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. 2003 Feb;62(2):151–158. doi: 10.1136/ard.62.2.151

Osteoarthritis of finger joints in Finns aged 30 or over: prevalence, determinants, and association with mortality

M Haara 1, P Manninen 1, H Kroger 1, J Arokoski 1, A Karkkainen 1, P Knekt 1, A Aromaa 1, M Heliovaara 1
PMCID: PMC1754437  PMID: 12525385

Abstract

Background: Prevalence and risk factors of osteoarthritis (OA) in finger joints have been amply explored in previous studies. However, no study has focused on finger joint OA as a predictor of mortality.

Objective: To investigate finger joint OA for its associations with alleged risk factors and with life expectancy in an extensive health survey.

Methods: From 1978 to 1980 a representative population sample of 8000 Finns aged 30 years or over was invited to participate in a comprehensive health examination; 90% accepted. Hand radiographs were taken from 3595 subjects. By the end of 1994, 897 of these had died.

Results: The prevalence of OA of Kellgren's grade 2 to 4 in any finger joint and in at least two symmetrical pairs of distal interphalangeal joints (DIPs) was 44.8% and 16.0%, respectively. Age and body mass index were significant determinants for OA both in any finger joint and in symmetrical DIP OA. The history of physical workload in women showed a positive association with OA in any finger joint. Smoking in men seemed to protect against symmetrical DIP OA. As adjusted for the determinants above, symmetrical DIP OA predicted mortality in women (relative risk (RR), 1.23; 95% confidence interval (95% CI) 1.01 to 1.51), but not in men (RR 0.89; 95% CI 0.68 to 1.16). In men, however, OA in any finger joint significantly predicted cardiovascular deaths (RR 1.42; 95% CI 1.05 to 1.92).

Conclusion: OA in any finger joint and symmetrical DIP OA have different risk factor profiles and predict mortality in different patterns between men and women.

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Figure 1.

Figure 1

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The flow of operations during the Mini-Finland Health Survey.

Figure 2.

Figure 2

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The prevalence and 95% CIs of OA of Kellgren grade 2 to 4 in any finger joint (white columns), OA in at least two distal interphalangeal joints symmetrically (dark grey columns), and one or more Heberden's nodes (light grey columns) in men and woman aged 30 or over.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Abramson S. B., Weissmann G. The mechanisms of action of nonsteroidal antiinflammatory drugs. Arthritis Rheum. 1989 Jan;32(1):1–9. doi: 10.1002/anr.1780320102. [DOI] [PubMed] [Google Scholar]
  2. Acheson R. M., Chan Y. K., Clemett A. R. New Haven survey of joint diseases. XII. Distribution and symptoms of osteoarthrosis in the hands with reference to handedness. Ann Rheum Dis. 1970 May;29(3):275–286. doi: 10.1136/ard.29.3.275. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Aho K., Heliövaara M., Sievers K., Maatela J., Isomäki H. Clinical arthritis associated with positive radiological and serological findings in Finnish adults. Rheumatol Int. 1989;9(1):7–11. doi: 10.1007/BF00270283. [DOI] [PubMed] [Google Scholar]
  4. Arokoski J. P., Jurvelin J. S., Vätäinen U., Helminen H. J. Normal and pathological adaptations of articular cartilage to joint loading. Scand J Med Sci Sports. 2000 Aug;10(4):186–198. doi: 10.1034/j.1600-0838.2000.010004186.x. [DOI] [PubMed] [Google Scholar]
  5. Bagge E., Bjelle A., Edén S., Svanborg A. Factors associated with radiographic osteoarthritis: results from the population study 70-year-old people in Göteborg. J Rheumatol. 1991 Aug;18(8):1218–1222. [PubMed] [Google Scholar]
  6. Butler W. J., Hawthorne V. M., Mikkelsen W. M., Carman W. J., Bouthillier D. L., Lamphiear D. E., Kazi I. U. Prevalence of radiologically defined osteoarthritis in the finger and wrist joints of adult residents of Tecumseh, Michigan, 1962-65. J Clin Epidemiol. 1988;41(5):467–473. doi: 10.1016/0895-4356(88)90048-0. [DOI] [PubMed] [Google Scholar]
  7. Carman W. J., Sowers M., Hawthorne V. M., Weissfeld L. A. Obesity as a risk factor for osteoarthritis of the hand and wrist: a prospective study. Am J Epidemiol. 1994 Jan 15;139(2):119–129. doi: 10.1093/oxfordjournals.aje.a116974. [DOI] [PubMed] [Google Scholar]
  8. Cauley J. A., Kwoh C. K., Egeland G., Nevitt M. C., Cooperstein L., Rohay J., Towers A., Gutai J. P. Serum sex hormones and severity of osteoarthritis of the hand. J Rheumatol. 1993 Jul;20(7):1170–1175. [PubMed] [Google Scholar]
  9. Cerhan J. R., Wallace R. B., el-Khoury G. Y., Moore T. E., Long C. R. Decreased survival with increasing prevalence of full-body, radiographically defined osteoarthritis in women. Am J Epidemiol. 1995 Feb 1;141(3):225–234. doi: 10.1093/oxfordjournals.aje.a117424. [DOI] [PubMed] [Google Scholar]
  10. Chaisson C. E., Zhang Y., McAlindon T. E., Hannan M. T., Aliabadi P., Naimark A., Levy D., Felson D. T. Radiographic hand osteoarthritis: incidence, patterns, and influence of pre-existing disease in a population based sample. J Rheumatol. 1997 Jul;24(7):1337–1343. [PubMed] [Google Scholar]
  11. Cheras P. A., Whitaker A. N., Blackwell E. A., Sinton T. J., Chapman M. D., Peacock K. A. Hypercoagulability and hypofibrinolysis in primary osteoarthritis. Clin Orthop Relat Res. 1997 Jan;(334):57–67. [PubMed] [Google Scholar]
  12. Cicuttini F. M., Baker J. R., Spector T. D. The association of obesity with osteoarthritis of the hand and knee in women: a twin study. J Rheumatol. 1996 Jul;23(7):1221–1226. [PubMed] [Google Scholar]
  13. Davis M. A., Neuhaus J. M., Ettinger W. H., Mueller W. H. Body fat distribution and osteoarthritis. Am J Epidemiol. 1990 Oct;132(4):701–707. doi: 10.1093/oxfordjournals.aje.a115711. [DOI] [PubMed] [Google Scholar]
  14. Dequeker J., Goris P., Uytterhoeven R. Osteoporosis and osteoarthritis (osteoarthrosis). Anthropometric distinctions. JAMA. 1983 Mar 18;249(11):1448–1451. [PubMed] [Google Scholar]
  15. Dodge H. J., Mikkelsen W. M., Duff I. F. Age-sex specific prevalence of radiographic abnormalities of the joints of the hands, wrists and cervical spine of adult residents of the Tecumseh, Michigan, Community Health Study area, 1962-1965. J Chronic Dis. 1970 Sep;23(3):151–159. [PubMed] [Google Scholar]
  16. Egger P., Cooper C., Hart D. J., Doyle D. V., Coggon D., Spector T. D. Patterns of joint involvement in osteoarthritis of the hand: the Chingford Study. J Rheumatol. 1995 Aug;22(8):1509–1513. [PubMed] [Google Scholar]
  17. Erb A., Brenner H., Günther K. P., Stürmer T. Hormone replacement therapy and patterns of osteoarthritis: baseline data from the Ulm Osteoarthritis Study. Ann Rheum Dis. 2000 Feb;59(2):105–109. doi: 10.1136/ard.59.2.105. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Felson D. T., Nevitt M. C. The effects of estrogen on osteoarthritis. Curr Opin Rheumatol. 1998 May;10(3):269–272. doi: 10.1097/00002281-199805000-00019. [DOI] [PubMed] [Google Scholar]
  19. Felson D. T., Zhang Y. An update on the epidemiology of knee and hip osteoarthritis with a view to prevention. Arthritis Rheum. 1998 Aug;41(8):1343–1355. doi: 10.1002/1529-0131(199808)41:8<1343::AID-ART3>3.0.CO;2-9. [DOI] [PubMed] [Google Scholar]
  20. Felson D. T., Zhang Y., Hannan M. T., Naimark A., Weissman B., Aliabadi P., Levy D. Risk factors for incident radiographic knee osteoarthritis in the elderly: the Framingham Study. Arthritis Rheum. 1997 Apr;40(4):728–733. doi: 10.1002/art.1780400420. [DOI] [PubMed] [Google Scholar]
  21. Hart D. J., Spector T. D. Cigarette smoking and risk of osteoarthritis in women in the general population: the Chingford study. Ann Rheum Dis. 1993 Feb;52(2):93–96. doi: 10.1136/ard.52.2.93. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Hart D. J., Spector T. D. The relationship of obesity, fat distribution and osteoarthritis in women in the general population: the Chingford Study. J Rheumatol. 1993 Feb;20(2):331–335. [PubMed] [Google Scholar]
  23. Hart D., Spector T., Egger P., Coggon D., Cooper C. Defining osteoarthritis of the hand for epidemiological studies: the Chingford Study. Ann Rheum Dis. 1994 Apr;53(4):220–223. doi: 10.1136/ard.53.4.220. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Hartz A. J., Fischer M. E., Bril G., Kelber S., Rupley D., Jr, Oken B., Rimm A. A. The association of obesity with joint pain and osteoarthritis in the HANES data. J Chronic Dis. 1986;39(4):311–319. doi: 10.1016/0021-9681(86)90053-6. [DOI] [PubMed] [Google Scholar]
  25. Heliövaara M., Aromaa A., Klaukka T., Knekt P., Joukamaa M., Impivaara O. Reliability and validity of interview data on chronic diseases. The Mini-Finland Health Survey. J Clin Epidemiol. 1993 Feb;46(2):181–191. doi: 10.1016/0895-4356(93)90056-7. [DOI] [PubMed] [Google Scholar]
  26. Hirsch R., Lethbridge-Cejku M., Scott W. W., Jr, Reichle R., Plato C. C., Tobin J., Hochberg M. C. Association of hand and knee osteoarthritis: evidence for a polyarticular disease subset. Ann Rheum Dis. 1996 Jan;55(1):25–29. doi: 10.1136/ard.55.1.25. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Hochberg M. C., Lane N. E., Pressman A. R., Genant H. K., Scott J. C., Nevitt M. C. The association of radiographic changes of osteoarthritis of the hand and hip in elderly women. J Rheumatol. 1995 Dec;22(12):2291–2294. [PubMed] [Google Scholar]
  28. Hochberg M. C., Lethbridge-Cejku M., Scott W. W., Jr, Plato C. C., Tobin J. D. Obesity and osteoarthritis of the hands in women. Osteoarthritis Cartilage. 1993 Apr;1(2):129–135. doi: 10.1016/s1063-4584(05)80028-7. [DOI] [PubMed] [Google Scholar]
  29. Horton W. E., Jr, Lethbridge-Cejku M., Hochberg M. C., Balakir R., Precht P., Plato C. C., Tobin J. D., Meek L., Doege K. An association between an aggrecan polymorphic allele and bilateral hand osteoarthritis in elderly white men: data from the Baltimore Longitudinal Study of Aging (BLSA). Osteoarthritis Cartilage. 1998 Jul;6(4):245–251. doi: 10.1053/joca.1998.0117. [DOI] [PubMed] [Google Scholar]
  30. KELLGREN J. H., MOORE R. Generalized osteoarthritis and Heberden's nodes. Br Med J. 1952 Jan 26;1(4751):181–187. doi: 10.1136/bmj.1.4751.181. [DOI] [PMC free article] [PubMed] [Google Scholar]
  31. Kanis J. A., Pitt F. A. Epidemiology of osteoporosis. Bone. 1992;13 (Suppl 1):S7–15. doi: 10.1016/s8756-3282(09)80004-5. [DOI] [PubMed] [Google Scholar]
  32. Larsen A., Dale K., Eek M. Radiographic evaluation of rheumatoid arthritis and related conditions by standard reference films. Acta Radiol Diagn (Stockh) 1977 Jul;18(4):481–491. doi: 10.1177/028418517701800415. [DOI] [PubMed] [Google Scholar]
  33. Lippiello L., Walsh T., Fienhold M. The association of lipid abnormalities with tissue pathology in human osteoarthritic articular cartilage. Metabolism. 1991 Jun;40(6):571–576. doi: 10.1016/0026-0495(91)90046-y. [DOI] [PubMed] [Google Scholar]
  34. Lloyd M. E., Hart D. J., Nandra D., McAlindon T. E., Wheeler M., Doyle D. V., Spector T. D. Relation between insulin-like growth factor-I concentrations, osteoarthritis, bone density, and fractures in the general population: the Chingford study. Ann Rheum Dis. 1996 Dec;55(12):870–874. doi: 10.1136/ard.55.12.870. [DOI] [PMC free article] [PubMed] [Google Scholar]
  35. Manninen P., Riihimäki H., Heliövaara M., Mäkelä P. Overweight, gender and knee osteoarthritis. Int J Obes Relat Metab Disord. 1996 Jun;20(6):595–597. [PubMed] [Google Scholar]
  36. Mäkelä M., Heliövaara M., Sievers K., Impivaara O., Knekt P., Aromaa A. Prevalence, determinants, and consequences of chronic neck pain in Finland. Am J Epidemiol. 1991 Dec 1;134(11):1356–1367. doi: 10.1093/oxfordjournals.aje.a116038. [DOI] [PubMed] [Google Scholar]
  37. Mäkelä M., Heliövaara M., Sievers K., Knekt P., Maatela J., Aromaa A. Musculoskeletal disorders as determinants of disability in Finns aged 30 years or more. J Clin Epidemiol. 1993 Jun;46(6):549–559. doi: 10.1016/0895-4356(93)90128-n. [DOI] [PubMed] [Google Scholar]
  38. Philbin E. F., Ries M. D., Groff G. D., Sheesley K. A., French T. S., Pearson T. A. Osteoarthritis as a determinant of an adverse coronary heart disease risk profile. J Cardiovasc Risk. 1996 Dec;3(6):529–533. [PubMed] [Google Scholar]
  39. Plato C. C., Norris A. H. Osteoarthritis of the hand: age-specific joint-digit prevalence rates. Am J Epidemiol. 1979 Feb;109(2):169–180. doi: 10.1093/oxfordjournals.aje.a112672. [DOI] [PubMed] [Google Scholar]
  40. Schouten J. S., van den Ouweland F. A., Valkenburg H. A. A 12 year follow up study in the general population on prognostic factors of cartilage loss in osteoarthritis of the knee. Ann Rheum Dis. 1992 Aug;51(8):932–937. doi: 10.1136/ard.51.8.932. [DOI] [PMC free article] [PubMed] [Google Scholar]
  41. Sowers M., Lachance L., Hochberg M., Jamadar D. Radiographically defined osteoarthritis of the hand and knee in young and middle-aged African American and Caucasian women. Osteoarthritis Cartilage. 2000 Mar;8(2):69–77. doi: 10.1053/joca.1999.0273. [DOI] [PubMed] [Google Scholar]
  42. Spector T. D., Cicuttini F., Baker J., Loughlin J., Hart D. Genetic influences on osteoarthritis in women: a twin study. BMJ. 1996 Apr 13;312(7036):940–943. doi: 10.1136/bmj.312.7036.940. [DOI] [PMC free article] [PubMed] [Google Scholar]
  43. Spector T. D., Cooper C. Radiographic assessment of osteoarthritis in population studies: whither Kellgren and Lawrence? Osteoarthritis Cartilage. 1993 Oct;1(4):203–206. doi: 10.1016/s1063-4584(05)80325-5. [DOI] [PubMed] [Google Scholar]
  44. Spector T. D., Nandra D., Hart D. J., Doyle D. V. Is hormone replacement therapy protective for hand and knee osteoarthritis in women?: The Chingford Study. Ann Rheum Dis. 1997 Jul;56(7):432–434. doi: 10.1136/ard.56.7.432. [DOI] [PMC free article] [PubMed] [Google Scholar]
  45. Stewart A., Black A. J. Bone mineral density in osteoarthritis. Curr Opin Rheumatol. 2000 Sep;12(5):464–467. doi: 10.1097/00002281-200009000-00021. [DOI] [PubMed] [Google Scholar]
  46. Stürmer T., Günther K. P., Brenner H. Obesity, overweight and patterns of osteoarthritis: the Ulm Osteoarthritis Study. J Clin Epidemiol. 2000 Mar 1;53(3):307–313. doi: 10.1016/s0895-4356(99)00162-6. [DOI] [PubMed] [Google Scholar]
  47. Swanson A. B., de Groot Swanson G. Osteoarthritis in the hand. Clin Rheum Dis. 1985 Aug;11(2):393–420. [PubMed] [Google Scholar]
  48. Waldron H. A. Association between osteoarthritis of the hand and knee in a population of skeletons from London. Ann Rheum Dis. 1997 Feb;56(2):116–118. doi: 10.1136/ard.56.2.116. [DOI] [PMC free article] [PubMed] [Google Scholar]
  49. van Saase J. L., van Romunde L. K., Cats A., Vandenbroucke J. P., Valkenburg H. A. Epidemiology of osteoarthritis: Zoetermeer survey. Comparison of radiological osteoarthritis in a Dutch population with that in 10 other populations. Ann Rheum Dis. 1989 Apr;48(4):271–280. doi: 10.1136/ard.48.4.271. [DOI] [PMC free article] [PubMed] [Google Scholar]

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