Osteoarthritis may be common in the hands and feet of people who have rheumatoid arthritis.

What is it about?

It appears that osteoarthritis may be common in the hands and feet of people who have newly diagnosed rheumatoid arthritis. 3 sentence summary . 1--It appears that osteoarthritis may be common in the hands and feet of people who have newly diagnosed rheumatoid arthritis. 2--Studying X-rays shows that both rheumatoid arthritis and osteoarthritis progress over the course of 3 years. 3--We found that people whose rheumatoid arthritis was slightly more “inflammatory” had worse erosions; and those people whose rheumatoid arthritis was more painful had less severe erosions Background In people with rheumatoid arthritis (RA) pain in the hands and feet is common. Osteoarthritis (OA) is common in the age group that develop new RA, and is also known to be a source of pain. Aim This study looked at whether osteoarthritis (OA) might be an extra cause of pain in people with newly diagnosed RA. How we did the work. We looked at X-rays of hands and feet from people with newly diagnosed RA, who agreed to join a research study called the Early RA Network (ERAN). Scores were given for RA and OA, based upon the appearance of the X-rays. RA scoring was done by looking for areas of bone that have been eaten away, called erosions. OA scoring was done by examining for new bone spurs in the joints, called osteophytes. What was found? Features of RA and OA (erosions and osteophytes) were generally common in the X-rays (40-60% of people) and were often found together in the same X-rays. We also looked at the progression of erosions and osteophytes over the course of 3 years, and found that both got worse in many people. This suggests that pain from OA may be worth investigating in further research in people with RA. We also tried to work out the balance (or inter-relationship) between inflammation and pain in RA. We found that people whose RA was slightly more “inflammatory” had worse erosions; and those people whose RA was more painful had less erosions. This supports previous research from other studies, where inflammation has been found to be a major cause of erosions.

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Why is it important?

The results from this study inform our research into different pain mechanisms in people with arthritis, and shows that pain might be caused in different ways than are the erosions in the joints. Worse pain was not associated with more severe erosions in the people with rheumatoid arthritis. Osteoarthritis may have a meaningful effect on people with rheumatoid arthritis; which should be explored in future research.