JOINT FAILURE IN EROSIVE OSTEOARTHRITIS OF THE HANDS

Erosive osteoarthritis (EGA), the type of hand osteoarthritis characte rized by faster destructive changes, may be suspected clinically becau se oi phlogistic presentation especially in DIP and in PIP joints. Sci ntiscan may be useful in early diagnosis, but the final diagnosis of E OA is always radiological, and depends upon the presence of central er osions. The inflammatory and crystal-induced origin of EOA is sometime s stressed in the literature, but despite the phlogistic course of the disease there is evidence against EOA being a primitive synovitis, th e most cogent point being the cellular content of synovial fluid. The pathogenetic hypothesis that we propose is of a chondral primitive dis order, with synovitis causing further chondral erosion, subchondral bo ne damage, and finally joint instability or fibrous and bone ankylosis with severe impairment of joint function.