Radiotherapy Compared to Corticosteroid Injection for Treatment of Hand Osteoarthritis

Inclusion Criteria:

* Patient at Mayo Clinic, Rochester, MN
* Age 50 years or older
* Mild, moderate, or severe hand OA (Kellgren and Lawrence classification grade 2, 3, or 4) on hand radiographs within the last 24 months
* Hand OA pain with a minimum VAS score relating to hand pain of ≥40 (on a 100-point scale) when using the affected hand
* Ability to complete study questionnaires

Exclusion Criteria:

* History of previous surgery to the affected hand(s)
* Autoimmune joint disease such as rheumatoid arthritis or psoriatic arthritis
* Active confounding hand condition such as stenosing tenosynovitis or Dupuytren's contracture
* Recent injury (within last 1 month) to the affected hand causing current pain
* History of crystalline arthritis (gout or pseudogout) flare in the affected hand(s)
* Active use of opioid pain medication(s) or oral steroids within the last 3 months
* Fibromyalgia or central sensitization syndrome
* Hand CSI or other hand injection within the past 3 months
* History of hand LDRT within the past 3 months
* Poorly controlled diabetes (HbA1c \> 10%)
* Active infection
* Current pregnancy