Mohajer B, Kwee RM, Guermazi A, et al. - Metabolic syndrome (MetS), a potentially modifiable risk factor, is linked to radiographic distal interphalangeal joint (DIP) and proximal interphalangeal joint (PIP) osteoarthritis (OA), as well as longitudinal hand pain incidence, while the metacarpophalangeal (MCP) and first carpometacarpal (CMC1) joints are spared. MetS is associated with phenotypes of nodal and erosive hand osteoarthritis (HOA), indicating possible distinct pathophysiology.

• Utilizing 1:2 propensity score matching for relevant confounders, 2,509 candidates (896 MetS positive and 1,613 MetS negative) from the Osteoarthritis Initiative dataset were included.

• MetS was associated with an increased risk of radiographic HOA, including the number of joints with OA, the sum of joints modified Kellgren-Lawrences, primarily in distal and proximal interphalangeal joints, but not in MCP and CMC1 joints.

• Hand pain was more common during the follow-up period when MetS was present.

• MetS was associated with an erosive HOA phenotype and joint nodal involvement.