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