A 56-year-old woman presents with persistent pain and tenderness in both hands. A workup reveals she has erosive osteoarthritis. Which factors are most strongly associated with increased pain?

A 56-year-old woman presents to your office with persistent pain and tenderness in both hands on palpation. Her body mass index (BMI) is 37 kg/m², and her blood pressure is 135/85 mm Hg. A workup reveals that the patient has erosive osteoarthritis of the hand.

Which factors are most strongly associated with increased pain in erosive OA of the hand?

A. High BMI and depression

B. High blood pressure and poor mental health

C. Lower educational status and having familial OA

D. Diabetes and synovitis

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