CHICAGO—Is erosive, inflammatory osteoarthritis (EOA) a separate condition from osteoarthritis (OA)? Roberta Ramonda, MD, PhD, a rheumatologist at the University of Padova, Italy, spoke at the 2018 ACR/ARHP Annual Meeting on the clinical presentation of EOA and how it differs from OA.
Explore this issueFebruary 2019
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EOA is characterized by a frequent aggressive clinical course and occurs most often in the hands of middle-aged women, when it is called erosive hand osteoarthritis. The mean age of onset is 50 years, while typically the earliest onset occurs at 36 years. Although EOA has been considered an uncommon clinical subset of generalized OA, Dr. Ramonda explained that debate continues over whether it is a separate condition with a pathophysiology distinct from OA.
Erosive Hand Osteoarthritis
Those rheumatologists who consider erosive hand OA to be a severe form of hand OA feel the difference in frequency and patterning of joint involvement between these two forms is not significant. Evidence is accumulating, however, to suggest the pathophysiology of erosive hand OA is distinct from hand OA, Dr. Ramonda noted. This evidence includes clinical and radiological distinctions that translate into aggressive clinical involvement in erosive hand OA, with higher clinical burden—more pain, disability, stiffness—and worse outcome than in non-erosive hand OA. Moreover, patients with erosive hand OA are more likely to be positive for HLA-DRB1*07.