasinski, S. L. et al. 2019 American College of Rheumatology/Arthritis Foundation Guideline for the management of osteoarthritis of the hand, hip, and knee. Arthritis Rheum. 72, 220–233 (2020).

    Google Scholar 

  117. Lee, W. et al. Efficacy of hydroxychloroquine in hand osteoarthritis: a randomized, double-blind, placebo-controlled trial. Arthritis Care Res. 70, 1320–1325 (2018).

    CAS  Google Scholar 

  118. Saviola, G. et al. Clodronate and hydroxychloroquine in erosive osteoarthritis: a 24-month open randomized pilot study. Mod. Rheumatol. 22, 256–263 (2012).

    CAS  PubMed  Google Scholar 

  119. Kedor, C. et al. Hydroxychloroquine in patients with inflammatory and erosive osteoarthritis of the hands: results of the OA-TREAT study — a randomised, double-blind, placebo-controlled, multicentre, investigator-initiated trial. RMD Open 7, e001660 (2021).

    PubMed  PubMed Central  Google Scholar 

  120. Ferrero, S. et al. Methotrexate treatment in hand osteoarthritis refractory to usual treatments: a randomised, double-blind, placebo-controlled trial. Semin. Arthritis Rheum. 51, 831–838 (2021).

    CAS  PubMed  Google Scholar 

  121. Magnano, M. D. et al. A pilot study of tumor necrosis factor inhibition in erosive/inflammatory osteoarthritis of the hands. J. Rheumatol. 34, 1323–1327 (2007).

    CAS  PubMed  Google Scholar 

  122. Aitken, D. et al. A randomised double-blind placebo-controlled crossover trial of HUMira (adalimumab) for erosive hand OsteoaRthritis — the HUMOR trial. Osteoarthritis Cartilage 26, 880–887 (2018).

    CAS  PubMed  Google Scholar 

  123. Verbruggen, G., Wittoek, R., Vander Cruyssen, B. & Elewaut, D. Tumour necrosis factor blockade for the treatment of erosive osteoarthritis of the interphalangeal finger joints: a double blind, randomised trial on structure modification. Ann. Rheum. Dis. 71, 891–898 (2012).

    CAS  PubMed  Google Scholar 

  124. Kloppenburg, M. et al. Etanercept in patients with inflammatory hand osteoarthritis (EHOA): a multicentre, randomised, double-blind, placebo-controlled trial. Ann. Rheum. Dis. 77, 1757–1764 (2018).

    CAS  PubMed  Google Scholar 

  125. Kroon, F. et al. Etanercept therapy leads to reductions in matrix metalloproteinase-3 in patients with erosive hand osteoarthritis. Scand. J. Rheumatol. 49, 167–168 (2020).

    CAS  PubMed  Google Scholar 

  126. Fioravanti, A., Fabbroni, M., Cerase, A. & Galeazzi, M. Treatment of erosive osteoarthritis of the hands by intra-articular infliximab injections: a pilot study. Rheumatol. Int. 29, 961–965 (2009).

    CAS  PubMed  Google Scholar 

  127. Bacconnier, L., Jorgensen, C. & Fabre, S. Erosive osteoarthritis of the hand: clinical experience with anakinra. Ann. Rheum. Dis. 68, 1078 (2009).

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Contributions

All authors contributed equally to all aspects of the article.

Corresponding author

Correspondence to Roberta Ramonda.

Ethics declarations

Competing interests

The authors declare no competing interests.

Peer review

Peer review information

Nature Reviews Rheumatology thanks Michelle Marshall, Ruth Wittoek and the other, anonymous, reviewer for their contribution to the peer review of this work.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary information

Glossary

Osteophytes

Bone spurs that grow along bone–joint margins.

Subchondral cyst

Fluid-filled sac occurring in subchondral bone.

Subchondral sclerosis

Hardening of the bone just below the cartilage surface.

Ankylosis

Fusion of the joint.

Paraesthesia

Abnormal skin sensation (such as numbness or a burning feeling).

Gradient echo MRI sequence

The gradient echo sequence is an excitation sequence for rapid image acquisition.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Favero, M., Belluzzi, E., Ortolan, A. et al. Erosive hand osteoarthritis: latest findings and outlook. Nat Rev Rheumatol 18, 171–183 (2022). https://doi.org/10.1038/s41584-021-00747-3

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41584-021-00747-3

This article is cited by

Search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing