{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T17:37:02Z","timestamp":1782754622937,"version":"3.54.5"},"posted":{"date-parts":[[2026,3,17]]},"group-title":"Rheumatology","reference-count":50,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T00:00:00Z","timestamp":1773705600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2026,3,17]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>Patients with osteoarthritis (OA) affecting multiple joints have poorer health outcomes than those without, yet most research examines isolated joints, leaving a gap in multi-joint disease. This study aimed to describe radiographically defined hip (rHOA) and knee OA (rKOA) within UK Biobank (UKB), exploring interrelationships across joints, and associations with joint pain, obesity, race and deprivation.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Automated machine learning was applied to left and right hip and knee dual-energy X-ray absorptiometry scans. Radiographic OA (rOA) was defined as custom grades \u22652. Joint pain was assessed through self-reported questionnaires. Descriptive statistics summarised the population characteristics. Logistic regression models examined bilateral and cross-joint associations, as well as associations with joint pain. Adjustments were made for age, sex, race, height, weight and deprivation. Other models examined the associations between body size and OA.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Among 59,475 individuals (mean age 65 years; 52.8% female), rHOA prevalence was 4,098 (6.9%)) and 4,841 (8.1%) for the right and left joints, respectively. The corresponding estimates for rKOA were 3,750 (6.3%) and 4,220 (7.1%). Overall, increasing grades of rOA and number of joints affected were more strongly associated with joint pain. Regarding joint-interrelationships, bilateral associations were stronger at the knee, whereas cross-joint associations (hip-knee) were weaker. Associations with BMI and height differed between the hip and knee.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Radiographic hip and knee OA exhibit distinct patterns of interrelationship, associations with symptoms and risk factors, suggesting heterogeneity in disease process and the need for joint-specific treatment.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Key Messages<\/jats:title>\n                  <jats:sec>\n                    <jats:title>What is already known on this topic?<\/jats:title>\n                    <jats:list list-type=\"bullet\">\n                      <jats:list-item>\n                        <jats:p>Osteoarthritis (OA) commonly affects the hip and knee and is associated with pain and disability, with recognised risk factors such as age, obesity and deprivation.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>Increasing interest in multi-joint OA challenges the traditional concept of lower-limb OA as a monoarthritis, but most research examines joints in isolation.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>Genetic evidence suggests that hip and knee OA may differ in underlying mechanisms, yet population-scale comparisons are limited.<\/jats:p>\n                      <\/jats:list-item>\n                    <\/jats:list>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>What this study adds?<\/jats:title>\n                    <jats:list list-type=\"bullet\">\n                      <jats:list-item>\n                        <jats:p>Among 59,574 individuals, this study identifies that radiographic OA captures structurally and clinically relevant disease with increasing severity and greater number of joints affected, positively associated with chronic joint pain.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>Radiographic hip and knee OA demonstrated strong bilateral but weaker cross-joint associations, indicating preferential within-joint symmetry.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>Risk factors differed by anatomical site with BMI and weight strongly associated with knee OA and weakly associated with hip OA. Height showed the opposite associations.<\/jats:p>\n                      <\/jats:list-item>\n                    <\/jats:list>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>How this study might affect research, practice or policy?<\/jats:title>\n                    <jats:list list-type=\"bullet\">\n                      <jats:list-item>\n                        <jats:p>These findings support that hip and knee OA may partially represent different disease processes rather than a single condition.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>Clinical practice should consider cumulative joint involvement and joint-specific risk factors.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>Future research should consider the development of more targeted treatment to prevent multi-joint progression.<\/jats:p>\n                      <\/jats:list-item>\n                    <\/jats:list>\n                  <\/jats:sec>\n                <\/jats:sec>","DOI":"10.64898\/2026.03.15.26348416","type":"posted-content","created":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T01:00:13Z","timestamp":1773795613000},"source":"Crossref","is-referenced-by-count":1,"title":["A comprehensive descriptive analysis of hip and knee radiographic osteoarthritis in the UK Biobank in relation to joint pain, joint site interrelationships, obesity, race and deprivation: Findings from 59,475 individuals"],"prefix":"10.64898","author":[{"given":"A","family":"Hashmi","sequence":"first","affiliation":[{"name":"Musculoskeletal Research Unit, University of Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Scott","sequence":"additional","affiliation":[{"name":"Musculoskeletal Research Unit, University of Bristol, 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