This population-based cohort study (Xiangya Osteoarthritis Study, China) examined whether ultrasound-detected hand synovitis (grade ≥2) at baseline was associated with all-cause mortality in 3,552 middle-aged and older adults over a mean follow-up of 5.72 years.
393 deaths occurred. Hand synovitis was independently associated with a 26% higher all-cause mortality risk (aHR 1.26, 95% CI 1.01–1.58). Bilateral involvement carried greater risk (aHR 1.42, 95% CI 1.03–1.96) than unilateral (aHR 1.20, 95% CI 0.93–1.54); polyarticular synovitis (>1 joint) showed aHR 1.35 (1.02–1.80; P-trend <0.05). Distal interphalangeal joint synovitis showed the strongest signal (aHR 1.82, 95% CI 1.14–2.91).
- Single Chinese population limits generalizability. - Observational design cannot establish causality or clarify mechanism. - DIP joint finding is exploratory and hypothesis-generating only.
Bilateral or polyarticular hand synovitis on ultrasound may flag patients at elevated mortality risk, warranting closer systemic evaluation. Consider ultrasound synovitis extent as a potential risk-stratification tool in older patients with hand joint disease.
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