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2014 ; 43
(6
): 713-20
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"Generalized osteoarthritis": a systematic review
#MMPMID24461078
Nelson AE
; Smith MW
; Golightly YM
; Jordan JM
Semin Arthritis Rheum
2014[Jun]; 43
(6
): 713-20
PMID24461078
show ga
OBJECTIVES: Given the conflicting definitions of "generalized osteoarthritis"
(GOA) in the literature, we performed a systematic review of GOA definitions,
risk factors, and outcomes. METHODS: We searched the MEDLINE literature with the
terms osteoarthritis, generalized, polyarticular, multiple joint, and multi-joint
to obtain articles related to GOA, following evidence-based guidelines. Titles
and abstracts of 948 articles were reviewed, with full-text review of 108. Data
were extracted based on pre-specified criteria for 74 articles plus 24 identified
through bibliographic review (n = 98). RESULTS: Twenty-four large cohorts (n ~
30,000) were represented along with numerous clinical series (n ~ 9000), across
22 countries and 60 years (1952-2012). No less than 15 definitions of GOA were
given in 30 studies with a stated GOA definition; at least 6 groups used a summed
score of joints or radiographic grades. Prevalence estimates based on these GOA
definitions were 1-80%, although most were 5-25%. Increased risk and progression
of GOA was associated with age, female sex, and genetic/familial factors.
Associations with increased body mass index or bone mineral density were not
consistent. A study estimated the heritability of GOA at 42%. Collagen biomarker
levels increased with the number of involved joints. Increased OA burden was
associated with increased mortality and disability, poorer health, and function.
CONCLUSION: While there remains no standard definition of GOA, this term is
commonly used. The impact on health may be greater when OA is in more than one
joint. A descriptive term, such as multi-joint or polyarticular OA, designating
OA of multiple joints or joint groups is recommended.
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