Radiographic hand osteoarthritis: patterns and associations with hand pain and function in a community-dwelling sample

Abstract Objective To describe associations between hand abnormalities on MRI or radiographs (X-ray) and pain and function in a cross-sectional study of community-based older adults. Methods Distal and proximal interphalangeal index finger joints (n=221) were examined using MRI, X-ray, and hand examination. Hand pain, function, and stiffness were assessed using Australian/Canadian hand osteoarthritis index (AUSCAN) questionnaire. Grip strength was assessed using dynamometer. Models were adjusted for age, sex, and other MRI or X-ray abnormalities. Results Absence of collateral ligament (CLs) on MRI (relative risk; RR=3.15 (95% confidence interval 1.33, 7.50), and joint space narrowing (JSN) on X-ray (RR=2.96 (1.33, 6.58)) was associated with having a painful joint after adjustment for confounders. JSN was also associated with tender joints (RR=2.19 (1.01, 4.76)). Effusion-synovitis was associated with better AUSCAN pain scores (OR=0.51 (0.28, 0.94)) and JSN with worse AUSCAN pain scores (odds ratio; OR=1.67 (1.13, 2.48)). Absent CLs were also associated with stiffer joints (OR=3.12 (1.26, 7.70)) and weaker grip strength (β=-1.69 (-2.95, -0.43)) independent of pain and other features; JSN was also associated with weaker grip strength (β=-0.87 (-1.62, -0.14)). No other MRI or X-ray abnormalities were associated with pain or function independent of age, sex or pain. Conclusion Most MRI abnormalities were not associated with pain and function cross-sectionally. Absent CLs and JSN were associated with painful joints and weak grip strength independent of pain and other imaging features. JSN was also associated with tender joints and absent CLs with stiff joints. Unexpectedly, effusions were associated with reduced odds of pain.

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SAT0478 Comorbidity in Hand Osteoarthritis: Its Impact on Hand Pain and Function

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2016-eular.3902 ◽

2016 ◽

Vol 75 (Suppl 2) ◽

pp. 843.2-843

Author(s):

W. Damman ◽

R. Liu ◽

F. Rosendaal ◽

M. Kloppenburg

Keyword(s):

Hand Osteoarthritis ◽

Hand Pain ◽

And Function

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037. Prognostic Factors for Long-Term Progression of Hand Pain and Function in Symptomatic Persons Aged over 50 Years, with, or at Risk of, Hand Osteoarthritis

Rheumatology ◽

10.1093/rheumatology/kev088.037 ◽

2015 ◽

Keyword(s):

At Risk ◽

Prognostic Factors ◽

Hand Osteoarthritis ◽

Hand Pain ◽

And Function

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Arthritis glove provision in rheumatoid arthritis and hand osteoarthritis: A survey of United Kingdom rheumatology occupational therapists

Hand Therapy ◽

10.1177/17589983211060620 ◽

2022 ◽

pp. 175899832110606

Author(s):

Alison Hammond ◽

Yeliz Prior

Keyword(s):

Rheumatoid Arthritis ◽

United Kingdom ◽

Hand Function ◽

Symptom Relief ◽

Occupational Therapists ◽

Hand Osteoarthritis ◽

North West ◽

Hand Pain ◽

And Function ◽

Hand Symptoms

Introduction Hand pain and function limitations are common in rheumatoid arthritis (RA) and hand osteoarthritis (HOA). Provision of arthritis (compression) gloves to relieve hand symptoms is increasing in occupational therapy. Research evaluating arthritis gloves dates to the 1990s, focussing on night-wear of full-length finger gloves in RA. This survey examined glove provision in contemporary clinical practice in the United Kingdom. Methods A survey of arthritis glove provision in RA was conducted with Royal College of Occupational Therapists Rheumatology Specialist Section members. A more detailed survey about glove provision in RA and HOA was conducted with rheumatology occupational therapists in North-West England. Results Response rates were good, with 60 (73%) therapists responding to the national and 24 (69%) to the regional surveys. Most therapists provided open-finger gloves (commonly IsotonerTM) to about a third of their RA and HOA patients, and to those with any arthritic condition causing significant hand pain and/or swelling. Day-wear was as common as night-wear, and patients were advised to wear these ‘as and when’ for hand symptom relief and support for hand function. They were advised not to wear gloves continually in the day, and regularly perform hand exercises and monitor for potential adverse effects, for example, skin discolouration. Therapists commonly provide replacement gloves as these are often used long-term. Conclusion Prescription of arthritis gloves has changed considerably in the last 30 years, with open-finger gloves provided to a wider range of people with arthritis, for a broader range of clinical reasons.

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Faculty Opinions recommendation of Impact of anemia on mortality, cognition, and function in community-dwelling elderly.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.14359.471858 ◽

2006 ◽

Author(s):

Joseph Mazza

Keyword(s):

Community Dwelling ◽

And Function

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Task shifting in the care for patients with hand osteoarthritis. Protocol for a randomized controlled non-inferiority trial

BMC Musculoskeletal Disorders ◽

10.1186/s12891-021-04019-9 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Ingvild Kjeken ◽

Kjetil Bergsmark ◽

Ida K. Haugen ◽

Toril Hennig ◽

Merete Hermann-Eriksen ◽

...

Keyword(s):

Health Care ◽

Disease Activity ◽

Primary Outcome ◽

Hand Osteoarthritis ◽

List Type ◽

Specialist Care ◽

Randomized Controlled ◽

Number Of Patients ◽

Specialist Health Care ◽

And Function

Abstract Background Current health policy states that patients with osteoarthritis (OA) should mainly be managed in primary health care. Still, research shows that patients with hand OA have poor access to recommended treatment in primary care, and in Norway, they are increasingly referred to rheumatologist consultations in specialist care. In this randomized controlled non-inferiority trial, we will test if a new model, where patients referred to consultation in specialist health care receive their first consultation by an occupational therapy (OT) specialist, is as safe and effective as the traditional model, where they receive their first consultation by a rheumatologist. More specifically, we will answer the following questions: What are the characteristics of patients with hand OA referred to specialist health care with regards to joint affection, disease activity, symptoms and function? Is OT-led hand OA care as effective and safe as rheumatologist-led care with respect to treatment response, disease activity, symptoms, function and patient satisfaction? Is OT-led hand OA care equal to, or more cost effective than rheumatologist-led care? Which factors, regardless of hand OA care, predict improvement 6 and 12 months after baseline? Methods Participants will be patients with hand OA diagnosed by a general practitioner and referred for consultation at one of two Norwegian departments of rheumatology. Those who agree will attend a clinical assessment and report their symptoms and function in validated outcome measures, before they are randomly selected to receive their first consultation by an OT specialist (n = 200) or by a rheumatologist (n = 200). OTs may refer patients to a rheumatologist consultation and vice versa. The primary outcome will be the number of patients classified as OMERACT/OARSI-responders after six months. Secondary outcomes are pain, function and satisfaction with care over the twelve-month trial period. The analysis of the primary outcome will be done by logistic regression. A two-sided 95% confidence interval for the difference in response probability will be formed, and non-inferiority of OT-led care will be claimed if the upper endpoint of this interval does not exceed 15%. Discussion The findings will improve access to evidence-based management of people with hand OA. Trial registration ClinicalTrials.gov, NCT03102788. Registered April 6th, 2017, https://clinicaltrials.gov/ct2/show/NCT03102788?term=Kjeken&draw=2&rank=1 Date and version identifier: December 17th, 2020. First version.

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