FRI0342 EROSIVE OSTEOARTHITIS IN PATIENTS WITH SYSTEMIC SCLEROSIS
Authors: Cristina Pijoan Moratalla, Jaime Arroyo Palomo, Carlos De la Puente Bujidos
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> Erosive ostearthritis (EO) is a rare but aggressive variant of hand osteoarthritis. Its prevalence in Europe is 3.3% in men and 9.9% in women, affecting 15.5% of patients with hand osteoarthritis<sup>1,2</sup>. EO causes a significant loss of function in the hands, with more severe inflammatory signs and affecting almost exclusively the PIP and DIP joints, usually avoiding the TM and MCP. In systemic sclerosis (SSc), hands are commonly affected with pain and joint deformity that, added to sclerodactyly and the presence of digital ulcers, produce an important functional limitation. It has not been established yet whether the presence of the disease determines an increased risk for the development of erosive osteoarthritis. <h3>Objectives</h3> To determine the frequency of EO in patients with SSc seen in a tertiary hospital in Madrid and to compare it with the frequency observed in the large cohorts of healthy population (Framingham study<sup>1</sup>). Secondly analyze both the clinical and analytical factors that may be related to the presence of EO in these patients. <h3>Methods</h3> A descriptive, observational cross-sectional study was conducted. We included all patients with a diagnosis of systemic sclerosis attended in our Rheumatology Unit. A database was created including clinical and epidemiological data and all the available imaging tests to assess the presence of findings compatible with EO in interphalangeal hand joints were reviewed. Acroosteolysis lesions were not considered as EO. Finally, a descriptive analysis was carried out. <h3>Results</h3> The prevalence of EO in our cohort of SSc patients, although low, is higher than the estimated in general healthy population according to the large European studies, with 8.16% (12/147) of the patients affected. All the patients with EO were female, wih a higher age of presentation of SSc compared to patients without EO (66.72 vs 50.72 years). EO was more prevalent in patients with limited skin involvement (75% vs 62%) and they had a higher frequency of telangiectasias in the typical locations. Likewise, patients with EO had more frequently positive AMA (25% vs 8.88%) and calcinosis (33% vs 17.77%). The frequency of ANA, Raynaud's phenomenon and interstitial lung disease was similar in both groups. No patients with positive Ro or La presented EO. <h3>Conclusion</h3> Although it is an uncommon variant of hand osteoarthritis, in our cohort a higher prevalence of EO was observed in patients with SSc compared to the healthy general population. In our group, the most associated risk factors were female sex, advanced age at the diagnosis of SSc, the presence of AMA and calcinosis, regardless of its location. The frequency of pulmonary involvement and Raynaud's phenomenon was similar in both groups. <h3>References</h3> [1] I.K. Haugen, M. Englund, P. Aliabadi, et al. Prevalence, incidence and progression of hand osteoarthritis in the general population: The Framingham Osteoarthritis Study. Ann Rheum Dis, 70 (2011), pp.1581-1586. [2] W.Y. Kwok, M. Kloppenburg, F.R. Rosendaal, et al. Erosive hand osteoarthritis: Its prevalence and clinical impact in the general population and symptomatic hand osteoarthritis. Ann Rheum Dis, 70 (2011), pp.1238-1242. <h3>Disclosure of Interests</h3> None declared