Associations of trabecular bone texture with anatomical phases of osteoarthritis evolution and its progression in finger joints: Results from the Nor-Hand study.

内容摘要

To explore differences in trabecular bone (TB) texture with anatomical phases in the evolution of hand osteoarthritis (OA), and association of baseline TB texture with a progression to erosive OA (EOA) at follow-up. The Norwegian Hand OA (Nor-Hand) study (300 persons) was used. Distal (DIP) and proximal (PIP) interphalangeal joints on hand radiographs were graded according to the Verbruggen-Veys anatomical phase scoring system (normal, stationary, joint space narrowing (JSN), erosive, remodeled) at baseline and 3.5 years follow-up. Fractal dimensions (FDs) along the horizontal (FDH) and vertical (FDV) directions, and the direction of TB roughest part (FDSta) were calculated for distal and proximal bone in each joint. Associations of TB texture with OA phases and progression to EOA (erosive, remodeled) were evaluated using linear mixed and Poisson models. Means (95% confidence intervals [CI]) of distal FDH calculated for the stationary, JSN, erosive and remodeled phases were lower than for the normal phase, with differences of -0.008 (-0.013, -0.003), -0.031 (-0.041, -0.021), -0.067 (-0.080, -0.055) and -0.059 (-0.070, -0.046), respectively. The differences were similar for the distal and proximal FDs, with smaller differences found for FDSta and FDV. Higher baseline values of proximal FDs were associated with a reduced risk of progression to EOA at follow-up. Risk ratios (95% CI) were 0.71 (0.60, 0.83) for FDV, 0.80 (0.70, 0.92) for FDH, and 0.71 (0.59, 0.84) for FDSta. No evident relationships were found for baseline distal FDs. Marginal proportions with 95% CIs indicated that higher proximal FD values at baseline were associated with a lower risk of progression to EOA at follow-up, with distal FDs associations showing smaller effect sizes than proximal FDs associations. TB texture roughness decreases with OA phases and lower baseline roughness is associated with an increased risk of developing EOA. These findings suggest that TB texture may be a useful marker for hand OA progression.