1068 The Journal of Rheumatology 2016; 43:6; doi:10.3899/jrheum.150841 Personal non-commercial use only. The Journal of Rheumatology Copyright © 2016. All rights reserved. Increased Frequency of Hand Osteoarthritis in Patients with Primary Sjögren Syndrome Compared with Systemic Lupus Erythematosus Adem Aksoy, Dilek Solmaz, Gercek Can, Pinar Cetin, Ali Balci, Servet Akar, Merih Birlik, Nurullah Akkoc, and Fatos Onen ABSTRACT. Objective. In daily practice, we noticed that hand osteoarthritis (OA) was commonly associated with primary Sjögren syndrome (pSS). Therefore, we aimed to investigate its prevalence in patients with pSS in a controlled study. Methods. The study included patients with pSS and controls with systemic lupus erythematosus (SLE). Standard hand/wrist radiographs were obtained and classified according to the Kellgren-Lawrence system. “Erosive hand OA” was defined according to the Verbruggen-Veys classification. Results. There were 114 patients with pSS (110 women, 51.0 yrs) and 34 patients with SLE (33 women, 42.4 yrs). Among 114 patients with pSS, 42.7% had radiographic, 30.3% symptomatic, and 16.0% erosive hand OA. The prevalences of radiographic (45.5%) and erosive hand OA (14.4%) in 90 patients with pSS with age- and sex-matched patients with SLE were significantly higher than those in patients with SLE (14.7% and 0.0%, p = 0.007 and p = 0.012, respectively). Interobserver reliabilities for diagnosing radiographic and erosive OA were found to be good (ĸ = 0.780 and ĸ = 0.788, respectively). Intraobserver reliabilities for diagnosing radiographic and erosive OA were also good (ĸ = 0.784 and ĸ = 0.825 for FO, and ĸ = 0.722 and ĸ = 0.800 for AB, respectively). The frequency of hand OA in patients with pSS was found to be increased with increasing age (r = 0.513). The mean age of those with erosive hand OA was significantly higher than those without erosive OA (p < 0.001). Conclusion. This study suggests that pSS, conversely to SLE, is more frequently associated with hand OA. (First Release April 1 2016; J Rheumatol 2016;43:1068–71; doi:10.3899/jrheum.150841) Key Indexing Terms: HAND OSTEOARTHRITIS SJÖGREN SYNDROME From the Department of Internal Medicine, and Division of Rheumatology, and Department of Radiology, Dokuz Eylul University School of Medicine, Izmir, Turkey. A. Aksoy, MD, Department of Internal Medicine, Dokuz Eylul University School of Medicine; D. Solmaz, MD, Department of Internal Medicine, Division of Rheumatology, Dokuz Eylul University School of Medicine; G. Can, MD, Department of Internal Medicine, Division of Rheumatology, Dokuz Eylul University School of Medicine; P. Cetin, MD, Department of Internal Medicine, Division of Rheumatology, Dokuz Eylul University School of Medicine; A. Balci, MD, Department of Radiology, Dokuz Eylul University School of Medicine; S. Akar, MD, Department of Internal Medicine, Division of Rheumatology, Dokuz Eylul University School of Medicine; M. Birlik, MD, Department of Internal Medicine, Division of Rheumatology, Dokuz Eylul University School of Medicine; N. Akkoc, MD, Professor, Department of Internal Medicine, Division of Rheumatology, Dokuz Eylul University School of Medicine; F. Onen, MD, Department of Internal Medicine, Division of Rheumatology, Dokuz Eylul University School of Medicine. Address correspondence to Dr. F. Onen, Department of Internal Medicine, Division of Rheumatology, Dokuz Eylul University School of Medicine, Izmir, Turkey. E-mail: fatos.onen@gmail.com Accepted for publication February 19, 2016. The distribution of arthritis in primary Sjögren syndrome (pSS) is similar to that of systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA), primarily affecting the small joints of the hands. Unlike RA, erosive arthritis is rarely seen in pSS 1 . In daily practice, we noticed that hand osteoarthritis (OA), especially erosive hand OA, was commonly associated with pSS. In the review of literature, we found no controlled study investigating the relationship between pSS and hand OA, although there are some published observations similar to ours 2,3 . The aim of our study was to investigate the preva- lence of hand OA in patients with pSS. MATERIALS AND METHODS The patients with pSS followed up in a university hospital were called by telephone and invited to participate in our study. Patients with SLE were included as controls. We obtained a detailed medical history and performed a full physical examination in all patients who agreed to take part in our study. All patients were asked whether they had pain/aching/stiffness on most days in any of their hand joints including the bilateral distal interphalangeal (DIP), proximal interphalangeal (PIP), metacarpophalangeal (MCP), thumb interphalangeal (IP), and thumb base joints. The results of laboratory investigations were recorded, including rheumatoid factor (RF), anticyclic citrullinated peptide antibodies (anti-CCP), antinuclear antibody (ANA), anti-Ro/SSA and anti-La/SSB anti- bodies, and minor salivary gland biopsies previously performed. www.jrheum.org Downloaded on February 18, 2022 from