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Pachydermodactyly (PDD) is a rare, benign disease associated with progressive swelling of the periarticular soft tissue of phalangeal hand joints typically treated with local steroid injections. We present a case of a 37-year-old man with PDD treated with local steroid injections. He later developed heterotopic ossification and para-articular calcifications in the injection sites. Heterotopic ossification is not associated with PDD nor is it a recognised complication of local steroid injections. This is the first case in literature of heterotopic ossification occurring after local steroid injection and brings to attention a new potential complication of a widely performed procedure.

Background:We have previously reported that the presence of musculoskeletal pain in psoriasis patients is associated with a higher risk of developing psoriatic arthritis (PsA) (1). Furthermore, a subset of psoriasis patients shows evidence for structural entheseal lesions (SEL) in their hand joints (2), sometimes also referred as “Deep Koebner Phenomenon”, which are highly specific for psoriatic disease and virtually absent in healthy controls, rheumatoid arthritis and hand osteoarthritis patients (2-4). However, it remains unclear whether SEL alone or in combination with musculoskeletal pain are associated with the development of PsA.Objectives:To test whether the presence of SEL in psoriasis patients increases the risk for progression to PsA and how this is related to the presence of musculoskeletal pain.Methods:Psoriasis patients without evidence of PsA were enrolled in a prospective cohort study between 2011 and 2018. All patients underwent baseline assessment of SEL in their 2ndand 3rdMCP joints by high-resolution peripheral quantitative computed tomography (HR-pQCT). The risk of PsA development associated with SEL and arthralgia was explored using survival analyses and multivariable Cox regression models.Results:114 psoriasis patients (72 men/42 women) with a mean (SD) follow-up duration of 28.2 (17.7) months were included, 24 of whom developed PsA (9.7 /100 patient-years, 95%CI 6.2 to 14.5) during the observation period. Patients with SEL (N=41) were at higher risk of developing PsA compared to patients without such lesions (21.4/100 patient-years, 95%CI 12.5 to 34.3, HR 5.10, 95%CI 1.53 to 16.99, p=0.008) (Kaplan Meier plot A). Furthermore, while patients without arthralgia and without SEL had a very low progression rate to PsA (1/29; 3.4%), patients with arthralgia but no SEL showed higher progression (5/33; 15.2%), which was in line with previous observations (1) (Kaplan Meier plot B). Presence of SEL further enhanced the risk for progression to PsA both in the absence (6/16; 37.5%) and presence (6/14; 42.8%) of arthralgia with the highest progression rate in those subjects with both arthralgia and SEL (pConclusion:Presence of SEL is associated with an increased risk of developing PsA in patients with psoriasis. If used together with pain, SEL allow defining subsets of psoriasis patients with very low and very high risk to develop PsA.References:[1]Faustini F et al. Ann Rheum Dis. 2016;75:2068-2074[2]Simon D et al. Ann Rheum Dis. 2016;75:660-6[3]Finzel S et al. Ann Rheum Dis. 2011;70:122-7[4]Finzel S et al. Arthritis Rheum. 2011;63:1231-6Disclosure of Interests:David Simon Grant/research support from: Else Kröner-Memorial Scholarship, Novartis, Consultant of: Novartis, Lilly, Koray Tascilar: None declared, Arnd Kleyer Consultant of: Lilly, Gilead, Novartis,Abbvie, Speakers bureau: Novartis, Lilly, Sara Bayat Speakers bureau: Novartis, Eleni Kampylafka Speakers bureau: Novartis, BMS, Janssen, Axel Hueber Grant/research support from: Novartis, Lilly, Pfizer, Consultant of: Abbvie, BMS, Celgene, Gilead, GSK, Lilly, Novartis, Speakers bureau: GSK, Lilly, Novartis, Jürgen Rech Consultant of: BMS, Celgene, Novartis, Roche, Chugai, Speakers bureau: AbbVie, Biogen, BMS, Celgene, MSD, Novartis, Roche, Chugai, Pfizer, Lilly, Louis Schuster: None declared, Klaus Engel: None declared, Michael Sticherling Grant/research support from: Novartis, Consultant of: Advisory boards Abbvie, Celgene, Janssen Cilag, Lilly, Pfizer, MSD, Novartis, Amgen, Leo, Sanofi, UCB, Speakers bureau: Abbvie, Celgene, Janssen Cilag, Leo, MSD, Novartis, Pfizer, Georg Schett Speakers bureau: AbbVie, BMS, Celgene, Janssen, Eli Lilly, Novartis, Roche and UCB

Background:Several studies have evaluated the association between serum adiponectin levels and knee and hand osteoarthritis (OA), with mixed results.Objectives:The aim of this study was to investigate the relationship between OA and serum adiponectin levels according to the radiographic features of knee and hand OA.Methods:A total of 2,402 subjects were recruited from the Dong-gu Study. Baseline characteristics were collected via a questionnaire, and X-rays of knee and hand joints were scored by a semi-quantitative grading system. The relationship between serum adiponectin levels and radiographic severity was evaluated by linear regression analysis.Results:Subjects with higher tertiles of serum adiponectin were older and had a lower body mass index than those with lower tertiles. In the knee joint scores, serum adiponectin levels were positively associated with the total score (PConclusion:In this study, we found that increased adiponectin levels were associated with higher radiographic scores in the knee joint, but not in the hand joint, suggesting different pathophysiologic mechanisms in the development of OA.Disclosure of Interests:None declared

Osteoarthritis (OA), also known as degenerative joint disease, hypertrophic arthritis, senile arthritis and articular cartilage osteoarthritis, is a common clinical disease. The common symptoms of OA include pain in affected joints, aggravation after exercise, remission after rest and a feeling of stiffness without activity for a long time.1 OA can occur in any joint, but mainly in the hip joint, knee joint, hand joint and spine facet joint. Recently, it was with great interest that we read the report entitled ‘Intramuscular glucocorticoid injection versus placebo injection in hip osteoarthritis: a 12 week blinded randomised controlled trial’ by Dorleijn and colleagues published online in 7 March 2018 in Annals of the Rheumatic Diseases .2 Dorleijn et al concluded that an intramuscular glucocorticoid injection showed effectiveness in patients with hip OA on one of the three primary outcomes at 2 weeks postinjection and all primary outcomes showed effectiveness from 4 to 6 weeks. Certainly, the study of Dorleijn et al will be important for …

Background A phase of arthralgia precedes the emergence of rheumatoid arthritis (RA). This phase is not yet well characterized. The presence of MRI-detected subclinical inflammation has been identified in this phase and is correlated with RA development. However, it is unknown if patients with arthralgia at risk for RA (with and without subclinical inflammation) have functional limitations. Objectives This study assessed functional disability in patients with clinically suspect arthralgia (CSA) and the associations with MRI-detected inflammation and progression to clinical arthritis. Methods Between April 2012 and April 2015 patients were included in the CSA cohort. Patients with CSA were defined as having no clinical arthritis, with symptoms of hands or feet for Results Of the 255 patients included, 77% were female and the mean age was 44.2 years. Median HAQ score was 0.50 at baseline and median duration of follow-up was 61 weeks. In univariable linear regression, a higher total inflammation score was significantly associated with a higher HAQ score (β=0.01, p=0.019). Of the individual types of inflammation, tenosynovitis showed the strongest correlation (β=0.04, p=0.003). When evaluating subclinical inflammation at specific hand joints in relation to HAQ-questions measuring hand function, significant correlations were observed. For instance, difficulties with opening previously opened jars was associated with MRI-inflammation score at the wrists (Pearson r=0.18, p=0.011). Patients that progressed to clinical arthritis had higher HAQ scores at presentation, than CSA-patients that did not progress (median HAQ scores 0.90 and 0.50 respectively). HAQ scores above 0.90 in particular were associated with arthritis development (HR=2.62, 95% CI: 1.06–6.47, p=0.036) as shown in the Kaplan-Meier plot (figure 1). An analysis of the patients that did develop arthritis revealed that median HAQ-scores were the same both at initial presentation with CSA and at conversion to clinical arthritis (median HAQ scores 0.90 and 0.68 respectively, paired t-test p-value = 0.751). Conclusions CSA-patients already have functional limitations. The severity of functional disability is associated with the severity of local subclinical inflammation. CSA-patients that progressed to clinical arthritis had high HAQ scores at baseline and these HAQ scores did not increase when arthritis became clinically evident. Disclosure of Interest None declared

Background Altered microcirculation (abnormal perfusion/capillary leakage) of synovial tissue can be detected early using Fluorescence Optical Imaging (FOI). FOI utilizes an intravenous fluorophore 1,2 that displays high-resolution hand images that can be analyzed visually (FOI-v) in real-time, or by using digital Disease ACTivity (DACT) scoring methods. We previously reported FOI9s sensitivity and specificity in detecting silent synovitis in various rheumatic diseases 1 . Objectives Here, we test the diagnostic performance of FOI-DACT in detecting subtle hand joint inflammation in early rheumatoid arthritis (eRA), as compared to clinical evaluation and MusculoSkeletal UltraSound (MSUS). Methods Fingers and wrists of patients with eRA were assessed by clinical examination, MSUS and FOI-DACT imaging. Inflammation was defined as having synovial hypertrophy/effusions and intra-articular Doppler signaling on MSUS, and as increased optical intensities on FOI-v. Scores of DACT≥1 were considered indicative of disease activity. Results 1326 joints of 39 eRA patients [72% females, 56% previous/current smokers, 54% RF(+) and 69% ACPA(+)] were studied. The incidence and mean number ±SD of joints inflamed by clinical, MSUS and FOI-v were 23% (7.8±8.1), 29% (9.7±7.7) and 30% (10.3±7.2), respectively. Using MSUS as a reference, FOI-DACT was 95% (35/37) accurate in identifying patients with active disease, 24% (9/37) of whom had erosive RA. High correlations and agreements emerged between MSUS and FOI-v (r=0.803, p Conclusions In early RA, Fluorescence Optical Imaging (FOI) coupled with digital Disease ACTivity (DACT) scoring correlates well with MSUS, and has a high positive predictive value. FOI-DACT emerges as a useful automated quantitative scoring method for synovial inflammation, and may be used in monitoring the effects of therapy. References Kisten Y, Gyori N, af Klint E, et al. 2015 Detection of clinically manifest and silent synovitis in the hands and wrists by fluorescence optical imaging. RMD Open 2015;1: e000106. doi: 10.1136/rmdopen-2015-000106 (http://rmdopen.bmj.com/content/1/1/e000106.full.pdf+html) Glimm AM, Werner SG, et al. Analysis of distribution and severity of inflammation in patients with osteoarthitis compared to rheumatoid arthritis by ICG-enhanced fluorescence optical imaging and musculoskeletal ultrasound: a pilot study. Annals of the Rheumatic Diseases. Published online Aug. 26, 2015. (http://dx.doi.org/10.1136/annrheumdis-2015-207345). Disclosure of Interest None declared

Background The disease activity score in 28 joints (DAS28)1 and health assessment questionnaire (HAQ) 2 are guides the treatment of rheumatoid arthritis (RA). Smart System of Disease Management (SSDM) is a series of mobile phone applications for chronic diseases management, which includes interfaces of both doctors9 and patients9 applications. After entry data of lab test, treatment regiments, and executing DAS28 evaluation entry by patients, all data can be synchronized automatically to the authorized rheumatologist9 mobile tool. The rheumatologist can adjust treatment regiments base on patients9 profile. We have confirmed that the results of self-assessment in DAS28 by RA patients with SSDM were consistent with professionals9 assessment in our previous study3. Objectives To evaluate the susceptible joints and the recovery sequence of swollen joint counts (SJCs) and tender joint counts (TJCs) based on DAS28 which self-assessed by Chinese RA patients with SSDM, and to describe the association between DAS28 and HAQ. Methods Since August 31, 2014, thirty-one rheumatologists from twenty-five hospitals participated in the study. Adult patients fulfilling the 1987 ACR (formerly the American Rheumatism Association) criteria for RA were recruited. Patients were taught to self-assess DAS28 and HAQ with SSDM at the baseline, and were asked to repeat the assessment once a month during the treatment. Results As of January 14, 2016, 636 RA patients self-assessed for 2,306 times. At the baseline, 1,628 joints were swollen and 2,761 joints were tender. The top five swollen joints were right wrist, right middle proximal interphalangeal, left wrist, right knee and left knee joints, and the top five tender joints were right wrist, left wrist, right knee, left knee and right shoulder joints. Table1 shows the proportion of different joint involvement at the baseline and the last assessment. After treatment, the top five recovery joints were left little metacarpophalangeal, left ring metacarpophalangeal, right index proximal interphalangeal, right little metacarpophalangeal and right middle proximal interphalangeal in tender, and left little proximal interphalangeal, left little metacarpophalangeal, right little proximal interphalangeal, right little metacarpophalangeal and left index proximal interphalangeal in swelling. HAQ score showed that the top two difficult functions of RA patients were “reaching” and “hygiene” at the baseline. At the last assessment, the degree of recovery about “hygiene”, “dressing and grooming” function were quicker than “reaching” and “walking”, which was matched with DAS289s joints recovery characteristic (Detailed see Table 2). Conclusions In this study, most involved joints in tender and swelling are hand and wrist joints, which co-related to the physical activity function of “hygiene” and “dressing and grooming”. After treatment, hand joints recovered more quickly than other joints, which matched with HAQ assessment results. References J Rheumatol 1993; 20: 538–41. AR 67 (suppl 10). Disclosure of Interest None declared

Background Detection of abnormal Rheumatoid Arthritis (RA) related autoantibodies, Rheumatoid Factor (RF) and Anti-Citrullinated Peptide Antibody (ACPA), along with Musculoskeletal ultrasound (MSUS) play a critical role in the diagnosis of early RA (eRA). Fluorescence optical imaging (FOI) is an emerging modality designed for the hands and wrists that detects subclinical hand joint inflammation1 and may therefore prove valuable in the assessment of eRA. Objectives Here, we analyzed the FOI results of eRA patients and investigate whether patterns of hand joint inflammation may distinguish seropositive from seronegative RA. Methods In FOI, Inflammation is considered positive, when altered microcirculation (capillary leakage/perfusion) is seen as abnormally increased focal optical signal intensities by visual inspection of the entire image series in real-time (360 seconds all 34 joints: 3 wrists, 5 MCPs, 5 PIPs and 4 DIPs, bilaterally are evaluated using post-processing imaging techniques). Unsupervised ascending hierarchical clustering was used to identify clusters of patients with different patterns of joint involvement in FOI. The robustness of the clustering was verified using another clustering method (k-means), and agreement between the 2 methods was assessed using Cohen9s kappa. Baseline clinical and biological characteristics of patients were compared between the clusters using non-parametric tests. Results Out of 1326 joints of 39 eRA patients (26 females; 9 with erosive RA; 54% RF+; and 69% ACPA+), 400 (30%) were considered positively inflamed by FOI. The mean (±SD) number of active joints detected by FOI was 10.3 ± 7.2. Clustering of joint involvement according to the FOI distinguished 2 separate clusters of patients: Cluster1 (n=29) and Cluster2 (n=10). The proportion of seropositive patients was significantly higher in cluster 1 versus cluster 2 (26/29 versus 3/10, p Conclusions Two separate patterns of inflammatory joint involvement may be distinguished in early RA, using fluorescence optical imaging. The proportion of seropositive patients was significantly different between these patterns, suggesting that FOI identifies patterns of joint involvement that are different for seropositive and seronegative RA. References Kisten Y, Gyori N, af Klint E, et al. 2015 Detection of clinically manifest and silent synovitis in the hands and wrists by fluorescence optical imaging. RMD Open 2015;1: e000106. doi:10.1136/ rmdopen-2015-000106 (http://rmdopen.bmj.com/content/1/1/e000106.full.pdf+html) Disclosure of Interest None declared

Background Ultrasound (US) assessment of small joints is essential for the diagnosis of polyarticular inflammatory arthritis (IA) and guidance of the therapeutic decisions in patients with established rheumatoid arthritis (RA). The access to US varies among hospitals and rheumatology services. Even if a considerable proportion of patients with hand joint pain or established RA might have subclinical inflammation, it is not cost-effective to screen them all. Objectives The objective of our study was to build a statistical model to assess the influence of several outcome measures (such as number of tender joints (TJC) and swollen joints (SJC) out of 28, GVAS, CRP, ESR, presence of RF and anti CCP antibodies, disease duration and medication) on the presence of Power Doppler (PD) signal at the US examination of hand joints. Methods We proposed a regression model to assess the contribution of every outcome measure to the risk of having active joint inflammation as well as predict PD signal. We excluded patients with PD signal present in more than 10/22 joints to ensure homogeneity in the data. We conducted a real life study including 276 patients referred for the suspicion of active joint inflammation (new referrals for the suspicion of IA, RA patients and patients with other inflammatory rheumatic conditions). We assessed 22 hand joints in every patient, irrespective of their hand symptoms, using the Omeract scoring system for PD signal. All patients had clinical assessments and lab tests within 2 weeks from the US scan. The proposed regression model was based on a beta-binomial distribution (1 = disease present, 0 = disease absent) for the PD score variable and a mix of main interaction effects for the outcome measures stated above. Negative interaction effects showed that the respective outcome was associated with a lower number of joints with PD signal. Results The marginal effects of different variables on the number of joints with PD signal at the US examination in newly referred patients for the suspicion of IA, previous diagnosis of RA, and patients with other inflammatory conditions were examined. Our statistical model suggested that patients with RA diagnosis treated with Tocilizumab tend to have a lower PD score than patients treated with other biologics or DMARDs, despite similar clinical and laboratory findings. The presence of RF increased the PD score only in patients with clinical suspicion of IA. CRP and ESR had almost no effect on predicting PD. Out of all three clinical outcomes, TJC, SJC and GVAS, only the SJC correlated with an increased PD score and only in patients with RA. Conclusions This prediction model has potential to be useful in identifying what patients will benefit from having an US scan and improve our referral criteria to the US clinics, aiming also to minimise the risk of underdiagnosing active IA. Disclosure of Interest None declared

Background Radiography is considered the gold standard for the detection of bone erosions in Rheumatoid arthritis (RA). Early detection of small erosions may potentially promote timely initiation of treatment and improve outcome. Small cortical breaks cannot be seen on radiographs, but can be detected with High-Resolution peripheral Quantitative Computed Tomography (HR-pQCT). Small cortical breaks can be seen in healthy controls (HCs) and can be the first stages of erosions in RA. Objectives To compare the number of cortical breaks in hand joints of RA patients and HCs according to their size. Methods Nineteen subjects (mean age ± SD; 53.9±8.0) from 3 different groups were evaluated: 1) 6 late RA, (diagnosis ≥10 years ago); 2) 6 early RA, (diagnosis ≤2 years ago); and 3) 7 HCs. From these subjects the 2nd MCP and PIP joints were imaged and evaluated with HR-pQCT (isotropic voxel size of 82 μm). In the RA groups, both hands were evaluated (24 joints per RA group), in the HC group only the dominant hand (total of 14 joints). A semi-automated algorithm was applied to the HR-pQCT images for the detection of cortical breaks. First, the outer margin of the bone structure was contoured. Second, the bone within 0.25 mm from this contour was defined as the cortical region. Last, different sizes for defining a cortical beak (>0.50mm, >0.66mm and >0.82mm) were applied and the number of breaks using each cut off was evaluated. Descriptive statistics were calculated and non-parametric tests for comparisons were performed. Results In the HC group, one joint was excluded due to movement artifacts; therefore, in total 61 joints could be evaluated (Late RA 24 joints, early RA 24 joints, HCs 13 joints). Table 1 shows the total number of breaks of each group stratified per cortical break size. Significant differences were found for break sizes >0.50mm and >0.82mm across the three different groups (p 0.50mm and >0.66mm (both p=0.07), and between early RA and late RA with breaks of >0.82mm (p=0.06). Most breaks were located close to the rim of the joint (Fig. 1). Conclusions The number and size of cortical breaks increases over the course of the disease in RA, with a significantly higher number of breaks in late RA compared to HCs. Therefore, the use of HR-pQCT in combination with our semi-automatic algorithm is a promising tool for early detection and monitoring of the number of small cortical breaks. Disclosure of Interest None declared

Background Whereas hand osteoarthritis (OA) is a frequent disease, which may lead to considerable pain and physical limitations, limited research has been performed, compared to lower limbs OA. The primary complaint of patients is frequently related to the disgracious appearance of their hand joints. However, few studies have been conducted to identify the magnitude and the determinants of aesthetic discomfort in hand OA. Objectives The LIege Hand Osteoarthritis Cohort (LIHOC) is a prospective cohort of 203 patients diagnosed with hand OA which are prospectively followed to better understand the impact of hand OA on quality of life and health resources utilization. Methods At baseline, these patients were asked to rate their aesthetic discomfort related to hand OA on a 100 mm Visual Analog Scale and also use a seven-point Likert scale (0-7), commonly used in forensic medicine, to quantify the magnitude of their aesthetic damage. Results The median value of the aesthetic discomfort VAS was 35.0 (Q1: 6.0-Q3: 59.0). Correlation analyses were performed between these scorings and clinical hand parameters. The median damage was rated at 3.0 (1.0-4.0), corresponding to a “moderate” level. Aesthetic discomfort (VAS) and the magnitude of the aesthetic damage (Likert) were significantly (p Conclusions Aesthetic discomfort and aesthetic damage are significant complaints in patients presenting with hand OA. The major determinants of their impact are gender, duration of hand OA, number of erosive joints and the Australian Canadian Osteoarthritis Hand Index. Disclosure of Interest None declared

Background Joint ultrasound is a sensitive means to detect joint inflammation particularly in recent RA. Ultrasound findings in elderly onset RA patients have not been previously compared with sonographic signs in young onset RA patients. Objectives To compare sonographic scores of inflammation and erosion between patient with elderly onset and young onset patients with recent RA. Methods Cross sectional study of 88 consecutives patients with recent rheumatoid arthritis ( Results Seventy two women and 16 men were included. Their mean age were 52.1±14 years [16-76]. Twenty four patients were diagnosed with elderly onset RA. Comparison of ultrasound scores were showed in table 1. Only erosion score was significantly higher in elderly onset RA than young onset RA patients. Conclusions This study shows that ultrasound detect more erosion in elderly onset recent RA compared with young onset RA but similar inflammation scores. Disclosure of Interest None Declared

Background Cervical lesions are known to occur at high frequency as a complication of rheumatoid arthritis (RA). Treatment with Anti-TNFα agents are more clinically effective than the DMARDs that werein use previously, in particular, with their efficacy in suppressing joint destruction having been emphasized. However, most clinical studies on the efficacy of biological agents in suppressing joint destruction in the hands and feet. Therefore, we reported the efficacy of infliximab (IFX) for inhibiting the radiographic progression of RA cervical lesions at ACR2009, EULAR 2010,11 and 12. Objectives To investigatethe efficacy of IFX for inhibiting theradiographic progression of RA cervical lesions over three years. Methods We used IFX for treating 604 Japanese patients with active RA who fulfilled the ACR criteria in 1987. Treatment with IFX was initiated between November 2003 and January 2010; the final study cohort of 45 patients receivedcontinuous IFX treatment for at least 3 years. For evaluation of cervicallesions, theatlanto-dental interval (ADI), the space available for the spinal cord (SAC), and the Ranawat value weremeasured by plain lateral radiographs in the flexion position, at initiation, 1, 2 and 3year. For evaluation of hand jointlesions, simple X-radiography of both surfaces of the hands was carried out, and joint destruction was evaluated usingthe Sharp/Van der Heijde Score (SHS). Results The mean ADI changed from 3.5 ± 1.8 mm at initiation to 4.0 ± 2.0 mm after 3 years (p 0.5/y) in SHS. In the non-progressive group (n=12) and progressive group (n = 33), the respective changes in cervical lesion parameters in 3 years were as follows:ADI: 0 and 0.76 ± 0.87 mm (p Conclusions IFX treatment can be used to suppress the progression of RA cervical lesions, as well as hand and footjoints lesions. It is possible that response to IFX could be used to predict the progression of RA cervical lesions. 3 year after initiation, the cervical lesion did not progress at all for the patients that a hand joint destruction was prevented as well as the results of one and two year follow-up. Disclosure of Interest : None Declared

Background Previous research has revealed low adherence with published recommendations for osteoarthritis (OA) care. Little is known about the quality of OA care in Norway and whether OA joint location is of importance for self-reported OA care. Objectives To investigate patient reported quality indicator (QI) pass rates among members of the Norwegian Rheumatism Association and compare QI pass rates between the different joint locations. Methods About half of the 2190 members registered with OA as the only rheumatic disease, received a postal questionnaire, while those registered with an email address received a link to an electronic web-survey. The QI pass rates were obtained using the OsteoArthritis Quality Indicator questionnaire 1 , a 17-item questionnaire that includes QIs related to patient education and information, regular provider assessments, referrals and pharmacological treatment. The total QI pass rate for each person was calculated as the total number of QIs passed, divided by the total number of QIs for which they were eligible. Satisfaction with OA care was reported on a five-point Likert scale (very dissatisfied-very satisfied), and visits to physicians and physiotherapists in the past year were self-reported using six response categorical alternatives (never-more than 12 visits). Mean total QI pass rates were compared across the OA disease locations using Student t-test, and multiple regression analysis was used to assess the association between the total QI pass rate and covariates. Results The overall response rate was 57% (n=1247). The study sample consisted of 92% females with mean age (sd) 68 (10.3) years, and mean BMI (sd) 27 (4.5). 70% reported OA in their hand, 53% in their hip, and 68% in their knee joints, and 67% reported OA in more than one joint. The mean total QI pass rate was 47%; with 44% vs. 53% for non-pharmacological vs. pharmacological treatments, respectively. The total QI pass rates were similar for those with single site OA vs. multisite OA. Those reporting OA in hand joints only had significantly (p Image/graph Conclusions Persons with only hand OA reported lower quality of OA care compared to persons with lower limb OA, indicating that OA care is dependent on OA joint location. The results show that older persons report lower quality of care compared to younger persons. The low patient self-reported QI pass rates suggest a potential for improvement in OA care, especially for those with hand OA and for non-pharmacological care. References Osteras et al, 2013 Disclosure of Interest None Declared

Osteoarthritis is a musculoskeletal disease affecting especially the knee, hip and hand joints. It is a prevalent disease with a high “global burden of disease” as estimated by the World Health Organization in 2010. OA is an important cause of years lived with disability worldwide. In the Western World, this impact is even higher. OA is affecting all compartments of the joint, and especially the involvement of other tissues than than articular cartilage is of interest. To understand the role of bone and synovium MR images have played an important role, however a recent study showed that also in knees of patients with normal knee radiographs many MRI abnormalities can be observed. What the meaning of these signs is has to been investigated. Currently OA is considered not as one disease but as a group of diseases with different phenotypes. Further insight in the risk factors for OA could increase insight in these phenotypes. Especially associations with genetic and metabolic risk factors have been investigated recently and increased our understanding about underlying biological mechanisms of OA. The current treatment of OA is directed at symptom relief. For this purpose both non-pharmacological and pharmacological treatments are used. Physical therapy can be effective in pain reduction, although not all interventions are, as shown in a recent systematic review. A recent randomized controlled trial comparing physical therapy with surgery for a meniscal tear in patients with signs of knee OA, suggested that no difference was seen on pain and functional outcome, although 30% of patients who were assigned to physical therapy alone underwent surgery. The ultimate goal is to develop disease-modifying treatments and these are actively sought for, especially for OA in the knee or hip. Recently, randomized controlled trials have been finalized on the effect of avocado- soybean unsaponifiable, strontium ranelate, selective iNOS inhibitor, vitamin D, etc. The results of these trials will be discussed. Disclosure of Interest M. Kloppenburg Grant/research support from: Pfizer, TI-Pharma, Servier, Speakers bureau: Bristol-Myers Squibb