Objective Pain sensitization is associated with pain severity in persons with hand OA. What contributes to pain sensitization is unclear. This study explores whether hand OA pathologies and symptom duration are related to central sensitization. Method Participants with hand OA in the Nor-Hand study underwent bilateral hand radiography and US examination. Central sensitization was assessed with pressure pain thresholds (PPT) at remote sites (wrist, trapezius and tibialis anterior muscles) and temporal summation. We examined whether hand OA pathologies, independent of each other, including structural severity (Kellgren–Lawrence sum score, presence of erosive hand OA), inflammatory severity (greyscale synovitis and power Doppler activity sum scores) and symptom duration, were related to central sensitization, adjusting for age, sex, BMI, comorbidities and OA-severity of knee/hip. Results In 291 participants (88% women, median age 61 years, interquartile range 57–66 years) Kellgren–Lawrence, greyscale synovitis and power Doppler activity sum scores were not associated with lower PPTs at remote sites. Persons with erosive hand OA had lower PPTs at the wrist (adjusted beta −0.75, 95% CI −1.32, −0.19) and tibialis anterior (adjusted beta −0.82, 95% CI −1.54, −0.09) and had greater temporal summation (adjusted beta 0.56, 95% CI 0.12, 1.01) compared with persons with non-erosive disease. No associations were found for symptom duration. Conclusions A person’s overall amount of structural or inflammatory hand OA pathologies was not associated with central sensitization. Although persons with erosive hand OA showed greater signs of central sensitization, the small differences suggest that central sensitization is mainly explained by factors other than joint pathologies.

中文翻译：

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手骨关节炎患者关节病变与中枢敏感性之间的关联：Nor-Hand 研究的结果

目的 疼痛敏感性与手部 OA 患者的疼痛严重程度相关。导致疼痛敏感的原因尚不清楚。本研究探讨手部 OA 病理和症状持续时间是否与中枢致敏有关。方法 Nor-Hand 研究中手部 OA 的参与者接受了双侧手部 X 线摄影和超声检查。中枢致敏性通过远程部位（手腕、斜方肌和胫骨前肌）的压力痛阈值 (PPT) 和时间总和进行评估。我们检查了相互独立的手部 OA 病理，包括结构严重程度（Kellgren-Lawrence 总分、侵蚀性手部 OA 的存在）、炎症严重程度（灰度滑膜炎和能量多普勒活动总分）和症状持续时间是否与中枢敏化有关, 调整年龄、性别、BMI、膝关节/髋关节的合并症和 OA 严重程度。结果 在 291 名参与者（88% 的女性，中位年龄 61 岁，四分位距 57-66 岁）中，Kellgren-Lawrence、灰度滑膜炎和能量多普勒活动总分与偏远地区较低的 PPT 无关。患有糜烂性手部 OA 的人在腕部（调整后的 beta -0.75, 95% CI -1.32, -0.19）和胫骨前肌（调整后的 beta -0.82, 95% CI -1.54, -0.09）的 PPT 较低，并且时间总和更大（与非糜烂性疾病患者相比，调整后的 beta 0.56, 95% CI 0.12, 1.01)。没有发现症状持续时间的关联。结论 一个人的结构性或炎症性手部 OA 病变的总量与中枢敏感性无关。尽管患有糜烂性手部 OA 的人表现出更大的中枢致敏迹象，