Progression from non-erosive to erosive form of hand osteo- arthritis. A report of two cases.

摘要

Sirs, Hand osteoarthritis (HOA) is a common musculoskeletal disorder that affects the proximal (PIP) and distal (DIP) interphalan-geal joints, and the carpometacarpal joint of the thumb (1). Aminority of patients, mainly middle-aged women, may present the so-called erosive form (erosive HOA, EHOA). This form is diagnosed when, in addition to the fulfillment of the ACR clinical criteria, patients show radiographic features of erosions with "gull-wing" or "saw tooth" characteristic radiographic appearances (2). There are no clinical data as to whether erosive and non-EHOA are two different subsets of disease or two stages of the same disorder. Here we describe the radiographic progression in two patients from non-EHOA to EHOA. Neither patient had any family or personal history of psoriasis; inflammatory markers were normal; rheumatoid factor, anti nuclear and anti CCP antibodies were negative. Hand radiographs obtained from patients were graded according to the Kel-lgren and Lawrence (K-L) and Kallman methods (3, 4).