Table 3.
Synthesis of studies reporting a definition of generalized osteoarthritis
|
Author (year) |
Country | Joint sites considered |
OA criteria |
n | Age range or mean (SD) |
% female |
Joint sites affected |
GOA definition |
Frequency (%) of GOA |
|---|---|---|---|---|---|---|---|---|---|
| Kellgren (1952)(3) | UK | Ha, Hi, K, F, LS | C, R | 120 | 35–73 | 92 | 86% nodes, 66% CMC, 52% both, 41% PIP, 42% feet, 53% knee, 30% hips, 48% LS | Required HN and CMC OA in addition to other joints | 52% of OA pts had HN and CMC OA |
| Lawrenc (1969)(4) | UK | Ha, Hi, K, F, CS, LS | C, R | 1179 | 45+ | 54 | 15% of men and 28% of women had HN and 3+ joints with OA; 10% men and 15% women had HN and 5+ joints with OA | Either 3+ or 5+ joint groups where at least one joint has KL grade 2 or more | Non-HN: 3+ joints in 25% men and 20% women; 5+ joints in 9% men and 8% women |
| Solomon (1976)(82) | South Africa | Ha, F (some Hi, LS) | R | 300 | 35+ | 71 | 10% of men and 12% of women had 3+ joint groups, 1% of men and 3% of women had 5+ | HN and 2+ joint groups with rOA | HN and 2+ joints in 1 man and 0 women; non-HN and 2+ joints in 6% men and 9% women |
| Doherty (1983)(24) | UK | Ha, K | C, R | 150 | 36–80 | 15 | Among knees after meniscectomy, 92% had rOA vs. 52% of unoperated knees; those with hand OA had more severe knee OA | 3+ IP joints | 43% |
| Brighton (1985)(83) | South Africa | Ha, F | R | 543 | adult | 72 | DIP most frequent (21–30%), then PIP (11–15%), MTP (3–11%) | 3+ joint groups | 4% |
| Price (1987)(42) | UK | ns | C, R | 40 | 69 (5) | 100 | ns | HN and 6+ joint groups with rOA | 100% (selected GOA) |
| Doherty (1990)(84) | UK | ns | ns | ns | ns | ns | ns | HN + polyarticular hand OA (IP and CMC) | ns |
| Waldron (1991)(25) | UK | all | P | 255 | ns | 49 | Most common sites: shoulder (AC, 26–30%), spine (21–24%), hands (18–19%), feet (10–12%), sternoclavicular (6–8%), knee (4–6%), hip (3%); 27% had 3+ joints | DIP, CMC, and knee | 2% |
| Hopkinson (1992)(59) | UK | Ha, Hi, K | C, R | 255 | 45–90 | 90 | ns | HN and symptomatic IP OA in 3+ rays of each hand and clinical and/or radiographic OA at other sites | 34% (selected GOA cases) |
| Hart (1993)(46) | UK | Ha, K | C, R, S | 985 | 54 (6) | 100 | rOA: DIP rOA in 14%, PIP in 4%, CMC 17%, knee 12% | DIP, CMC, and knee rOA | 2% |
| Hordon (1993)(43) | UK | Ha, Hi, K, F, CS, LS, S, A | C, R | 20 | 52–79 | 100 | All had DIP, 65% had PIP, 60% CMC, 75% MTP, 90% knee, 15% hip | 3+ joint groups | 100% (selected GOA) |
| Loughlin (1994)(85) | UK | ns | ns | 133 | ns | ns | ns | HN before age 60 and 3+ other joint groups | 100% of cases (selected for GOA) |
| Cooper (1996)(67) | UK | Ha, Hi, K | R | 702 | 45–64 | 100 | Age 63–64: 54% had DIP, 45% CMC, 20–25% had PIP, hip, or knee | Age and threshold-based: for O:E 1.5 or more, 2+ joint groups needed at age 45–47 but 5+ at age 63–64. | 7% overall for O:E 1.5 |
| Dougados (1996)(86) | France | Ha, Hi, K, F, CS, TS, LS, S, E, others | C, R | 1021 | ns | ns | Most frequent: LS (63–65%), CMC (46%), CS (46%), DIP (45%), Knee (40%) | Either bilateral finger OA or spine and bilateral knee OA | 44% (27% bilat finger, 17% spine and knee) |
| Gunther (1998)(27) | Germany | Hi or K and Ha | TJR, R | 809 | 63 (8) | 62 | Of TJR pts, only 16% had unilateral (signal joint only) findings; 66% had IP, 30% CMC | 2 or more IP joints and one or more CMC in addition to TJR of hip or knee (Ulm definition (39, 60, 61)) | 27% |
| Malaviya (1998)(87) | Kuwait | nd | C, R | 69 | 39–97 | 74 | 94% had knee OA, bilateral in 85%; no pts had hip OA | HN and DIP/PIP OA | 6% |
| Ushiyama (1998)(31) | Japan | Ha, Hi, K | R | 383 | 49–86 | 100 | Of GOA pts, 55% had hip, 82% had knee, 43% had both, 6% had neither | 3+ IP joints | 17% |
| Naito (1999)(57) | Japan | Ha, K | C, R | 102 | 71 (8) | 100 | 100% had knee OA | 3+ IP joints | 45% |
| Huang (2000)(62) | Japan | Ha, Hi, K | R | 270 | 29–87 | 100 | Hand OA (50%), hip (54%), knee (67%), PFJ (62%) | Hand, hip, and knee (hand=3+ IP joints) | 17% |
| Min (2005)(33) | Netherlands | Ha, Hi, K, CS, LS | C, R, S | 1751 | 60–63 (4–8) | 58–82 | 2+ of 4 sites (hand, knee, hip, spine) | 23% Rotterdam and 66% GARP | |
| Miura (2008)(40) | Japan | DIP, K, LS | R | 518 | 24–87 | 72 | Knee (23% men/31% women), LS (68% men/44% women), DIP (16% men/20% women) | Bilateral knee and LS OA | 13% |
| Riyazi (2008)(47) | Netherlands | Ha, Hi, K, CS, LS | R, S | 382 | 40–79 | 64–82 | 57% had hand/spine, 21% hand/knee, 13% hand/hip, 27% knee/spine, 20% hip/spine, 8% hip/knee | Symptomatic OA in 2 or more sites (GARP definition(52, 63)) | 90% had multiple hand joins or 2+ other sites |
| Carroll (2009)(88) | Australia | Ha, Hi, K, F, A, E, wrist | C, R | 67 | 67–71 (9) | 64 | Type I had more CMC OA and more HN | Type I: 2+ DIP or PIP and both knees or both MTP1. Type II: 2+ of MCP2,3 and at least 1 of elbow, wrist, hip, ankle, or tarsometatarsa l (alternate (89)) | 58% type I, 42% type II |
| Hoogeboom (2010)(90) | Netherlands | ns | C, S | 170 | ns | ns | ns | All 3: 1) complaints in 3+ joint groups; 2) 2+ signs of OA in 2+ joints; 3) limited ADLs | ns |
Ha=hand; Hi=hip, K=knee, F=foot, CS=cervical spine, LS=lumbar spine, S=shoulder, A=ankle, E=elbow, HN=Heberden’s nodes, ns=not specified or no data
C=clinical, R=radiographic, P=pathologic
*
For cohorts using the same definition, only one representative study is included in the table with others referenced along with the definition; 24 listed studies are representative of 30 total studies with a definition