Clinical subtypes of osteoarthritis

NewsBot · Apr 25, 2015

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Distinct subtypes of knee osteoarthritis: data from the Osteoarthritis Initiative
Jan H. Waarsing, Sita M. A. Bierma-Zeinstra and Harrie Weinans
Rheumatology (2015) April 16, 201

Objective. OA is suspected to be a collection of distinct subtypes, each with different aetiology and clinical characteristics. We aimed to explore the existence of different subtypes of knee OA, using cluster analysis of the data of the OA Initiative.

Methods. We used latent class cluster analysis (LCA) to cluster baseline data of 518 subjects of the OA Initiative progression cohort. Data included radiographic scores of OA features per compartment, regional quantitative MRI measures of cartilage quantity and denuded bone, and self-reported clinical scores on knee symptoms. To ensure that the clusters were found independently of OA severity, the LCA model was corrected with a measure of OA severity. The resulting clusters were compared with respect to the presence of risk factors and progression.

Results. LCA resulted in four clusters containing 47%, 27%, 15% and 12% of the subjects. Clusters 1, 2 and 4 showed OA features at the medial compartment, while cluster 3 only showed lateral OA features. Clusters 3 and 4 showed severe increases in areas of denuded bone, whereas no denuded bone was present in cluster 1. Prevalence of OA progression over 24 months was highest in clusters 3 and 4 and lowest in cluster 1. The clusters also differed significantly in BMI, knee alignment and prevalence of reported trauma.

Conclusion. LCA confirmed the existence of distinct subtypes of knee OA with clear differences in structural degradation and symptoms. The fact that subtypes also differed in risk factors suggests that different causes lead to different types of knee OA.
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NewsBot · Aug 6, 2015

Investigation of potential phenotypes of foot osteoarthritis: Cross-sectional analysis from the Clinical Assessment Study of the Foot.
Rathod T, Marshall M, Thomas MJ, Menz HB, Myers HL, Thomas E, Downes T, Peat G, Roddy E.
Arthritis Care Res (Hoboken). 2015 Aug 3

Objective To investigate the existence of distinct foot osteoarthritis (OA) phenotypes based on pattern of joint involvement and comparative symptom and risk profiles.

Methods Participants aged ≥50 years reporting foot pain in the previous year were drawn from a population-based cohort. Radiographs were scored for OA in the 1st metatarsophalangeal (MTPJ), 1st and 2nd cuneometatarsal, navicular first cuneiform and talonavicular joints according to a published atlas. Chi-square tests established clustering, and odds ratios examined symmetry and pairwise associations of radiographic OA in the feet. Distinct underlying classes of foot OA were investigated by latent class analysis (LCA) and their association with symptoms and risk factors was assessed.

Results In 533 participants (mean age 64.9 years, 55.9% female) radiographic OA clustered across both feet (p<0.001), and was highly symmetrical (adjusted odds ratio 3.0, 95% CI: 2.1,4.2). LCA identified three distinct classes of foot OA: 'no or minimal foot OA' (64%); 'isolated 1st MTPJ OA' (22%); 'polyarticular foot OA' (15%). After adjustment for age and gender, polyarticular foot OA was associated with nodal OA, increased BMI, and more pain and functional limitation compared to the other classes.

Conclusion Patterning of radiographic foot OA has provided insight into the existence of two forms of foot OA: isolated 1st MTPJ OA and polyarticular foot OA. The symptom and risk factor profiles in individuals with polyarticular foot OA indicate a possible distinctive phenotype of foot OA, but further research is needed to explore the characteristics of isolated 1st MTPJ and polyarticular foot OA
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